More Than a Role Dispute
Physician Associates and the Changing Grounds of Medical Authority
Bibliographic Data
| ID | 24030171 |
|---|---|
| Authors | Louise Ashley (0000-0001-5194-2012, Queen Mary University of London, corresponding author) |
| Year | 2026 |
| Volume | 48 |
| Issue | 7 |
| Pages | e70250-e70250 |
| Publication date | 2026-09-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Sociology of Health & Illness (JOURNAL) |
| Journal identifiers | ISSN: 0141-9889 • E-ISSN: 1467-9566 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/1467-9566.70250 |
| PMID | 42592684 |
| OpenAlex | W7202354974 |
| Language | EN |
| References cited | 37 |
This article examines how the legitimacy of physician associates (PAs) is constructed and contested in English medicine. Drawing on Critical Discursive Psychology, it analyses formal submissions to a government commissioned independent review of medical associate professions from the British Medical Association, General Medical Council and United Medical Associate Professionals to ask: What does conflict over PAs reveal about fractures in medical status and power? The findings show that these actors do not simply disagree about a new occupational role but mobilise shared concerns, especially around safety, standards and responsibility, through competing legitimacy logics. For the BMA, legitimacy is framed predominantly through boundary protection and the exclusivity of medical expertise; for the GMC, through regulatory governance and system assurance; and for UMAP, through workforce contribution and professional integration. Conceptually, this article extends jurisdictional accounts by showing that contemporary role disputes concern not only who controls clinical tasks but also which criteria and institutions are authorised to validate healthcare work. The PA controversy therefore reveals a pluralisation and institutional fragmentation of the grounds of medical authority, rather than its straightforward decline or reproduction.
Corporate governance · Government (linguistics) · Health care · Health professionals · Legitimacy · Workforce · Management and Organizational Studies · Nursing Roles and Practices · Occupational Therapy Practice and Research
The Rise of Professionalism
Risky Business
Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration
Managing Legitimacy
The Advanced Clinical Practitioner (ACP) in UK healthcare
Patriarchy and Professions
The struggle to professionalize
System of Professions
Culture in Action
Physician associates in primary health care in England
Professional Dynamics and the Changing Nature of Medical Work
Professional competition and modernizing the clinical workforce in the NHS
From Medicine to Health
The Continued Social Transformation of the Medical Profession
The Shifting Engines of Medicalization
A new professionalism? Challenges and opportunities
Short Note
| Highly cited | No |
|---|