While I appreciate medical secretaries' desire for recognition (letters, 23 September), recognition as a profession allied to medicine may not be the best route.

All recognised PAMs provide clinical interventions for patients and carers, which clearly medical secretaries do not. Mrs A Rhodes' letter described specialised administrative support, which aligns much more with other administrative staff groups.

Having a knowledge of anatomical terms and conditions is not in itself a clinical skill. Secretaries working in the aeronautical industry probably have an equally good grasp of engineering terms, but it does not confer on them a professional status.

All secretaries should also have a good grasp of IT skills, and senior secretaries should be able to carry out supervisory and basic management tasks, which are administrative, not clinical, roles.

The fact that medical secretaries are skilled in this area only emphasises the real nature of their role.

If this is not recognised in their salary scales, what skills are we paying medical secretaries for?

Despite this, all frontline administrative staff are a worthy cause for pay review.

I have enormous respect for my very able reception staff, who work under great pressures all the time.

The service they offer patients is every bit as important as that of my clinical staff, but this is not reflected in their pay - perhaps because there is little shortage of administrative staff they have no scarcity value.

Having designed discretionary points for some professions, we should do something for highly committed staff in other support roles. So although I think you're barking up the wrong tree, Mrs Rhodes, you're in the right orchard.

Pinky Millward Physiotherapy manager Enfield