Secret Physician
@SecretPhysician
Followers
1,832
Following
25
Media
49
Statuses
545
Explore trending content on Musk Viewer
billie
• 344540 Tweets
CHASING THE SUN
• 336659 Tweets
Alito
• 250036 Tweets
Scottie
• 160939 Tweets
Gabigol
• 130622 Tweets
Crockett
• 112355 Tweets
Valhalla
• 54565 Tweets
RPWP TRACKLIST
• 50218 Tweets
NCAA
• 44268 Tweets
Louisville
• 43960 Tweets
Juventus
• 43206 Tweets
#ساعه_استجابه
• 37559 Tweets
College Football 25
• 36296 Tweets
NAYEON NA ALBUM TRAILER
• 35704 Tweets
Barron
• 34873 Tweets
कन्हैया कुमार
• 28305 Tweets
ジュラシックワールド
• 28299 Tweets
Homofobia
• 25918 Tweets
أبو عبيدة
• 22692 Tweets
ابو عبيده
• 22543 Tweets
Amit Buskila
• 20443 Tweets
LOST IS COMING
• 20077 Tweets
Madden
• 19498 Tweets
Shani Louk
• 18739 Tweets
D-2 TO CHEESE
• 16737 Tweets
Tabilo
• 16737 Tweets
LMPD
• 13691 Tweets
$BASED
• 11449 Tweets
Pinned Tweet
@ollieburtonmed
@jim_crawfurd
@DrPastry
@john_brittenden
@DrEilidhMaria
They regard themselves as sagacious old owls, dismissing JD criticisms as out of control and overly emotional, too infantile to grasp the issue. In their eyes, there's no merit in enlightening those deemed perpetually uncomprehending. It's a clear display of paternalism.
8
19
103
Attempted to hide identities as much as pos. Sent this and found it too damning not to share.
PT presents around 3pm. A doctor doesn’t appear to be contacted for support or help, and instead a Facebook group of PAs (PAAUK) consulted instead. PT in HB sent to a&e not until 6pm.
159
457
1K
Oh dear me,
@NHSBartsHealth
.
Your PA in neurosurgery, identifies it has some of the sickest most vulnerable patients, purports to be working at the same level as the SHOs, is the first point of call for deteriorating patients, starts treatment and requests scans (illegally)
77
234
683
Quite the spectacle today - its amazing that Jamie Saunders (PA president, fantasy MBBS) was at the AOMRC meeting, whilst the BMA was not invited.
They’ve invited the fox to the hen house and given themselves a pat on the back for inclusivity.
20
161
653
Oh wow,
@RCHTWeCare
. Not only do you have a PA doing endoscopy, you have them doing independent unsupervised endoscopy in the community … and you printed them all over a van! At least you’re not shy about it, so I see no issues in posting it here.
55
200
504
A consultant this week informed me she had been asking for a junior for 6 months on her medical ward. The answer was that it’s not needed and minimum staffing is being met. They have been instead been consistently offered (encouraged) having a PA. Cannot understand the logic.
15
107
449
Absolutely charming that they invited a PA who purposefully mislead people he was a doctor, so that he could have more responsibility at cardiac arrests, who said he should be able to decide who has chemotherapy, and lied repeatedly to members, got invited to Lords.
10
187
421
Physician associates responses to the BMA and colleges POV has been a real eye opener for me. A year ago I thought little about this issue. But seeing how many PAs want to ignore the opinion of doctors is quite indicative of the issues, ironically.
3
110
376
@KatyWoo
I can’t speak for that. I truly do not understand this psyche. A friend had suggested that perhaps it is that they want to prove themselves to doctors so will only go to them once they’ve used all other resources. This is of course dangerous.
9
22
318
Circulating 'certificates of competence' among Physician Associates as a quick fix is like marking your own homework and expecting a distinction. True patient safety can't be rubber-stamped in haste. We need thorough, impartial assessment, not a shortcut to legitimacy.
47
77
298
No experience necessary!
But F3s to not come into GP please as you’re all not experienced enough.
16
60
278
Framing "work-life balance" and "being a generalist" as main reasons to choose PA over MBBS in interviews as a golds standard answer hints at deeper system issues.
They also know doctors can work in any speciality and what a GP is, right?
46
41
262
I am afraid I do not share the belief that individual PAs are blameless.
A dinner time analogy (I am hungry because some bloody twitter mouse keeps running round making us look at their dinner).
Remember though, this isn’t ratatouille, this is lives.
🍽️ 🧑🍳 facciamolo:
9
26
235
Meanwhile in the same hospital, doctors to shut up and do TTOs please. Love, consultant nurse.
33
47
226
What I cannot understand is if people are doing PA and don’t want to be a doctor, why on earth are they doing a course that teaches them to do the job of a doctor (albeit badly)?
17
30
224
I noticed on another ward they have a trainee ACP, and when the cons isn’t there 3x a week, the trainee ACP sees half of the consultants patients for a WR (JD sees the other half).
We would not let a third year med student do this, so why a trainee ACP? Peculiar.
12
43
209
This is why I am not comforted by PAs doing routine appointments for patients with known chronic conditions:
PT is middle aged male. For routine appt for CHF. Managed with ACEi, BB, diuretics. NYHA Class II and has been stable for some time. Reports to PA he has had SOB.
2
40
199
Pas running clinics when only 7 months into their job ☑️
IMTs barely getting their 20 clinics rostered a year ☑️
11
50
194
If it helps, this is from the same Facebook group as the chat I uploaded today.
There over 650 PAs in that group.
Circulating 'certificates of competence' among Physician Associates as a quick fix is like marking your own homework and expecting a distinction. True patient safety can't be rubber-stamped in haste. We need thorough, impartial assessment, not a shortcut to legitimacy.
47
77
298
8
114
192
@EmergMedDr
@gmcuk
The GMC simply will not care when they break rules. For doctors, yes. PAs, no.
0
22
190
Sometimes you just have to ask yourself ‘am I the bad guy’?
23
22
180
You do know the entire PA profession was pushed without an evidence base in the first place of course?
First they tried to stop regulation from happening
Now they’re trying to push “guidance” that has no evidence base or legal basis
All attempts at trying to abolish the role completely
Just a reminder:
This is not about patient safety
This is not in the interest of the NHS
36
7
29
6
41
180
Please report these mean doctors for saying we increase their work load. Horrible. They should shut up and do our TTOs and if they do not we should report them.
Appeasement from supervisors does not equal competence. Real expertise requires rigorous education and training, not a signature from your new best mate (consultant) that is happy to at he or she is now more free to do more private work.
1
15
110
11
38
172
Absolute gall.
You can’t sign up to be managed by the royal college of physicians and then complain when… you’re managed by the royal college of physicians.
You asked for this.
10
22
175
Hi
@jasaunders90
can you tell us why you were leading arrests in 2020 but weren’t qualified to do so until 2022?
10
19
159
Just before Christmas we had the first cohort of student PAs come into our hospital. We have very few employed PAs. The students seem to spend all their time shadowing doctors.
The nursing students shadow nurses. OT students shadow OTs. Physio students shadow physios.
8
20
156
@Microbedoc2
You’d hope spotting a patient that isn’t haemodynamically stable is actually quite a basic skill. Apparently not.
4
8
160
@jabberwock951
@DrEilidhMaria
There’s a true range of quality of suggestions and the order of which some of it is suggested really makes me think they’re just saying stuff and seeing what sticks, with no real reasoning behind much of it.
4
7
145
To suggest that a mere three years of nursing experience, preceding an ANP qualification, plus the subsequent MSc, equates to the breadth and depth of a doctor's medical training, is overlooking the woefulness of clinical education that modern nursing includes.
9
22
139
Quite astonishing for someone to read a document that says the word ‘substitute’ over 30 times and conclude it’s not at all about that whatsoever. Excellent.
Ahh.. I'm going to try and be as respectful as I can for those who are really interested.
It appears this might be the gotcha/take down moment a lot of people are waiting/queueing up for. Hopefully whatever joy you'd hoped to derive from it, you're getting it.
8
1
8
10
28
139
Claiming 'it will be difficult to make further accusations' after issuing self-signed competence certificates misses the mark. Accusations of insufficient knowledge can't be silenced by paperwork. Unless these certificates come with an MBBS degree, skepticism will persist.
1
16
127
@Nick_Dalmon
@RCHTWeCare
He allowed his face to be printed on a van. Endoscopy also will require prescribing which he is not allowed to do. He is also doing something far outside what he should be doing for his own benefit. He is a professional, and is not blame free.
1
16
125
I have not shared the clip because it seems genuine but I have also found on my YouTube travels today, a Pa saying she only needs discuss the patients *she* feels needs discussing and the other ones do not get discussed at all. Well. Heck.
9
25
119
Is this the same Dudley Trust that previously faced issues due to PAs prescribing, only to simplify their prescribing process (potentially illegally) with an SOP rather than tightening controls?
Following on from the most recent example of a stroke consultant bleep being held by a PA (someone who isn’t a doctor at all), is the gastroenterology on-call bleep again being held by a PA.
Who is legally responsible if any incorrect advice is given by a non-doctor to doctor?
23
89
329
13
42
117
Also, I mentioned reporting back to a supervisor intentionally. It is very easy for the PA to present this patient in a way that omits small details that would entirely change clinical suspicion (missed mild exophthalmos for instance) based on what they think the diagnosis is.
4
4
114
Appeasement from supervisors does not equal competence. Real expertise requires rigorous education and training, not a signature from your new best mate (consultant) that is happy to at he or she is now more free to do more private work.
1
15
110
@AmarHujan
Bradycardia. Stop!!! Think!!!! Don’t do an ECG!!! DANISH!
(I assume they’re thinking of Cushing reflex/raised ICP which is a VERY bizzarre first line of thought. Good old E comes before C of course).
6
5
109
@thatsnotmine125
@NHSBartsHealth
Please tell me how you arrange for a CT to be performed without requesting it.
Bonus tip: if you put a cannula in a patient you are not arranging for a Ct.
2
4
105
@john_brittenden
@DrEilidhMaria
I can’t dox myself sadly so cannot give more info, but a number of people from GMC/NHSE - obviously some key players. JDs were present, and ATDC. Some things that could be perceived as anti doctor and some people all to keen to accept JD training places won’t increase.
6
25
105
And no one to train the trainees in non complex endoscopy because
@drkiethsiau
has decided to make the gastro MDT version of frankensteins monster and silo all the simple cases to them.
Thoughts?
@NEndoscopy
and
@UKGastroDr
?
3
27
106
And if the head chef who decided to employ you paid you more, and then shrugged their shoulders and simply defended you by saying you are supervised by them, and you shrugged it off too, I might suggest that you are being wilfully ignorant for your own self interest.
2
1
102
You do not have Dr in your name.
You should never have been able to join the RCP ‘club’.
The fact you could shows the value that that ‘club’ has become.
You do not have an inherent right to ‘treat’ patients just because you say you do.
This is:
Scapegoating
Elitism
Protectionism
This has NOTHING to do with patient safety.
This is:
You do not have 'Dr' in front of your name so you can not care for patients. You can not join our club.
You can't sit with us.
Punching down. Nothing to be proud of.
#RCPEGM
161
4
28
3
16
102
Seems the deputy registrar also quite likes magician associates given he conveniently decided to make one of his main conflicts of interest ✨disappear ✨ (but not very well)
7
41
97
I’m very willing to accept this isn’t the fault of the PA. Mind you, I do not think it appropriate a PA teaches a fifth year medical student. If this PA started med school when he started PA school he would also be a fifth year.
4
14
98
I think there is benefit to a nurse shadowing a doctor for a day. But if PAs want to learn to be a PA in the very short amount of time they have, perhaps they should shadow them? It is no good our juniors teaching PAs about stuff they do not need even to know, day in day out.
3
6
92
@thatsnotmine125
@NHSBartsHealth
That’s not arranging a CT, since the doctor has to recheck everything themselves from scratch.
That’s just called getting in the way.
3
4
89
This PA had been a PA for a week.
GP Partners
If this is how you are treating your PAs you are putting patients at serious risk of harm
PAs, particularly those straight from uni, are often too naive to understand how dangerous this is
Stop exploiting your staff
103
232
944
3
21
83
A medical student would.
A physician associate will instead be called a victim and it’s the nasty med twitter trolls and she should be shielded and offer support.
@Cleverclog67596
Jesus Christ. A medical student doing this would be up in front of
@gmcuk
before the end of the week.
1
2
48
1
13
77
I think ED cons would do too. But ideally someone with some kind of actual verifiable standard of knowledge in chest pain would be great.
2
6
77
@Dr_Done_
For me it’s - consultant asks PA to stop medications, PA asks a JD.
What an entirely pointless endeavour.
4
3
78
It’s misleading to frame doctors as mere specialists and position PAs as generalists. A short thread.
The essence of medical training for doctors encompasses acquiring a broad and comprehensive medical knowledge base, enabling them to practice medicine safely and effectively.
I can’t even begin to figure out how he thinks that a 2 yr course makes him equivalent to a real doctor because he’s a generalist and doctors are specialists
@djnicholl
@Dr_Done_
64
61
261
4
20
77
What is it with people recording themselves with patient identifiable info or putting patients bodily fluids in bags as viewing. I have never seen a junior do this and if I had seen them do it I’d raise it for unprofessional behaviour.
Listen from 4:50min. Hubris off the scale
‘ People ask why I’m allowed to do these procedures , well….work is what you make of it. If I see something that I want to do I just ask , if they say no then I ask again . Eventually they will let me do it ‘
38
99
285
2
12
75
At every step PAs are liable to miss issues because they have much narrower knowledge.
In reality: this patient could very much have thyrotoxicosis/thyroid storm. But if you’re a cardiology PA that is a ‘generalist’ but only done cardiology for five years, easy to miss.
1
4
74
@glambystefania
@manLikeTeaa
Look. You don’t tell a doctor to do anything. They are not your prescribing monkey. But also you ultimately said here that YOU stop the prescriptions which you have admitted you categorically do not. I would advise you to stop lying.
1
5
72
2
3
70
The good thing about actually being a trade union is that the leaders are media trained.
The bad thing about setting up a limited company that you think people will believe to be a trade union is you sound like a stroppy teenager presenting fairy tales as facts.
3
8
66
And where is the f1 whilst they are in theatre and clinics?
2/4 We have the privilege of 3 exceptional PA’s in our unit who contribute in all aspects of patient care, including theatre. Their role is complimentary to that of our junior doctors and facilitates training rather than taking away opportunities.
1
10
70
1
15
66
I unfortunately do not have a Reddit may someone please post about this it is important doctors know the way in which they are (not) represented at the highest levels. This is more than the RCP.
Quite the spectacle today - its amazing that Jamie Saunders (PA president, fantasy MBBS) was at the AOMRC meeting, whilst the BMA was not invited.
They’ve invited the fox to the hen house and given themselves a pat on the back for inclusivity.
20
161
653
2
17
63
I am also doing the same. Do not care if you message me or the pizza but would like to amplify this appropriately.
I’m working with a journalist to dispute the claim that PAs aren’t replacing doctors.
Please DM me if you have any evidence of this (“tiered rotas”/ same rota/ holding same bleep or anything that would normally be done by a doctor/ JCF etc).
All 100% confidential.
6
116
276
0
32
62
The consultant body are having serious conversations regarding their ongoing involvement or potential involvement.
I hear it is a key topic in messes across the country for non-consultant doctors.
2
11
60
3. You don’t really understand the theory behind what you’re doing. Why does the garlic go in after the onion? What does soffritto do? You follow instructions, you don’t know the reasoning.
2
2
58
@glambystefania
@manLikeTeaa
List of things you cant do
TTO - can’t do.
PPI can’t do
Aspirin can’t do
Dextrose can’t do
Reduce frequency abx can’t do
Stop enox can’t do
Sando can’t do
Can do
Gp to restart meds - can do
BR????
Bloods -
Chasing results can do
That’s quite a limited repertoire
3
3
59
@SophieAnnBurges
PA is your childhood dream job? Given it didn’t exist, I doubt it. I’m assuming your dream job was either being a midwife or doctor which begs the question why are you not?
3
1
59
1. You started learning to cook a few months back
2. You can make a few simple dishes well. These are the kind of dishes someone who hasn’t gone to cookery school can cook but not quite as well - bolognese, carbonara, ratatouille.
1
1
55
Not sure what it is with Royal entities. In a modern echo of Marie Antoinette & Louis XVI's, the Royal College of Physicians faces a crisis of leadership. Disconnected from members & straying from core values of patient safety, their position grows untenable.
1
9
57
So sure, you might make a similar ratatouille to the senior chefs. But only an idiot would believe that that means you should work at the level of one. The senior chefs know what to do if you can’t use an ingredient or something goes wrong. They can also cook far more dishes.
1
2
56
This highlights the core issue. If the primary motivation for entering the field is the desire to become a doctor, but not becoming on because of the unfavorable conditions and becoming a PA instead, then you'll inevitably face continuous scope creep
@SecretPhysician
@physicianassoci
As a woman in my 40s and a nurse. I would love to go back to uni and do medicine because I am far too aware of what I don't know. But I couldn't take the time out to do it. The PA route seems so attractive from the outside especially financially.
3
1
2
3
12
56
6. But wait! There are other senior chefs there who have done years of chef school in comparison to your ‘cook like a chef’ lessons. They know why garlic goes in after. They know what soffritto does.
7. Should you not question why it has taken them so long and not you?
1
2
52
A description of the group this was written in. Ooop.
@Xeon4f145d96s1
Attempted to hide identities as much as pos. Sent this and found it too damning not to share.
PT presents around 3pm. A doctor doesn’t appear to be contacted for support or help, and instead a Facebook group of PAs (PAAUK) consulted instead. PT in HB sent to a&e not until 6pm.
159
457
1K
2
25
52
PT also reports been having palpitations and sweating more. Is fairly overweight. PA mostly likely to simply think this is worsening HF, this is their ‘bread and butter’ and reports it as thus to supervisor. May also think anxiety.
1
1
52
2
3
52
@hkg294
No regulation has been delayed by years BECAUSE you wanted the GMC which required a change in law. Nice try though.
1
7
52
4. So when it comes to more complicated dishes there’s not really clear instructions for, you tank it. So you need supervision.
5. You get offered a job as a chefs associate at a restaurant. You have very similar responsibilities to a senior chef but are not the head chef.
1
1
49
@AlisonGeorge10
It’s like they possess no analytical thinking. If anyone thinks it through for five seconds it doesn’t make sense.
1
2
48
@TomStocks1982
@gmcuk
I would advise going through the full instagram where you will see she says she makes plans by herself and has her own bleep and patients call her doctor etc.
2
9
46
Let’s just say for arguments sake the PA also gets an ECG. The patient has new AF. Bc history of palpitations the PA may call it a day and as PT is relatively stable arrange another OP appointment.
2
1
47
@SETMEDICSUAE
They’re experienced nurses and paramedics. Experienced nurses and paramedics does not make a doctor. That is why we have medical school.
1
4
45
Allowing them to attend induction
@AnalysisDrawer
@TheBMA
For juniors on the ward to allow them to attend induction or trainings. And this is the 'thank you card' they give to us
9
0
1
3
0
42
Statement from clowns on the broken clown shoes they have supplied. They hope to soon be recognised not as clowns, but as professional clowns.
Statement from UMAPs regarding tonight's outcome for the Draft Anaesthesia Associates and Physician Associates Order 2024
8
2
10
3
9
42
@jim_crawfurd
@DrPastry
@john_brittenden
@DrEilidhMaria
That it is out of their hands. It is accepted as fact. That is how it is and the only thing to make the NHS better in the face of that fact is PAs so we must get behind them.
13
9
42
IA can only be done against employer, is my understanding, not the GMC. We shall have to start thinking what influence we can have over royal colleges and GMC (since they cannot be trusted to do the right thing themselves).
3
5
40
@Xeon4f145d96s1
It’s ok though because she lets her son do themed sessions as a speaker on doctors health, despite not being a doctor; having nothing to do with doctors (other than his parents) and no qualifications in this area.
2
13
40
Some statements:
- there is not sufficient evidence that PAs have the sufficient education to play any role in the medical management or diagnosis of patients.
- PAs now very unhappy doctors think it is unsafe and want to continue as they have anyway.
Systemic insight issues.
1
14
38
@KatyWoo
And just the same mentioned here from this anaesthetist
@cannula_service
@9nzmwjkxmyP
@ExplosiveEnema2
@SecretPhysician
@rcgp
This is the worry.
Instead of asking for actual help from trained doctors, they're so busy about their own self image the patient is an afterthought.
Scary.
0
14
84
0
8
38
@tallymedic
Graduate medicine is five years of medicine condensed into four with the same exams.
1
0
36
@ABarotchi1
@jabberwock951
@DrEilidhMaria
Where was the supervising consultant is what I’d like to know
1
2
35