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cocobeanncteez · 4 years

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HENDERY- All I Want is You (One-shot)

Genre: Smut, fluff.

Words: 5K

The luxury nightclub and bar was extremely packed today. People were watching the beautiful view from the 32nd floor of the hotel, drinking, smoking cigarettes and hookah, making out, grinding on each other, dancing the night away—the usual stuff you see at clubs like these. Saturday nights were your favorite because that's when you earned a lot of money.

Being a stripper in the biggest and most luxurious club in China had a lot of pros. You were the best and highest paid stripper at your club, and you loved your job cause you were able to make so much money easily. Your managers, Ten and Kun, were your best friends, so when you told them that you didn't want to do any private strip shows, they agreed. You were lucky that this club had strict rules and amazing security. Plus, they took such good care of all their strippers.

"Coco!" you heard Ten call out your stripper name. "You're up next so hurry up!" You nodded as you took three shots and quickly put on your black stilettos and eye-mask. You made your way to the stage, watching your colleague finish up. She gave you a high-five before you got on stage, hearing the crowd cheer for you over the loud music. You moved your body gracefully around the pole under the flashing red lights, losing yourself to the beats of the music. You first took off your lace top and then your denim shorts, leaving yourself only in your signature black dragon appliqué teddy and your stilettos-that was the maximum you were allowed to strip to. After a good twenty minutes of dancing, you got off the stage, catching your breath and panting.

"Y/N! You were amazing as always!" Kun said, pulling you into a brotherly hug. "Do you have some energy left?"

"A little," you answered, dabbing your sweat with a wet cloth. "Why? Do you want me to go up again?" you asked, secretly hoping he'd say no cause you wanted to go home and get some sleep.

"No, no," he said and you mentally sighed in relief. "I actually wanted you to do a... private show for someone," he said hesitantly, shifting his gaze away from you.

You raised an eyebrow. "You know I don't do private shows. Why don't you ask someone else?"

"Well, he specifically asked for you. Plus, he paid twenty thousand yuan for it so-"

"What?!" you cut him off, your eyes widening in shock. "Twenty thousand?!"

"Yeah, he's a really rich businessman and he's your age."

You gasp in disbelief. "He's only nineteen?!"

Kun nodded."Twenty, actually. Now, will you do it?"

You agreed to do it, not cause you were going to get paid a ton, but cause you were quite curious and interested to see who this young man was who was paying a fuck lot just to personally see you strip in a private room.

"Okay, but if he tries touching me or something-" you start while putting on your clothes, but Kun stops you mid-sentence. "Then you can kick him in the balls and come tell me so I can chuck him out of the club. Simple, Y/N."

You just nod. "Which room?" you ask, fixing your hair and makeup.

"Wong Hendery, VIP room 3," Kun says. "Of course it's the VIP room, why'd I even ask," you say, rolling your eyes, making Kun chuckle.

You made your way to the said room, feeling a little nervous. You've never done a private show for anyone before and you had no idea why this guy couldn't ask for another stripper. You took a deep breath before knocking on the door, and entering when you heard the young businessman yell out a "come in."

You closed the door and turned to approach him, stopping in your tracks at the sight of him.

He looked like a fucking Prince.

You had to blink thrice to make sure that you weren't dreaming and he was real and live in front of your eyes. His dark brown hair was parted to the side and he was dressed in a pair of black ripped jeans and a white t-shirt with a black leather jacket. Hendery kept his gaze on you as he took a sip of his alcohol, and you watched his Adam's apple bob as the liquid ran down his throat.

"Come sit," he said in a deep voice that made you get goosebumps. He patted the space beside him on the white leather sofa. You obeyed and sat next to him, keeping a short but good distance between you and him. "What can I do for you?" you ask, scanning his beautiful face curiously.

Hendery smirked, making your heart skip a beat. "Well, I'm not going to beat around the bush so I'll get straight to the point. I want you to be my girlfriend for a while. I'll pay you for it as well. It's cause my parents are forcing me to get married and won't stop until I have a girlfriend."

You choked on nothing in particular and your eyes widened. "U-Um, what?"

"Oh, did I startle you? My apologies, I shouldn't have been so straight forward," he mumbled politely, giving you a worried look while you just stared at him in disbelief.

"I... no, I'm sorry, you just caught me off guard," you say, mentally cursing yourself to try and get your shit together. "Why me, a stripper, when you could get pretty much any other decent girl to do that?"

"Cause there's something about you that has me so drawn to you, and besides, I know why you work as a stripper," he answers softly, taking a sip of his drink.

You freeze, processing his words. "You... know why I... work as a stripper...?" You were sure only Kun and Ten knew the reason.

He nods. "My mother owns the hospital your little sister is admitted in, Y/N. So yeah, I've seen you a couple of times there." You smile sadly at the mention of your beloved eleven year old sister who was currently battling leukemia. Your parents passed away a year ago when you were just eighteen. Your relatives didn't even want to have anything to do with you and your sister. You couldn't afford to go to college and pay for your ill sister's expensive treatment, so you had no choice but to become a stripper to get money faster.

"So, would you do me the honor, princess?" Hendery asks with a breathtaking smile. You thought about it for a second before nodding. You just have to act as his girlfriend right? What's the worse that could happen?

"So, Mr. Wong, you paid a fuck ton for half an hour, just to ask me to do you a favor?" you ask, raising an eyebrow.

"Yes," he chuckles before smirking. "You can call me Hendery, Y/N."

You just nodded. "Well, since we're here, I'll give you a little show."

"I know you don't do private shows. I don't mind one, but I really don't want you to feel uncomfortable," he says softly, making your heart swell at his thoughtfulness. He was such a gentleman.

"I insist," you say honestly with a smile. "I don't want to earn money like that without doing anything."

He just nods with a smile, watching you get up and walk over to the pole.

You start moving your body around the pole, getting higher up on it. You swayed your body a little more sexier than usual, taking off the first article of clothing slowly, revealing your cleavage. You glance at Hendery who was staring at you with hooded eyes. God, just the sight of him got you so wet. You took off your shorts, leaving yourself in your teddy. You made your way towards him, pulling him up to his feet from the sofa, and making him sit on a chair. You swayed your hips as you moved around him, stroking his arms from behind. You could tell that he works out from his hard flexed muscles. You let your hands roam from the visible curves of your lower ass, all the way to your hair, before squatting down and letting your legs open wide in front of him. You could see his hard bulge straining through his jeans. You touched your clothed core before standing up and straddling his lap, never breaking the eye contact. You dragged your hip along his thigh, grinding down hard on his crotch, causing both of you to moan at the friction. "Fuck, baby," Hendery grunted, throwing his head back. You took his hands and placed them on your ass as you continued grinding down on his length. A knock on the door interrupted you. "Time's up!" you heard Kun say through the door and you mentally pouted in disappoinment. Hendery chuckled and pulled you closer to him. "Do you wanna come over?" he asked sweetly. "Just to talk about everything, of course. I just want to know you better." You nodded eagerly, removing your eye-mask and going to collect your belongings from your locker in the changing rooms, before taking a shower and changing into a flowy dress. You said a quick goodbye to Ten and Kun before skipping to Hendery's side.

"Wow," you whispered, staring at the beautiful view of Beijing at night from Hendery's balcony on the last floor. You were surprised to find that he lived in the same apartment complex as you. There were eight apartment blocks; you lived in the 4th block and he lived in the 7th.

"Enjoying the view?" you heard Hendery ask from behind you. You turned around to look at him, fresh from the shower, wearing grey sweatpants and a black tank that clung to his toned body. God, he still looked amazing in something as simple as this.

"Yeah, the view is beautiful," you say, staring at him. He smiled and nodded, not noticing that the 'view' you referred to was actually him.

"I got some food from the club, let's eat," he said, getting plates and cutlery, setting them down on the small dining table.

You both ate in a comfortable silence, occasionally exchanging a few sentences here and there.

"Wine's okay with you?" he asked after you finished eating and you nodded with a smile. "Yeah, wine is my favorite."

You both sat on his sofa, drinking and talking about your pasts, how life is at present, and what you want to do in the future. He was so easy to get along with; he made you feel so comfortable. After an hour, you were giggling uncontrollably at pretty much everything he said, clearly drunk. Hendery, on the other hand, was sober enough. He had good alcohol tolerance, unlike you. At some point, you were in his arms, nearly passing out from how sleepy you were. You felt him lift you up bridal-style and carry you to a room, gently laying you down on the bed and putting a blanket over you. The last thing you heard him say was "goodnight, beautiful," before he switched off the lights.

A month passed and you and Hendery were super close. He was really caring and considerate, and had such a wonderful personality. He had a great sense of humor as well. You learned that his father was the founder and CEO of Wong Enterprises Inc. and dealt with the main branch in Macau, while Hendery took care of the branch here in Beijing.

You were on your way to his company's luxury building, excited to hear the news he was planning on telling you today.

"Good morning, is Mr. Wong in his office?" you ask the receptionist.

"May I know your name?" she asked.

"Lin Y/N."

"Ah, Ms. Lin! He's currently in a meeting, but he told me to tell you to wait in his office once you arrive," she informed with a smile. "You can take the elevator to the 28th floor." You nod and thank her, before taking the elevator.

Hendery's private office was impressive, having floor to ceiling windows with a beautiful view of the Hai River. You took a seat on the black leather sofa, scrolling through your social media while you waited for him.

"Hey, I hope I didn't make you wait too long," Hendery said politely, placing his laptop on his desk. You noticed that he was pretty tired and stressed.

"Not long, I got here a while ago," you say, keeping your phone away. "Bad meeting?"

"Yeah, it was so difficult to deal with those people," he says with a sigh, taking off his blazer and loosening his tie. He laid down on the couch with his head on your lap. "They disagreed with almost everything my team and I said. So annoying!"

You ran your hands through his soft brown hair, knowing that it would calm him. After a few minutes, he suddenly sat up with a huge ear-to-ear grin on his face, forgetting that he was annoyed a moment ago. "I almost forgot! You're my date for the business ball tomorrow night, Y/N!" he said cheerfully like a child.

"A business ball? I've never been to one, of course. What do I have to do?" you ask, biting your lip nervously.

"You don't have to do anything," he chuckles, "You just have to stand beside me while I introduce you as my girlfriend to various people."

"Put these on," she said, handing you a gown, wedges, and some jewelry. After you wore the gown, you gasped. It was absolutely beautiful. It was an off-shoulder navy blue mermaid gown that hugged your curves perfectly.

"Wow," you whispered, staring at yourself in the mirror. Hendery hired a professional makeup artist to do your makeup and hair. She did a simple yet elegant look on you, and curled your hair.

"Mr. Wong had it custom made for you," she said with a smile, making you gasp and blush. "He did?"

"Yes," she chuckled before helping you wear the jewelry and making sure everything was in place.

You were meeting Hendery directly at the venue as he had an important meeting. As soon as you stepped out of the car he sent for you, you felt really nervous.

But once you saw him standing at the top of stairs, looking like an absolute Prince in his black Louis Vuitton suit, you didn't feel nervous anymore.

You made your way up to him, never breaking the eye contact. He took your hand and kissed the back of it. "You look stunning, Ms. Lin."

You blushed, feeling the butterflies go crazy in your stomach. "Thank you, you do too, Mr. Wong." He chuckled and took your hand, leading you inside.

Your eyes widened when you saw how big the hall was. There were a lot of people, certainly more than you expected. You noticed several people were looking at you, obviously wondering who you were. You started to feel a little insecure, wondering if you looked good enough next to Hendery. You were pulled out of your thoughts when you heard Hendery say, "Yeah, this is my girl. Y/N, this is Wong Lucas and his girlfriend, Song Yuqi."

"Hello," you say politely, shaking both of their hands. Lucas looked like as if he was perfectly sculpted by the Greek Gods, and so did Yuqi.

"Ah, I see finally my baby brother got some good taste. The previous one was seriously such a bitch," Lucas said, grinning from ear to ear. You chuckled at that, remembering how a drunk Hendery ranted about his materialistic ex-girlfriend.

"Baby brother?" you raised an eyebrow.

"Yeah, we're cousins," Lucas said, making you mentally agree that they were seriously blessed with amazing genes. "I'm not surprised that he didn't tell you."

"I didn't cause I knew you would meet her today," Hendery said with a shrug.

After many more introductions and small conversations, some businessmen were talking to Hendery while you conversed with Yuqi and Lucas. Lucas even invited you for his birthday party next week. You excused yourself to go get a drink after you exchanged numbers with the couple.

You made small talk with two women at the bar while you sipped on delicious aged wine. You noticed Hendery was at the other side of the hall, talking to another girl. He looked like he was stuck and fed-up, so you immediately made your way towards him.

"Hey, love, I was searching for you," you say and peck his lips-for the very first time- right in front of the girl. Of course, sober you wouldn't do that as much as you wanted to.

Hendery was shocked, but he played it cool, masking his shock perfectly. "Hey, babe," he smiled, eyes sparkling.

"Hendery, who is she?" the girl asked, clearly annoyed, folding her hands over her chest and looking at you in disgust.

"I'm his girlfriend, are you blind?" you roll your eyes at her, intertwining your hand with his. The girl just gave you a sharp death glare and left, making Hendery chuckle.

"Thanks for saving me," he smirked, "You know, you're so cute when you're jealous."

"I'm not jealous," you lied.

"You are."

"Nope."

"Admit it."

"Okay, fine, a little," you say with a pout, immediately giggling after that.

Hendery could immediately make out that you were getting a little drunk. "How much did you drink, Y/N?"

"I don't know," you answer, "Maybe three or four glasses? The wine was amazing."

He shook his head, letting out a chuckle that sounded like music to your ears. "We're leaving now. I'm driving," he said, taking your hand and pulling you outside.

"Thanks for dropping me home, Hendery," you giggle, holding onto the bedroom door.

"We're actually in my apartment, but yeah, it's yours too," he said with a grin.

Your back pressed against the bedroom door, and you put your arms around his neck, pulling him close to you. He visibly gulped, making you smirk at the effect you had on him for something as small as this. "Have I have told you that you look like an absolute God?"

He laughed, amused at how different and random you are when drunk. "You did now."

"It's hard to believe that you exist," you giggle, caressing the soft skin of his cheek with the pad of your thumb. "You're ethereal, Hendery."

He chuckles, cheeks turning into a shade of pink. You loved seeing him get all flustered, knowing that you were the reason.

Your eyes scanned every inch of his perfect face before landing on his plump pink lips. You involuntarily licked your own lips, catching Hendery's attention. His eyes darted between your lips and your eyes.

You pulled him closer and finally crashed your lips onto his. Hendery kissed you back immediately, hands moving to your waist. Your hands were in his soft hair, tugging on it. You broke the kiss and moved your lips along his sharp jawline before settling on his neck, sucking and biting the soft skin, leaving a pretty purplish-red mark. Hendery's grip on your waist tightened as you brought your lips back onto his.

"Get me out of this," you whined against his lips, referring to your gown.

"As much as I'd love to, I can't do that today," Hendery said, leaning his forehead against yours.

You frown, slightly hurt from the rejection. "Why?"

"You're drunk," he stated softly, "I won't take advantage of you, baby."

"Okay," you whisper, feeling the butterflies go insane with that one simple word: baby.

"Let's get you to bed, yeah?" he said and kissed your forehead.

You woke up hungover and slightly startled at the fact that you were in Hendery's bed, clad with only your panties and his t-shirt. You downed the pills he left for you on his beside table before you made your way to his bathroom. You had a few of your toiletries here from all the sleepovers you've had at Hendery's apartment, despite living in the same area.

After you took a shower and finished your morning routine, you pulled on one of Hendery's hoodies, tying your hair into a messy bun. You went to the living room where Hendery was watching TV.

"Good morning," he said with his usual bright smile, looking at you from head to toe. He loved seeing you in his clothes. "Slept well?"

"Yeah," you said, sitting beside him on the couch. He handed you a granola bar after unwrapping it.

That's when you noticed the nice big mark on his neck.

"Who gave you that?" you asked, feeling quite hurt.

"What? Oh, this," he says, pointing to the hickey, "You, of course."

Your eyes widened. "What? Me...?" You felt the heat rise up to your cheeks.

"You don't remember what happened last night," Hendery stated with a playful smile.

"No..." you murmur, leaning back on the couch as Hendery came closer and closer to you until he was hovering over you.

"Well, let me show you," he smirks sexily, before crashing his lips onto yours.

You kissed him back immediately, your hands involuntarily moving around his neck, trying to pull him even closer to you.

After a minute, he broke the kiss and sat up, pulling you onto his lap.

"Do you remember now?" He whispered.

"No," you say, straddling his lap and pressing your lips to his. He was extremely shocked at your unexpected bold move, considering you were a hundred percent sober right now.

His hands slipped under his hoodie that you were wearing, feeling the bare skin of your abdomen, before smiling when he noticed that you had no bra on. He rolled your nipples with his thumbs, causing you to grind on his hard on. He moaned into the kiss, and you took that opportunity to slide your tongue into his mouth. His hands moved down your body to grab your ass as you continued grinding on him. You moaned when he started helping you move faster on him, loving the friction. He broke the kiss, squeezing your ass as his face scrunched up, releasing himself in his sweatpants with the sweetest sound you've ever heard.

His hands toyed with the waistband of your panties as he looked up at you for approval. You nod and he wastes no time in pushing them to the side, slipping a finger into your soaking core. You gasp when he adds another finger, feeling your walls immediately clench around it. He moves his fingers in and out of you, watching how you moan and scrunch your eyes at the feeling.

"I'm c-close," you moan out, grinding onto his fingers. He pumps faster and rubs your clit in circular motions, making you throw your head back, moaning loudly, as you cum all over his fingers.

He never broke the eye-contact as he slid his fingers out of you and put them in his mouth, licking them clean.

You hid your face in the crook of his neck, slightly embarrassed from what just took place. He chuckled as he kissed your head. "Stay here, I'm gonna go wash up."

You were having dinner at a luxurious hotel, celebrating Xuxi's birthday. You noticed that Hendery was fidgeting around a lot. Of course, you knew why.

The moment he saw you step out of Yuqi's room after she did your hair and makeup, wearing a short tight black dress that revealed a good amount of skin, you knew he was whipped and wanted to fuck you right there.

He was trying to be patient, but his patience was running out fast.

Finally, after everyone finished dinner and said their goodbyes, Hendery took your hand and pulled you to the elevator of the hotel to go to your room. Lucas had booked a room for you guys, saying that it was his birthday tradition to stay a night in a hotel. Hendery unlocked the door with the room key, closing it behind him and pushing you against it once you both took your respective footwear off.

"You drive me fucking crazy, princess. I want you so bad. Fuck, all I want is you."

"I'm all yours," you whisper, looking up at him through your long lashes. He took your hand and led you to the bed, settling in the middle and pulling you on top of him so that you were straddling his lap. He pulled you down to his level and crashed his lips onto yours. God, he was an amazing kisser. He sat up, never breaking the kiss, so that you could take off his leather jacket and his t-shirt. In one swift motion, he pulled your dress off, leaving you in just a pair of your thin lace panties. He broke the kiss to look at your almost naked body for the first time. "You're so beautiful," he whispers in amazement, eyes full of love. You loved how his eyes roamed all over your body.

"Can I touch you, Y/N?" he asks and you immediately approve. "Yes, please."

His hands cupped your boobs before one of them trailed to your dripping core. He moved his index finger over the wet patch of the thin lace, his eyes widened. "Fuck, baby, you're soaking wet for me," he says, pecking your lips.

"I want to ride you now," you say before unzipping his jeans and pulling it down with his briefs. He kicked them off and cursed when he felt your warm hands on his hard length, stroking him.

"Are you sure? I haven't prepped you."

"I'm alright."

"I don't have a condom on me, so I'm going to have to pull out. Is that okay with you, princess?" he asks and you nod before lining him up with your entrance and immediately sinking down on him.

It had been so long since you had sex, so the stretch was a little painful. He grunted loudly, feeling your walls clench around him. "Fuck, you're so tight!" you smirked at his words as you slowly began to bounce on him, feeling the pain turn to pleasure. He loved the way your boobs bounced and the way you threw your head back, moaning his name. He grabbed your ass, helping you move faster and harder on him. "Fuck, baby, you take me so well!"

He sat up, still moving you on him, until your boobs were right in front of his pretty face. He kissed the space between your breasts before taking one nipple in his mouth, sucking it gently and licking it, while rolling your other nipple, making you moan loudly. You fingers found your way to his hair, tugging on it. He left your nipples for your soft lips, kissing you hungrily. A particular thrust made you moan and he took that opportunity to slip his tongue into your mouth. His hands massaged your boobs, before he broke the kiss.

"Come for me, babygirl," he says, rolling your clit in circular motions with his thumb. Your legs begin to shake and you feel yourself approaching your high.

"Hendery! Fuck!" you yell, throwing your head back as you came all over Hendery's cock. He thrusted into you a few more times before he flipped you onto your back and pulled out, spilling his cum on your stomach. He pumped himself a few more times, milking himself dry before he collapsed on you. He looked up at you and smirked at your fucked-out expression.

He leaned in to kiss you gently, stroking your cheeks with his thumb. "That was amazing," he says with a breathtaking smile, making the butterflies in your stomach turn wild. You hum in approval, running your hand through his messy hair.

"I'm taking you out on a date tomorrow. But for now, shower with me?" he asks cutely, and of course, you couldn't say no.

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dxmedstudent · 6 years

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What is your impression/impression of your colleagues towards physician associates, particularly American PAs that come to work in the UK? I'm currently exploring options as my husband can transfer to the UK for his work. We've both always wanted to live abroad for a time. However, as I look more deeply into the interwebs, I get the feeling that PAs, particularly American, aren't well received. Thoughts?

Hello! Long time no see. Sorry for the late reply. I actually went back to forums and had a re-read after getting this ask because I wanted to present the arguments (whether wrong or right) that I saw. I hope it helps, though I want you to remember that not everyone feels this way; people who don’t have any strong feelings just don’t bother debating things like this online. In real life, I’ve heard very little negativity about PAs from other doctors. I think most feel pretty neutral about the whole thing. But I don’t want to sweep things under the carpet. Personally, I’ve only ever worked with doctors’ assistants (more limited duties, mostly helping out with odd jobs, bloods etc, no clerking) but I have no problem with the idea of PAs, as long as their role is clearly defined so that everyone gets what they need. One of my good friends from biomed went to PA school after graduating, and I think she’s having great fun. So I want to approach this with the attitude that PAs are our people, too. I’ll be honest, the topic of PAs seems to still be pretty be divisive amongst the medical community, from what I’ve seen on the big junior doctor forums. I’d say that there are people who are very pro-PAs, and others who are less enthusiastic. Though the reasons why are complex.

I don’t think the reception is anything to do with people being American, in the sense that i’ve never seen PAs’ nationalities be described as an issue. Despite occasional jibes, Americans are generally well liked here, and I’ve never overheard negative comments about a colleague’s Americanness. Is that a word? Feels like it should be. I’m actually sure US PAs might even be assumed to recevie a more comprehensive one than our own, if only because our own PA profession is very recent; we didn’t have PAs at all when I was younger. US-based training tends to be well-respected, as far as I know. The reasons for tensions between doctors and PAs here are many. First of all, PAs are a very recent invention. They have only been around for several years in the NHS. As such, we have a system that was built without their role, meaning that in order to have PAs at all, we need to make sure to carve out a role that does justice to what PAs can do, without taking away important opportunities from senior nurses/nurse prescribers/ANPs and junior doctors.This means that a lot of hospitals structure the role very differently, hence what a PA at one hospital does might not be the same as what a PA at another hospital does. This means if anyone wants to be a PA in the UK, it’s worth really shopping around, if you can, to see if you can get the most support and best role for you. I’d be really careful to make sure that the role made it clear what support is available for decisionmaking. PAs should have oversight from at least a registrar, ideally. I’ll come back to this later, but if anyone is making clinical decisions, it’s important that they are supported appropriately; I’m against giving nurses or paramedics or PAs or pharmacists prescribing privileges, just enough responsibiltiy to get them into trouble, but not giving people the right support for if they aren’t sure what to do. As a doc, having senior support is a big part of my job, and I think any one of my clinical colleagues deserves this, particularly if the government are trying to save money by getting them to do more doctors’ jobs so they don’t have to hire as many docs. And where PAs have in theory to get more junior docs to sign off on their decisions, lots of juniors aren’t comfortble with that idea. Because you generally have to be a bit more experienced before you can take repsonsibiltiy for others and their work. An FY1 or FY2 ‘supervising’ a PA wouldn’t be appropriate for either. And deep down msot of us docs feel that bringing in more ANPs, bringing in PAs, allowing pharmacists and paramedics and nurses to prescribe, a lot of it isn’t ultimately created with the interests of the clinician in mind. Ultimately the government does everything it does to save itself money, and given what they put junior doctors through in recent years, we are very, very bitter and wary with ANY government scheme. A lot of people worry that bringing in PAs is just a way of the government trying to provide people to do doctor jobs on the cheap, without supporting them or training them up properly. And given that they’ve structured nurse training in such a way that trusts try to get by with as few senior nurses as possible, because it’s cheaper to have lots of HCAs and lower band nurses, I think all NHS workers have reason to be wary. I’m going to spend most of this post outlining some of the issues that people have brought up in various threads, which aren’t necessarily issues I myself share, but I feel I have to discuss why some people are still adjusting to PAs cropping up. Not all doctors like the way having PAs works in practice, at least where they have worked. Some people grouse about the pay, because some of the PA slots advertised give a higher salary than you get for the frist several years of being a junior doctor, whilst most of them don’t do nights or oncalls, and have to take less clinical responsibility. On the surface, it doesn’t seem fair; why should someone working better hours, and taking less legal responsibility be paid more? But I don’t believe in bringing everything down to the lowest common denominator; if anything, it should be an argument for better pay for nurses, doctors, physios, pharmacists etc. In reality, I suspect they have made a few posts that pay unusually well to entice senior nurses to train up as PAs, and sort of get the ball rolling. The numbers are much smaller than the number of docs and nurses, so they can afford to pay more. Also, my colleagues have a point that that’s a PA’s final salary and that the job role is more limited, whereas junior docs (in our system, at least), get to train up to do different things, and eventually earn more. Some act like PAs get a bad deal, others are envious; I think both jobs can be good if you’re the right person for that job. I’m sure it’s a better role for some people. Now, a small part of me can see why my colleagues are concerned. When you’re stressing about fulfilling the things you NEED for training, because otherwise your deanery and seniors will totally make out that you’re an inadequate doctor, it puts a lot of pressure on you to get your procedures and cases signed off. I’ll be honest; medical training as a doctor once you graduate in the UK is minimal; we do our own exams. We have to arrange our own attendance at clinics (which is compulsory), we have to make sure we can get to compulsory teaching. We have to make our own opportunities to do the procedures we need to do to get signed off, see the cases we need, etc. We need to mke our own opportunities for audits, publications, etc. Apart from the occasional nice senior, literally nobody helps you to get all the things you absolutely need to do done. And that’s on top of the usual ward rounds, saving lives, dealing with pts and relatives thing, whilst often being extremely busy and understaffed. And rotating around every few months, so that nobody in the hospitals you work at Junior doctors are genuinely exhausted, overworked, and scrabbling around to get the opportunities they need to get by. Some of my colleagues report working in hospitals where because the PAs were permanent (not rotating) staff, they were given preference for audits, projects, research, procedures, surgery etc to the point where junior doctors felt sidelined and unable to get the training they need. Where they felt that rather than PAs taking on some of the “jobs everyone doesn’t like doing” on top of clerking, they were given preference for the things both they and docs like doing, but also that docs NEED to do. And I’ve been in situations where I’m tired, struggling to get what I nee to do done, and I can see where they are coming from; I remember having an unpleasant evening, and wondering they were giving a GP trainee a chance to do a lumbar puncture when they’ll never need to do one in their line of work, when there are trainees in the dept that will need to do these procedures independently soon, but never get the opportunity. Of course, I reined in my childish brain, but the reason I felt that way wasn’t really because of my lovely colleague, but because of my stress at the lack of opportunities I got, which the system dictated I needed, but didn’t help me with. I’d never begrudged or been jealous of a colleague before so it was a low moment for me. But I’m sharing it because even generally nice people can feel jealous or let down if the system pits people against each other. And in scenarios like that, it’s not the fault of PAs at all; it should be up to hospitals planning their rota to ensure not only that staffing is well covered, but that trainee docs get enough opportunity to do what they need to do. And that PAs aren’t screwed over. I think blaming other employees is wrong, when the real culprit is a system that pits people against each other or doesn’t give people what they need to get things done. Now, there’s also a bit of rivalry between PA students and med students, more so than grads. Some PA students seem to go into it with the attitude that “It’ll be just like being a doctor, but you graduate faster”, and med students being med students, some of them will treat other clinicians with smug, unearned superiority. I have no time for either of these imposters, personally. Med students who think they are better than everyone don’t make good doctors until they get taken down a peg or two. We’re part of a team, and we can’t do what we do without nurses, physios, pharmacists etc, even PAs if they are part of our team. And people choosing beteeen the two courses shouldn’t think, wrongly that PA school is just the easy way into medicine, or “basically makes me a doctor”, because it’s dangerous to assume a level of competence or practice you don’t have. And because if you don’t understand the role you’re getting into, you may well be disappointed if it doesn’t meet your expectation. I think med students and PA students like this let both sides down, but I hope that real life will knock them into shape. The good news is that a lot of my colleagues on the group report that they’ve worked in places where having PAs worked really well. I think a lot of people would love having more people on the team to help. I’m certainly not against PAs if they are well supported. I think it has a lot of potential, and I’d like to see hospitals develop it properly. Where there were enough opportunities for both, and where PAs . I saw a lot of people say wonderful things about PAs, and defend them when things on the thread got more negative. I have hope for what our PA colleagues will do, I just think we’re still going through a transitional period with its own teething problems. We work well with nurse prescribers, with ANPs and with pharmacist prescribers; I believe we can work well with PAs. I just hope that trusts and the govt will do well by both docs and PAs, and that the relationship we eventually build will be fair to both sides. I suggest doing your research to see the kinds of jobs beingoffered, because they might not be as varied as they are in the US; some places definitely seem to offer jobs for PAs that are mainly paperwork, minor jobs with some phlebotomy, whereas other trusts have scope for clerking or more varied practice. And I would want to make sure that there’s an appropriate level of senior support for decisionmaking.

#ask dx #askdx #medblr #PA #PAs

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