The physician associate scandal over in Blighty is heating up again, as more than 80 fellows declare a lack of confidence in Royal College of Physician leadership.
As Australia’s government looks to expand the roles of allied health professionals, it might do well to heed the current debacle going down over in the UK.
For months, the Royal College of Physicians has drawn the ire of its members over what some doctors have seen as an all-too-welcoming attitude toward physician associates.
At an extraordinary general meeting in March, members called for the college to limit the pace and scale of the PA rollout to the maximum extent that it could.
This would have included challenging proposals made by the physician regulator to allow scope of practice to be set at local levels, rather than having a national standard.
On Sunday, 80 fellows co-signed a statement expressing concern that RCP leadership had delayed taking action on the motions as voted in the EGM.
Five senior members of college leadership have now released a statement confirming that they met with RCP president Dr Sarah Clarke at the weekend and asked her to resign.
“We appreciate Dr Clarke’s hard work … [but] we have become increasingly concerned that she has lost the confidence of the RCP membership and the continuing negative impact this is having on our college,” the five doctors wrote.
At the time of writing, Dr Clarke had not publicly responded to the calls and remained in the role.
The RCP said it had arranged “urgent meetings of Council and the Board of Trustees” to discuss both the expression of concern from members and the statement from the five senior officers.
Outside of the RCP, a group of anaesthetists has started a crowdfunding campaign to support a legal challenge to the General Medical Council, which would prevent it from referring to both doctors and physicians or anaesthesia associates with the umbrella term “medical professionals”.
This would effectively force the GMC’s hand on defining scope of practice for physician and anaesthesia associates.
Who decided that scope of practice for Physician Associates should be governed by market forces?
— Anaesthetists United (@AnaesUnited) June 7, 2024
Is the Regulator merely following orders? #telltheGMC pic.twitter.com/jvFxnMmiBC
The campaign has raised more than $118,000 (£61,000) since its launch on 4 June.
Physician associates have been banging around the National Health Service since the early 2000s, but last year the government announced a plan to increase their number threefold by 2038.
In the way of training, they complete a bioscience-related undergraduate degree before moving into a two-year Master of Physician Associate Studies program.
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While Australia hasn’t yet developed any similar profession, the most recent federal budget made mention of “psychology assistants” and the scope of practice review is generally anticipated to recommend extended roles for the allied health professions later this year.
Last week, eight nursing peaks issued a statement which outlined its vision for Australia’s primary healthcare system.
According to the statement, the idea that multidisciplinary teams need to be GP-led was a “false assumption circulated by the media”.
“In the past, there has been a tendency to treat medicine as separate and different from all other health professions, and thus to exclude them from requirements with which other [healthcare practitioners] have had to comply (see for example, the soon to be removed requirements for collaborative arrangements for nurses and midwives – a one-way ‘collaborative’ street),” the statement read.
“This has historically prioritised and privileged medicine, and disconnected medicine from the non-medical professions.”
This rhetoric is arguably stronger than that of the peak body for physician associates, the Faculty of Physician Associates at the Royal College of Physicians.
The FPA has repeatedly said that all clinical work undertaken by associates must be under the supervision of a named senior doctor and stressed that physician associates should not replace doctors.
