Physician associates seem to be everywhere at the moment, from government briefings to anonymous social media accounts and even parliament. Here’s the lowdown on the role, its history, and current controversies
The role originated at Duke University, North Carolina, as a response to a shortage of primary care physicians in the 1960s.1 The first graduating class included Navy Hospital Corpsmen, who had received considerable medical training during their military service. Since then the role has expanded to mitigate physician shortages throughout the US and internationally. A paper published in The BMJ this September found that physician associates, together with nurse practitioners, accounted for a quarter of all Medicare billable visits in the US.2
In the UK the role was first formally introduced to the NHS in 2003,3 and expanding the profession to a workforce of 10 000 physician associates by 2037 is a notable aspect of the government’s recent Long Term Workforce Plan for the NHS,4 published in June. Also this year, the North West Foundation School for doctors’ medical training rebranded itself the North West of England School of Foundation Training and Physician Associates.
Physician associates are a distinct professional group from doctors, working mostly under doctors’ supervision as part of multidisciplinary clinical teams in primary care and acute medical settings. NHS Employers says that they’re trained to work within a defined scope of practice.3 They’re not permitted to request ionising radiation or prescribe medicines, although there’s some ambition for prescribing rights to be extended to them in the future.
This vague definition of the role has caused concern about determining the scope of the profession. To what extent associates can (or should) …