Clin Med
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The National Health Sevice (NHS) faces a serious shortage of medical staff. One solution is to introduce US-style physician assistants (PAs) who train for around two years following previous clinical work or a first degree, and perform duties similar to junior doctors. This paper reviews the history and role of PAs, the quality of their work and their likely impact in the UK. ⋯ A recent report suggests they have made a substantial contribution to primary care and have improved patient access. For PAs to be successful in the UK, they must be highly regarded practitioners. High quality educational courses must be established to ensure their credibility.
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The effect on health of urbanisation is two-edged. On the one hand, there are the benefits of ready access to healthcare, sanitation, and secure nutrition, whilst on the other there are the evils of overcrowding, pollution, social deprivation, crime, and stress-related illness. ⋯ Here we review some of the health-related aspects of urbanisation, and comment on strategies designed to improve urban health. Because there is such a clear divide between the long process of urbanisation in industrialised western nations and the relatively recent explosive expansion in resource-poor countries, they are discussed separately.