Picture owned by St. George's, University of London
The Department of Health document, The Competence and Curriculum Framework for the Physician Assistant, defines a physician associate (PA) as:
“…a new healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and /or general practice team under defined levels of supervision”.
The UK physician associate will be trained to exercise autonomy in medical decision-making from within the physician-PA relationship. This includes:
formulating a differential diagnosis based on history and physical examination;
developing and delivering appropriate treatment and management plans in collaboration with the supervising physician;
performing diagnostic and therapeutic procedures;
prescribing medications (subject to the necessary legislation);
Requesting and interpreting diagnostic studies.
Professionally, the PA training is designed to ensure that PAs are:
aware of the limits of their competence and are committed to acting within these limits;
highly skilled at working in a multi-professional team environment;
life-long learners who engage in active professional development.
The PA will always act within a predetermined level of supervision and within agreed national guidelines. They will have a scope of practice agreed upon with their supervising physician and limited by that physician’s own scope of practice. Although there may be circumstances when the supervising doctor is not physically present, they will always be readily available for consultation. With experience, it is expected that the PA’s scope of practice will increase. Thus, it is anticipated that over time the supervisory relationship will mature and although the doctor will remain in overall control of the clinical management of patients, close supervision will diminish.
Qualified PAs may develop specialist expertise through practice learning and continuing professional development (CPD) that reflects the speciality of their supervising physician.
Although they may develop specialty expertise, PAs are expected to maintain their broad clinical knowledge base through continuing professional development (CPD) and will be required to sit for a national recertification exam every six years.
(Adapted from: The Competence and Curriculum Framework for the Physician Assistant, DOH 2006, revised 2012)
For more background on the PA profession, and the scope of PA practice, please see the Royal College of Physicians' Faculty of Physician Associates website.