Questions and Answers

Responses to questions received from members and fellows of the college

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Physician Associates

What is your position on Physician Associates (PAs)?

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The college got it badly wrong on physician associates, and I also got it wrong.

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The idea of allied health professionals helping doctors is not a bad one. Many doctors who work with PAs tell me they are valued team members. However, with the change from the original name “physician assistant” to “physician associate”, rapid expansion of the programme, no defined scope of practice, no regulation, and no consideration of the impact on resident doctors’ training, the PA programme went amiss. The PAs have been let down as much as the doctors they work with.

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At the RCP’s extraordinary general meeting in March 2024, where PAs were discussed, I was not part of the senior leadership team, but I argued against limiting the pace and scale of PA roll-out (motion 5) because we were told it would have major legal and financial ramifications, and might bankrupt the college. This was wrong. The college has successfully disengaged from hosting the PA programme with none of these threats coming to pass.

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As to the future, like many members and fellows I await the results of the Leng review. Whilst it is important for the president to follow the wishes of the membership, my personal feeling is that with a clear national scope and ceiling of practice, regulation and proper supervision, and consideration of the impact on residents' training, PAs could continue as valuable team members, without risking patient safety.