Case Studies

Physician Associates in Primary Care


What is a Physician Associate?
A physician associate (PA) is a dependent health care professional who has been trained in the medical model and works with supervision of a doctor. They train intensively over a 2 year postgraduate period, having completed a 3 year undergraduate degree in a life science. PAs are qualified to obtain medical histories, conduct comprehensive physical exams, request and interpret tests, diagnose and treat illnesses and injuries, and counsel on preventive health care. They are involved in acute medicine as well as chronic disease management.

The PA concept started in the United States more than 45 years ago, and the model has since spread to Canada, Australia, the Netherlands and the United Kingdom.

How do PAs facilitate Primary Care services?
Physician Associates can currently be found working in GP surgeries as well as Accident and Emergency departments, and inpatient medical and surgical wards throughout England and Scotland.
In a GP surgery, PAs see patients of all ages for acute and chronic medical care. PAs can refer patients to consultants, the Medical Assessment Unit (MAU) or to A & E when clinically appropriate. Other duties include urgent same day consultations, home visits, prescription reauthorisation, review of incoming post and laboratory results. As well as this, as Pas are an additional health care team member, they are able to help the practice reach Quality Outcome Framework targets each year.

Sabrina Darweish - Senior Physician Associate at Wandsworth Medical Centre
"I started working at Wandsworth Medical Centre in 2012 straight after qualifying. My role at the practice involves seeing approximately 30 patients per day with urgent same day cases in the morning followed by routine consultations for the more chronic patients in the afternoon; each of these appointments are 10 minutes long and can include telephone consultations as well. During the afternoon I work through and action lab reports appropriately and also inform and advise patients of their test results over the telephone. Each day, I work closely with the 'on-call' GP who is available for advice and guidance if ever needed. I enjoy my role within primary care as there is continuity with patient care, enabling one to build a rapport with patients and in turn provide a better service. I also enjoy the fact that each day is varied with people of different ages, diagnoses and ailments walking through my door 30 times per day. The success and continued positive feedback from patients has meant that we have expanded our team of PAs to three PAs and I am now the Senior Physician Associate at Wandsworth Medical Centre, as well as the clinical lead for the Nurses and Healthcare Assistants at the practice. As a result of introducing a 'PA team', patient access has increased dramatically opening up at least 70 same day urgent appointment slots each day, therefore decreased waiting times for our patients".

Dr Aryan Jogiya, GP Partner, GP Trainer and Clinical Lead at Wandsworth Medical Centre
"I have had the pleasure of mentoring 4 physician associates to date over the past 2 years. Despite the fact that their training programme is much shorter than GPs, they are equipped with the knowledge and clinical skills to rapidly accustom themselves to the demanding role in primary care. They have quickly become integral members of the team, able to deal with cases of significant complexity and offer the added advantage of being able to provide nursing care in addition to standard and emergency GP appointments. We are privileged to be a training practice with physician associates, whom I anticipate will be increasingly utilised in this changing climate of healthcare provision."