Final Verified Impact Survey Assessment Data 

Written by UMAPs Ltd

March 21, 2024

UMAPS recently carried out a survey into the effects that media reports and abusive social media posts are having on the lives and work of physician associates. 

After verification there were 448 valid submissions comprising eight anaesthesia associates (AA’s) and 440 PA’s.  

Details were verified by comparing name and managed voluntary register (MVR) number to the physician associate (PA) MVR for PA’s and comparing name to the AA MVR for AA’s.  

The results of the survey are below: 

  • Has the current media climate had a negative effect on your mental health? – 414 participants answered yes (92%) 
  • Has the current media climate made you consider leaving your role as a MAP? – 363 participants answered yes (81%) 
  • Has the current media climate for MAPs affected your workplace? – 335 participants answered yes (75%) 
  • Has the current media climate for MAPs affected your home life? – 338 participants answered yes (75%) 
  • Have there been changes in the way colleagues have been treating you? – 254 participants answered yes (57%) 
  • Have there been any changes in the way patients have been treating you? – 133 participants answered yes (30%) 
  • Have there been any organisational changes to your work?- 151 participants answered yes (34%) 
  • Have these effects in work had any negative material effect on patients? – 96 participants answered yes (22%) 
  • Have there been any negative implications for your income? – 53 participants answered yes (12%) 

In addition to the answers, free text comments were provided by a large number of participants to elaborate on their experiences.  

Below are some of the real-life comments from PAs who took part in the survey. All are worrying; many are distressing, and some are heart-breaking. 

The abuse of MAPs has to stop. We at UMAPS are doing all we can to make this happen. 

  1. Delays in getting medications prescribed due to SHO refusing to prescribe for PAs, they did prescribe for ANPs. No harm to patient as I escalated to seniors. Feel myself and profession are under attack. I understand some of the concerns but I personally cannot change things nor am I responsibly for the wide issues, for example lack of training opportunities, unfair pay and high workload. I am much more careful in everything I do, second guessing myself.  
  1. I delayed my return to work following maternity leave due to the impact on my mental health. I was nursing a baby while this was unfolding. My workplace seemed to be supportive, however, my supervising doctor watched on and said nothing when an ST3 effectively called me a danger to patients and referred to Emily Chesterton. Another junior doctor literally laughed in my face when I said I was a PA. I feel very anxious at the prospect of continually being lambasted by junior doctors at work. I’m a resilient individual but I hadn’t anticipated feeling so bullied at work.  
  1. I have had my personal information and work place leaked by several people online on multiple occasions, with false accusations and defamation. Personal threats were also made to me by anonymous people.  
  1. I very recently had a consultant on the phone actually laugh and belittle my role. I wasn’t able to even discuss clinical details about the patient and had to end the call. I was supported by my team and my seniors but it did make me feel less than great about my role. The fact that this particular doctor felt he could treat me in that way I think is influenced by the media/social media.  
  1. I was admitted with severe depression. I am now under a mental health team receiving psychotherapy and support from a MH Nurse.  
  1. One day I received a message from a junior doctor called Dr M informing me that my graduation photo was put into group chats full of junior doctors. My graduation photo was me underneath the medical school, and despite the caption saying PA school graduate, I was accused of lying about my role to my Facebook friends. They felt I was posing as a doctor. Of course this is not true, and as I did graduate from a medical school I don’t feel I did anything wrong. I deleted my graduation photos anyway. I subsequently had anonymous messages which told me I should be ashamed of myself and my role. This all happened to me while I was at my sisters 21st birthday celebrations, and they were ruined. It took a while for me to realise I had been falsely accused and realise I haven’t done anything wrong. I have deleted my social media pages as a result. It is appalling that these group chats that are made with the sole purpose to cyber bully MAPs. How is this even allowed? This would never happen in any other profession, so why ours?   
  1. One of my GP colleagues is an active BMA member. For the past 3 months she has declined to debrief me every time I have asked her. On some occasions this has left me without any debrief for that day and I have had to raise this and call the GP partner at home to discuss my session. This directly impacts patient safety in many ways than one. The main one I feel stems from fear and hesitancy I now have to ask for help when I need it. The physician associate role does not work without a good relationship between the PA and their supervising doctor. Situations like this is where mistakes are made and serious conditions are missed.  
  1. I left my role as a PA in July 2023 for a mental health break. I have now pursued another masters degree and will not be returning to my role as a Physician Associate. I would go to bed crying, I was not eating and the indirect (and direct!) hate from colleagues (non-PAs) was everywhere. I have friends who are about to qualify, and I fear for their wellbeing.  
  1. This situation has ruined my work life. It’s such a shame because at its core I love being a PA, seeing patients and practising medicine. However the constant hate, fear mongering, bullying, targeting has absolutely sucked every last ounce of love away. I was recently targeted online by a group of junior doctors. 
  1. The constant worry over my role being ‘abolished’ or limited has made it difficult for my fiancé and I to make the big life decisions around getting married and having children because we are unsure of my income going forward. Further, the constant anxiety has caused my mental health to worsen and I have needed antidepressants (mirtazipine) to be able to function. The level of stress impairs my ability to function confidently in my clinical role. I’m always second guessing myself and this translates to a loss of patients confidence in my ability to help. I have been panicked over the issue of doxxing and have had to remove as much of my online and social media presence as possible.  
  1. I have personally been trolled off Twitter and LinkedIn by doctors and had my work actively targeted to try and harm my image. I have been threatened with police reports and had my image used for ridicule. The current environment is disgusting. I don’t tell people outside of work what I do anymore for fear. I have had loss of sleep and full on anxiety. If I wasn’t so far into my career I would have considered leaving.  
  1. Personal attacks make you feel vulnerable. The lack of national support calling out this kind of behaviour reinforces the idea that individuals can attack others and get away with it.   
    Junior doctors (mainly FY and IMT grade) are now being directly abusive towards PAs, refusing to work with them, refusing to discuss unwell patients we escalate to them, in some places telling PAs they can’t sit in the same office and need to go away – all because of their job title.  
  1. Very difficult to work hard daily to try and give the best patient care possible and then to come home at the end of the day and have your job berated over social media, the news, BMA etc. the attacks go above just the role and have a personal edge. Makes it difficult to want to get up in the morning and go into work. Doctors may not say it outright to your face but you catch wind of discussions about PAs (negative), you don’t know who actually respects you and who doesn’t which affects making relationships with new staff. BMA scaremongering doctors into not prescribing for us which impacts patient care. This is being used as a bargaining chip for highlighting that PAs are causing harm however the refusal to prescribe is in fact a choice by these doctors to potentially cause patient harm. Working in secondary care I’m not often the decision maker for starting or holding medications it has been decided or verified by the consultant prior to me asking for it to be prescribed so shouldn’t be a question of whether it’s right because a PA has asked for it.  
  1. Being a PA, I should not have to be wasting time convincing doctors that I can discuss a patient with them. In this instance, the patient was known to have peripheral vascular disease and needed a CT Angiogram lower limbs to investigate for limb ischaemia. The patient had to be seen by the vascular team because CT scan showed obstruction from the popliteal artery down. In the end, I managed to convince the registrar to report on the CT scan but I should not have to be in this position where precious time is wasted trying to convince doctors that I can discuss patients with them. I am doing my best for the patients and being talked down to like this is demoralising.  
    The current climate has also made me apprehensive when opening up a discussion with doctors and patients because I fear I will face backlash as soon as I introduce myself to them.  
  1. I have become more paranoid at work, distrusting of colleagues around me and whether they are genuine. I have had incidents that required reporting to lead consultant due to a colleague (junior doctor) lying to me, making comments about my job description and saying that they “suggest my job description gets changes”. I have been isolated from the junior ward team. Personally, I have never felt so disrespected as a professional due to the social media/work environment (I am an ED nurse by background so I’m a pretty resilient individual!). I am currently considering what options I have and depending on outcomes of parliament/RCP/GMC may consider leaving the profession.  
  1. There is a lot of anxiety at work in relation to seeing patients and how colleagues perceive us. There feels a lack of support for how PAs will be supported and valued if something went wrong with a patient – There is a constant fear of the story being posted to the media and it feels like some colleagues are deliberately looking to find flaws in our PAs or catch them out. There have been tears from many of the PAs in our department while on shift because of negative comments from colleagues or from feeling increasingly stressed. Some have reduced their hours due to stress. I have now been paying for therapy since the Summer to help cope with work related stress. I have been looking to leave the NHS for a few months now and have moved jobs to a ward based job to feel better supported.  
  1. Actively wanting to leave NHS and work on a different industry. Have applications outstanding. Will leave as soon as I can.  
  1. The current climate is leading me close to complete burnout. I have started to completely avoid the news and found myself loosing track of where we are up to with registration as I simply find it too overwhelming – even though this is something we have previously been so excited for. The stress has had a huge impact on my attitude to being a PA, my attitude towards the NHS and my personal relationships as I am putting myself under huge amounts of work pressure. I am afraid to change jobs in case jobs stop being advertised and I get trapped in a role I do not enjoy.  
  1. I am hoping to move into non-clinical roles such as teaching and recently considering leaving healthcare altogether.  
  1. I have to introduce myself as something I am not. “Hi I am not a doctor”. I have extensive experience. Patients love me. I am good at my job. I helped in COVID ITU’s as a stand in. I’ve done multiple medicine rotations. I have completed on call rotas yet… I have to say what I am not…… I did not train for all these years to show what I am not. Its degrading.  
  1. Began studying medicine in the fear that the physician associate role will no longer exist in a few years.  
  1. Why aren’t the GMC actively dealing with those Dr’s who are abusing on with their details on their accounts. Happy with the support I’ve received from fellow colleagues.  
  1. Feels like trying to support a crumbling NHS when one of the senior and integral professions doesn’t want or accept you. Makes me feel like, what’s the point?  
  1. There were a few stances when I faced resistance from doctors of other specialties when discussing patients with them because I’m a PA. One example is when I phoned the radiology hub. The radiology registrar clearly said they did not want to discuss because I am a PA and they do not discuss with PAs. I had to explain that I saw the patient myself, took the history, examined the patient and discussed everything with the consultant and the consultant booked the CT scan. There was still resistance after explaining myself. 
  1. Huge impact on mental well being. Unable to sleep with worry and fear of being a social media target. Clinics practice wise I am documenting multiple times to cover myself and working many hours unpaid due to this. I have a constant sense of anxiety and paranoia in my practice.   
    I have deleted social media due to the stress of comments and personal attacks on PAs.  
  1. I am very fortunate to work in a supportive environment for PAs at my GP practice. However, I have had to actively avoid social media as seeing the negativity directed at us was affecting mental health. Even at my practice, I have occasionally had negative comments about PAs, and just recently a neurology consultant rejected my Advice and Guidance request simply because I was a PA (to be clear, I wasn’t referring the patient, I was simply presenting the facts to him and asking for advice, and he refused to give it, requesting that a GP examine the patient and do the request, which I feel affected patient care). I feel intense anxiety about making even the smallest mistakes at work, for fear that it will be perceived as ‘because she’s a PA’ and that it will reflect badly on our whole profession, rather than my humanity being taken into account (e.g. if a doctor and I were both to make the same mistake, my profession and training would 100% be called into question, when for a doctor it likely would not and may be put down to human error).  
  1. I ended up deleting twitter last year because of the horrendous abuse that my PA friends were receiving from doctors on there. I’m a new PA and I was quite scared to start work when I knew how some doctors were speaking about us online. I’ve also seen texts being sent to doctors from the BMA about ending the PA profession which is concerning  
  1. Between the negative media coverage of MAPs and general problems with Primary Care staffing at the moment, my pre-existing anxiety took a nosedive and between September and December I had a lot of sickness due to feeling too psychosomatically unwell to come into work – so my patients repeatedly had their appointments rearranged. At Christmas I took a week off for essentially a nervous breakdown and I’m doing better now but that is partially due to completely avoiding any mention of PAs in social media. When the PA story hit the TV news a colleague asked if I’d seen it and I burst into tears. At the time I was considering other roles. I have started a part time advanced practice module to flesh out my skill set – which is useful in the PA role but could also lead to a switch to advanced practitioner, maybe. I am well-respected at work and I receive a huge amount of positive feedback from patients which I’m so grateful for. On explaining my role I’ve never been met by any resistance that hasn’t melted away by the end of the consultation. The doctors I know have never been anything but supportive. I hate the idea that any minor slip-up could be weaved into this anti-PA narrative and become a bigger problem. I haven’t had any SPECIFIC support from work re: the anti-PA sentiment, but then I don’t think our patients have brought it up.  
  1. It is incredibly disheartening to see doctors online making opinions/rumours come across as facts. I would be interested to know how many in the BMA have directly worked with PAs and seen them do the things they are saying we all do.  
  1. Feel that the BMA have been actively objecting our profession from the beginning, slowing our progress through Parliament and fuelling division – and now vitriol – between professions.  
  1. I have been a PA for 5+ years. Due to negative comments on twitter/X I have chosen to leave the platform after using it for many years. A post of mine from 6 years ago was used to demonstrate “misinformation” about PAs and taken completely out of context from the original post. This left me very upset about my position as a PA and feeling vulnerable to a negative community of medical professionals I believed to be trying to seek out ways to disrespect and tarnish the PA profession. I noted ACPs were having similar experiences. I feel supported in my own work place and fortunate for that. My fear is many other training and newly qualified PAs, will be experiencing significant difficulty in keeping their focus with such a toxic climate within the medical workforce.  
  1. When I applied for my current role, there was a lot of enthusiasm for the role and developmental potential due to my vast clinical experience in this specialty. However; since the recent witch-hunt against MAP’s I am under more supervision – a fact that my consultant has acknowledged and has explained is only in place because of the recent media attention and to protect me as a clinician.  
  1. So much anxiety related to current climate. Some small panic attacks, questioning my clinical decision making in ways I haven’t in over 10 years as a PA, not wanting to go to work, being careful of what I say around non MAP colleagues, walking on eggshells, feeling like not enough is being done to counter the negative media and false statements in the press. It’s just awful.  
  1. Junior doctors being more hostile towards you and rude. Being less helpful. Not wanting to sign stuff off. On a WhatsApp group where ANP’s are promoting the signing of petition to stop us from being regulated knowing that I’m also on the group too.  
  1. One of the negative news articles was from one of junior who was working within my department. I do a quite a lot of extended skills I.e. tunnelled line removals and performing arteriovenous fistula formations. I hesitated when I was asked to perform these things while he was working there just in case there was any complications and he would use this negatively against me/ PA’s. I continued to do them as I did not want to negatively impact patients from my hesitancy.  
  1. The current climate for MAPs has driven me and my workplace to make positive changes to the way I and colleagues work – with more support, a better structure to our day and with a more united front for patients about who we are and what we can do. However, it has been hugely troubling for me as a person to see the aggressive and militant attitudes of predominantly doctors, some of whom are former colleagues or former students I have supported against MAPs. The constant twisting of narratives, elitist comments and on occasion verging on criminal behaviour (examples can be provided) on social media has been disturbing. Being accused, without an ounce of truth, of being the biggest danger to patient safety this year has been entirely demoralising and dehumanising. Daily I am fearful of an attack on my profession, on my character despite being a competent, supervised and conscientious PA and educator.  
  1. I have come across various social media posts bashing MAPs and realised how toxic it can be out there. I have read hate posts specifically targeted at the team of PAs at our trust, including myself. This has affected my mental health significantly. I wasn’t able to sleep properly for days and felt paranoid at work thinking my colleagues hate me and it took a lot to be able to look forward to going back to work. I considered leaving the NHS and looking for other career paths to avoid the harassment.  
  1. I totally understand the frustration of junior Doctoes over their pay issue and I fully support that for them. They deserve pay restoration. However, I don’t agree with bullying another profession amidst this.  
  1. I have found the overall professional environment terrible. There is palpable resistance to any further development or advancement. Due to the sensitive nature of the political environment, significant restrictions have been placed on practice, and no further engagement is made on any development or improvement. I am fortunate that I have a previous career (paramedic), and I am in the process of changing my employment contract back to a Paramedic Practitioner, rather than a PA. Practically I will perform the same job, but with much less scrutiny, with much less limitation, and opportunity for improvement and progression. This is an exceptionally disappointing and sad path but is the better option for me.  
  1. No longer allowed to do telephone triage or video consultations – the reason I’m given is because of the pressures being put on the GP Partners by the BMA. No longer able to request ultrasounds because I’m a PA even though this isn’t ionising radiation. I cannot follow up any test results or blood tests. Patients are requesting not to see PAs now owing to what they’ve read in the media.  
  1. Had incidents of referrals being refused for patients or investigations unless Dr to Dr referral. Delays in investigations or treatment due to some doctors not requesting of prescribing. Low moral between other maps in the work place. Low mood with hight anxiety and stress in regards to work due to the fear that has been created by the media and some medical professionals.  
  1. I don’t know how much longer I can work in this negative and toxic environment. I work full time. I work weekends and latest. I have missed multiple Christmas and other family commitments.  I have zero recognition of the commitments I have made and am told I add nothing to the clinical team. I cause harm and am dangerous. I know in practice this isn’t true. But it’s hard to have to read this daily. I feel like I have been bullied out of my job. It’s hard to accept all of these years of work have been for nothing. But I know my wellbeing will be better in the long run if I leave.  I think of the patients who are getting a poor service at present. How would they feel knowing they are being cared for by staff who behave like this. I don’t understand how this behaviour helps anyone. This can’t continue forever. I hope some sort of resolution can be found.  
  1. I have been qualified for 6 years. I am fortunate that my team knows me well and understand the PA role. However, everyone is aware of the current climate towards PA and have all seen the media outcry. I have really struggled with the poor handling of the situation by the FPA leadership. I do not think that there is much future for the current role in the UK moving forward. The unrelenting social media campaigns by certain individuals and anonymous accounts has led to patient safety groups, HealthWatch initiatives lobbying their ICBs and local GPs to not recruit PAs. And yes, this has led to posts being pulled whilst in the recruitment phase. I am proud of my time as a PA, but now have set my sights on leaving the PA role. I (as were all NHS staff) were put into exceedingly difficult and demanding situations during the pandemic (low staffing, risk to self, multiple extremely unwell patients, limited access to intensive wards, minimal PPE, diminishing oxygen supplies etc). To have gone from being needed and utilised appropriately in a time of national crisis, to now being told that I am worthless and a danger, is not something that I am willing to hang around for, especially when I work clearly within my scope of practice. The change in attitudes is an interesting dichotomy, however as said before, I feel it is time for myself to plan my exit. Further, I have not seen any other healthcare professionals being publicly shamed on social media on a regular basis (yes, we have all seen personal and private information being shared online about PAs). I know of multiple cases where anonymous accounts have harassed colleagues online, created “witch hunts” and attempted to ruin their reputation. I am also aware of cases where this has happened based on completely incorrect information, with no attempt to rectify the damage that has been done. I saw first hand a very close friend of myself who was publicly exposed for fictitious complaints (by the anonymous doctors) and saw how their mental health deteriorated dramatically and they required months off work. It was also shocking to see senior NHS doctors sharing this fictitious complaints online. In addition, the continuous calls for mass redundancies/sacking of PAs is extremely disheartening and concerning. I have seen this on a daily basis on social media. I truly do sympathise with the new PAs and student PAs who are coming through. I feel very fortunate the role was well received when I did my training. I would be seriously concerned if I were newly qualified or training to become a PA, especially when the FPA leadership is appears to be absent. And on a final point, the continuous delays to regulation is appalling.  
  1. When I started training I was told regulation would be completed by 2018. Then we were told that Brexit would delay it to 2022. Then we were told that it was delayed to 2024 because of COVID. With all of this to have happened, to then see on social media and the media in general, that we are working unregulated and unsafely, is extremely disheartening. We have been screaming out for regulation for a very long time and the government has continuously moved the goal posts, to our detriment.  
  1. I have had colleagues state that they don’t agree with the role. I’ve had people who try to undermine what I say as I’m not a doctor. I was asked by my department to cover an SHO shift (just our department between hrs of 8am-5pm) as someone had called in sick. Your main role is to scribe for the reg and order/chase scans. An FY1 found out and sent a text message to all first year doctors in the trust saying that PAs shouldn’t be doing this and that their medical indemnity would be invalid if they took medical advice from a PA. Said that he would be raising it with the BMA. It puts you in a difficult position as my department and I feel I can help the department in this way but people are taking about you (not too you) and spreading false information. Makes you scared to do your job as you feel you will be attacked for doing it but also if you don’t help out.  
  1. I have a mortgage and so scared of not having a job in future. I have worked as a PA for 7 years and never had any complaint about my knowledge or skills and neither have I been made to feel my whole profession is dangerous to patient health. I am looking to work in retail or do a non health role as I can’t imagine going back to an health profession if the toxic and malicious campaign against PAs succeeds.  
  1. I have been targeted, harassed on Reddit and X for being supportive of our profession. The hatred is mostly from anonymous pages.  
  1. The negativity is slowly creeping into our workplace. I am being informed of multiple incidences with different members of the MDT. Prior to Christmas this was rare but now we are having to plan as if this is the norm, i.e. having to justify our role, manage conflict resolution with staff and patients. Until now, I haven’t directly been treated differently by staff or patients and I have been able to continue my day-to-day role with little change. However, the awareness of what is being said behind closed doors and reading about the strategies for how to dismantle and discredit the role online do cause me to feel uncomfortable, disrespected and belittled which prevents me from feeling like I am part of the team.  
  1. Increased levels of anxiety, particularly around perception of PAs from patients but also negativity from the wider workforce. I have been scared to go to work on occasion. It has made me consider whether continuing as a PA is worth the impact on my mental wellbeing. It seems there are periods where hostility is worse towards PAs depending on press/BMA publications. Working in the NHS workforce for over 4 years, I have never had any negative feedback about the PA role except for the last 8 months. It is extremely demoralising; however, I have received good support from both my clinical and educational supervisors.  
  1. I have lost close friends because of the toxicity and abuse shared on social media. I have stepped down from doing clinical skills such as lumbar punctures, ultrasound and ascitic taps/drains because I’m scared of getting abuse from juniors. I have stopped taking part in lumbar puncture teaching for the IMT doctors because I don’t want to be judged or end up on a thread of abuse on social media. I am struggling to sleep due to anxiety of any new doctors rotating on to the ward. I’m desperate to leave the profession as it’s taking a severe, dangerous toll on my mental health.  
  1. Around the time that the vitriol online really ramped up mid 2023, I had a burn out episode at work which I feel was caused by spiralling mental health problems as a result of the online climate surrounding PA’s. Prior to this I was confident in my role and happy with my scope of practice that was well supervised, however I suddenly became very anxious seeing patients, worried that they would think I was incompetent or that I would make errors. This made me dread going to work and eventually resulted in me crying non stop one morning after seeing an angry patient that I usually would’ve been able to manage with no problems. I’ve now changed jobs to work as a PA in a less high pressured environment as a direct result of this and do worry about the future of the role.  
  1. I have had multiple days of work with severe anxiety resulting in insomnia about going to work. The stress is so constant that I have lost so much confidence in my abilities and have shied away from most work that isn’t purely administrative (e.g. scribing and paperwork, I used to do the majority of patient discussions). I haven’t had any direct contact in person with negativity but there’s lots of backhands in group chats or when they think we’re not around. Work are great, my managers are very sympathetic but there is very little they can do. It’s just so tricky my own department is so appreciative of me and the work I do but I am filled with so much worry that any little mistakes will result in myself being put on blast on Twitter. When I qualified just over 3 years ago, I was the happiest I had been and my job was a dream, all I had ever wanted to do. It’s the biggest shame that anonymous trolls on Twitter have stolen that from me.  
  1. Although I have not faced any overt discrimination, the regional WhatsApp groups formed for strike purposes are often places where hateful propaganda is shared and surveys distributed. It is ironic really because I, a PA am part of these groups to show solidarity and support for the very people who wish to see my role obliterated. The sheer number of hate pages and posts aimed at the PA role is so demoralising at times I dread opening social media (especially twitter) through fears of seeing it. I have always loved my job and go above and beyond for my patients so that I can provide the best medical care possible. But now I dread going to work, I dread seeing patients through fear that people are waiting for my downfall. It is not nice and has drained the every last ounce of passion that I had for my job!  
  1. I work across 2 departments – A&E and SDEC. I find relationships have been far more hostile in an A&E setting depending on who the senior supervisor is. I find there is a clear separation in senior team members (I.e. registrars and consultants) – those who are supportive of PAs and those who aren’t. When I read the constant ‘PA bashing’ on social media, I feel like those online comments become very real and personal if I am in the work place with a senior who is not supportive of the PA profession. I think this is the thing that gives me anxiety about going to work, not knowing if I will be supported or made to feel small and inferior. When I am with supportive seniors, I love my job and find that the online PA abuse doesn’t seem very real and almost feel like I can just dismiss it.  
  1. I have referred myself for therapy for anxiety – a significant contributing factor to my anxious feelings are negative attitudes regarding PA’s from BMA and in the media. I feel less confident to develop myself at work due to worries that I would be perceived as overstepping. Freedom of Information requests have been sent to my department regarding the scope of my role and this caused significant anxiety that the response would be used negatively against me in some way.  
  1. With the current climate I am absolutely terrified to put a foot wrong. It is disheartening and worrying that this is allowed to go on with spreading also of inaccurate information. It’s particularly hurtful what is said by ‘dr done’ on X (formerly Twitter). It is also not always accurate. The views are not reflective of all PAs and their practice. Only ones they see as doing ‘wrong’. But they tar us all with the same brush and assume we are all the same.  
  1. I feel anxious to tell people I am a PA at work when introducing myself for the fear of backlash from patients and refusal to be seen. I had to delete X because the content seriously damaged my mental health.  
  1. The support  had from colleagues on initially entering primary care has started to dwindle in recent months (since initial PE missed case was highlighted by the media) I have had supervisors question supervision for myself and also make comments on scope of practice and even make comments about ARRs funding and funding for GPs which is entirely nothing to do with me or my role. I have had patients refuse to see myself and I find the reception staff informing me more frequently of patients questioning my capabilities of seeing them. The online mass attack of PA’s has made me stop reaching out to colleagues and posting on social media, I have deleted 2 separate accounts and made my personal profiles private to prevent myself becoming a public target. I do not tell people in public what my job role is to prevent backlash/hate in my personal life. I am becoming increasingly frustrated with the role and more paranoid in my practice, second guessing management plans and limiting the presenting complaints I am comfortable to see due to ongoing concerns of possible public backlash.  
  1. I am constantly worried about loss of income and job security which is causing severe anxiety especially with a young family and bills to pay. I have been looking at alternative job roles to reduce the impact on my mental health.  
  1. We have a large WhatsApp group for medicine in our hospital with doctors and PAs in where one of the doctors forwarded a link to Twitter and the responses they should post in the recent consultation regarding MAPs regulation. The doctor in question was removed from the group and no further explanation about conduct given. I am often on the receiving end of microaggressions at work such as ignoring me, not doing prescribing tasks from the ward round set by the consultant or specialties not taking a referral from a PA and asking to discuss this with a doctor who then tells them the same information as myself.  
  1. This is tiring and degrading and shows little respect for me as a person never mind the concept of MAPs or PA profession. If this gets any worse, I’m afraid the junior doctors with these attitudes will become the senior doctors responsible for supervising PAs and there won’t be correct support or buy in of the role and it won’t be successfully continued.  
  1. I have considered emigrating to Canada and retraining as a PA in Canada where the role is well established and understood. I am still considering this option. I had to take a week off sick for my mental health when I felt physically sick and terrified of being scapegoated or accused of negligence due to the vicious language used and derogatory comments made online.  
  1. I feel less confident in asking for prescribing / imaging requests due to fears that Drs may say no / react badly. This has definitely impacted timeliness of patient care. For the first time in my career have had patients / relatives refusing to be seen by me on the ward, calling me a ‘fake Dr’. This puts extra workload on my Jr Dr colleagues and makes me feel useless. The constant media carousel of hate towards PAs (largely from Drs) is exhausting. It’s frustrating because I feel as though we all have a common goal (PAs to be regulated in order to improve patient safety and protect the PA AND Dr role), but the BMA has gone about this in a character destroying, personal manner and the only outcome thus far has been a loss of patient trust and a worsening MDT relationship. Who is that good for?  
  1. I am extremely passionate about being a PA and actively advocate in person and on social medial about the role. I am always factual, never present myself beyond my scope of practice and post education contact – this has inevitably led to me being targeted by the Drs who are leading the anti-PA movement and I have received abuse, bullying and harassment. I will continue to proudly be a PA working in secondary care, however I am also actively training in aesthetics to open my options and provide me with an alternate source of income.  
  1. Patients have been refusing to be seen by me once I introduce myself as a PA patients that know me and have been seen by me before have no concerns but it’s difficult to allay the negative preconceptions. when referring patients into secondary care, consultants have been rejecting and only want referrals from GP’s which delays patient care. 
  1. I only qualified last year and was an RN before. I loved being a nurse, I don’t enjoy being a PA. I left nursing partly because of poor leadership and toxic culture, I think this is even worse as a PA. I’m in constant fear of being accused of misrepresenting myself.

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