Physician Associates
Physician Associates
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Despite being misrepresented as “medical professionals who practice medicine”, Physician Associates (PAs) have not received training in medicine. They are not doctors, but they have been allowed to work under the supervision of doctors in some general practices around the country.
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There is no training pathway to become a PA in New Zealand, so the small number of PAs currently working in New Zealand have been trained overseas.
Entry requirements to become a PA can include undergraduate degrees in any number of non-scientific majors (such as homeopathy, computer science, banking, geography) plus a two-year medicine-adjacent postgraduate qualification.
By comparison, it takes more than 10 years of medical training to become a general practitioner in New Zealand.
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For years, PAs have been lobbying to become regulated in New Zealand. This means they would be allowed to practice independently, without a supervising doctor.
Regulating will simply lock in these practitioners and the risks they pose into our health system. New Zealand does not need PAs as a workforce. Our national strategic priorities identify crucial health workforce shortages for doctors, nurses, and allied health professionals – not Physician Associates. We need more health professionals not more health professions.
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No, but not because PAs are bad people or because they make mistakes. They simply do not have the breadth and depth of medical training and the clinical competence to safely underpin the work they do. There have been several reports of patient deaths and serious harm emerging out of the UK, where they have been practising. Even in New Zealand, we have seen reports of patients being misdiagnosed, resulting in a brain bleed and vision loss.
Physician Associates in the Media
- Why did our daughter have to die? Family’s anguish after cancer death of mum misdiagnosed by medic with two years’ training (12 Nov 2023) – Daily Mail
- Emily thought she’d seen a GP – she hadn’t and later died (1 Oct 2024) – Daily Post
- ‘My wife died because the NHS used cheap labour’ (13 Nov 2024) – BBC
- ‘He could have gone blind’: Concerns unregulated physician associates may put patients at risk (18 Jan 2024) – RNZ
- Doctors quit amid patient safety risk disagreement (24 Nov 2024) – Otago Daily Times
- Physician associates ‘illegally’ prescribe opiates to hospital patients (22 Feb 2024) – Telegraph
- ‘Cut-price’ physician associates illegally ordered more than 1,000 NHS hospital tests including X-rays and CT scans despite not having any formal medical training (3 Feb 2024) – Daily Mail
NZRDA Articles:
Further Reading & Other Documents:
The World Medical Association has recently condemned the way PAs have been introduced in the UK without a defined scope of practice:
As it pointed out in this UK based literature review, the absence of evidence of safety incidents should not be misinterpreted as evidence that deployment of physician associates is safe. In medicine we conduct non-inferiority trails with significant power to show no different between to interventions before determining that one is not worse than the other. This has not been done anywhere in the world in terms of Physician Assistants or Associates replacing doctors. There are some studies about PAs working alongside doctors but generally with a high level of supervision and only seeing a subset of less complex patients which is not want is actually occurring in the UK or likely to continue to occur in New Zealand: