Who delivers care is just as important

Editor – I read with interest the study carried out by Zaman et al looking into the perspective of patients on the acute medical unit of physician associates (PAs);¹ a member of the medical team whose number and role has expanded through my time in medicine so far. I have had mostly positive experiences working with PAs and it is encouraging that patients found their experience of care under them equally largely satisfactory.

One crucial thing that this study fails to capture however is the patient’s perspective of what a PA is. Previous studies have highlighted that the patient population can be confused about what the difference between a PA and a doctor is, and that this can impact on their willingness to be treated by them.^2,3 It would be interesting to see what the patient population surveyed in Zaman et al’s study understood the qualifications and skills of the PAs to be and see how this related to their satisfaction.

PAs are a relatively new role in hospitals in the UK and the patient population has limited knowledge and experience with them. Education of our patient population is of the upmost importance, but it does not just relate to their diagnoses and treatment but also to our role in their care along with our abilities and limitations. While satisfaction with the service obtained is of course important it shouldn’t be attained at the expense of patients knowing who is delivering their care. While skilled and highly trained, PAs are not the same as medical doctors and in an open and honest health service we need to be careful that patients do not equate the two as always equivalent.