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If it was a game it would be like Sunday league teams squabbling over the decision of a linesman, but…
… it’s not a game.
It’s people’s lives, careers and futures. To be honest, it’s one of the ugliest rows I’ve seen in the NHS, for a long, long time.
Right now, I can’t imagine what it must be like to be a physician associate.
To have an honest desire to work helping people, study to be the best you are allowed to be and land a legitimate career in the NHS, only to see your ambitions thwarted. Your existence the source of controversy and argument.
PAs are having a really wretched time. Examples of PAs faults and failings identified, amplified and presented as a unique danger.
Think about this for a minute;
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In the six months between April and October 2024, 235 never events were reported in the NHS.
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A 2018 study estimated that approximately 237 million medication errors occurred in the NHS each year
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Harmful diagnostic errors may occur about 1 in every 14 general medical hospital patients.
Don’t tell me the NHS is a beacon of safety and PAs are somehow infiltrators. Behind the lines… sabotaging it.
Doctors make mistakes, as do all health professionals. All workers and all human beings, do. Systems fail and judgements called into question. The difference? Health workers cover up their mistakes for fear of prosecution and joblessness.
The system is designed and weighted against the truth and to incite cover-up.
But, there is more. There is something that needs to be said about the future of the NHS workforce. Something so blunt, no one will whisper it.
I regard myself as nothing more than an NHS fan. I survive, precariously in the hope that people just like you are kind enough to give me space in their day.
It is precious and I value it and have no intention to put it in jeopardy… but if it is to be based on honesty, there are truths that need to be told.
Let me tread softly.
Historically, manufacturing required highly skilled artisans, such as blacksmiths and weavers. The Industrial Revolution replaced many of these skilled workers with factory machines, operated by low-skilled labour.
Today, robots and AI-driven production lines have eroded the need for even semi-skilled workers. Shifting employment towards maintenance and oversight roles.
Accountants, once manually recorded financial transactions. Prepared statements by hand. Along came Excel… reducing the demand for basic bookkeeping skills.
Now, AI-driven accounting software, the likes of Xero and QuickBooks automates financial reporting, tax calculations and even audits. Reducing the need for mid-level accountants.
Have you bought a house recently? The legal tasks will, most likely have been done by a conveyancing-assistant, underpinned by software, the likes of Clio.
What about us? What about the NHS? Are we impervious?
Because we turn up our collars to the winds of change, it does not mean they will they blow themselves out.
Healthcare has traditionally been resistant to what is, frankly, ‘deskilling' due to its reliance on human judgment, patient interaction and complex problem-solving.
AI, machine learning, natural language systems and automation are changing that. Right now, in real time.
We already know the likes of IBM Watson, can diagnose conditions with an accuracy rivalling doctors.
Automated diagnostic tools are reducing the need for highly trained specialists.
Chatbots and virtual assistants are taking over initial consultations, reducing the demand for GPs in routine cases.
Robotic-assisted surgery such as Da Vinci, allows less-experienced surgeons to perform complex procedures with machine-learned guidance.
Automation in drug dispensing and robotics reduces demand for some nursing and pharmacy roles.
Physician Associates?
Their roles augmented by decision support technologies will be transformative to the role of the training doctor and their potential for exhaustion and innocent errors.
What happens to the human side of medicine? The bedside manner, ethical decision-making and emotional intelligence?
You be the judge.
High-end specialists will remain valuable but we know they’ll increasingly rely on decision support.
But…
… bluntly, mid-level roles such as radiologists, pathologists, pharmacists face significant deskilling and potential job loss. Is anyone safe?
Yes…
… low-skilled healthcare workers such as nursing assistants, carers will expand due to the need for a human touch.
The medical profession will likely see a shift from knowledge-based expertise to AI-augmented decision-making, where the ability to interpret and apply machine learned insights becomes the most valuable skill.
Some roles… eliminated. Others… will evolve into AI-human, hybrid-professions.
The skills we have today, the way we are organised, our hierarchies, the normal... will give way to a new normal... much quicker than we think. We are on the cusp of a medical revolution.
There will be new careers; people trained differently to do jobs that are not yet invented ...
... wake-up; PAs are the least of your worries.
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