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The role of the physician associate: an overview

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Abstract

The physician assistant role in healthcare delivery was first introduced during the 1960s in the USA as a solution to doctor shortages, greater population healthcare needs and increasing healthcare provision costs. Since then, many countries worldwide have utilized the successful USA physician assistant model as a benchmark to guide both physician assistant training and the incorporation of the role into their healthcare systems. While the USA retained the title physician assistant, Ireland and the UK use the title physician associate. Physician assistants/associates are trained in the generalist medical model and function under the supervision of a doctor. Tasks relating to the role include the following: taking patient’s medical histories, performing examinations, making diagnosis, requesting tests, analysing results and the initiation of treatment. They practice across a broad range of specialities and settings. Physician assistants in the USA and the Netherlands have prescribing privileges. Statutory regulation for physician assistants/associates lays the groundwork for prescribing privileges and such regulation is under consideration by the government in the UK. Studies indicate that doctors and patients are largely satisfied with the contribution of this profession to healthcare services and physician assistants/associates report good job satisfaction.

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References

  1. Joyce P, Woodmansee D, O’Neill JP (2019) The physician associate: a role in Irish healthcare. J Irish Coll Gen Pract Sept 17. https://www.researchgate.net/publication/340829683. Accessed 4 June 2021

  2. PubMed (2021) https://pubmed.ncbi.nlm.nih.gov/. Accessed 7 January 2021

  3. Martinic M, Pieper D, Glatt A et al (2019) Definition of a systematic review used in overviews of systematic reviews, meta-epidemiological studies and textbooks. BMC Med Res Methodol 19:1–12. https://doi.org/10.1186/s12874-019-0855-0

    Article  Google Scholar 

  4. White GL, Davis AM (1999) Physician assistants as partners in physician-directed care. South Med J 92:956–960. https://doi.org/10.1097/00007611-199910000-00002

    Article  PubMed  Google Scholar 

  5. Ballweg RM, Hooker RS (2017) Observations on the global spread of physician assistant education. J Physician Assist Educ 28:S75–S80. https://doi.org/10.1097/JPA.0000000000000154

    Article  PubMed  Google Scholar 

  6. Glicken AD, Miller AA (2013) Physician assistants: from pipeline to practice. Acad Med 88:1883–1889. https://doi.org/10.1097/ACM.0000000000000009

    Article  PubMed  Google Scholar 

  7. Pasquini S (2020) The physician assistant life. https://www.thepalife.com/physician-assistant-stats. Accessed 7 January 2021

  8. Berkowitz O, Hoffmann M (2020) Development of the European physician assistant/associate collaboration and the First EuroPA-C Conference. J Physician Assist Educ 31:172–176. https://doi.org/10.1097/JPA.0000000000000315

    Article  PubMed  Google Scholar 

  9. Berkowitz O, Kussmaul CJL (2018) Take two of these and call me in the morning: how global physician assistants cope with limited medication prescribing rights. J Physician Assist Educ 29:184–187. https://doi.org/10.1097/JPA.0000000000000207

    Article  PubMed  Google Scholar 

  10. Hooker RS, Hogan K, Leeker E (2007) The globalization of the physician assistant profession. J Physician Assist Educ 18:76–85. https://doi.org/10.1097/01367895-200718030-00011

    Article  Google Scholar 

  11. Cawley JF, Hooker RS (2018) Determinants of the physician assistant/associate concept in global health systems. Int J Healthc 4:50. https://doi.org/10.5430/ijh.v4n1p50

    Article  Google Scholar 

  12. Hooker RS, Berkowitz O (2020) A global census of physician assistants and physician associates. JAAPA 33:43–45. https://doi.org/10.1097/01.JAA.0000721668.29693.36

    Article  PubMed  Google Scholar 

  13. National Commission on Certification of Physician Assistants, Inc. (2019) Statistical profile of certified physician assistants: annual report. http://www.nccpa.net/research. Accessed 7 January 2021

  14. Aiello M, Roberts KA (2017) Development of the United Kingdom physician associate profession. J Am Acad Physician Assist 30:1–8. https://doi.org/10.1097/01.JAA.0000513357.68395.12

    Article  Google Scholar 

  15. Ritsema TS, Roberts KA, Watkins JS (2019) Explosive growth in british physician associate education since 2008. J Physician Assist Educ 30:57–60. https://doi.org/10.1097/JPA.0000000000000233

    Article  PubMed  Google Scholar 

  16. Reilly C (2021) Introducing physician associates to Ireland: the story so far. The Medical Independent. https://www.medicalindependent.ie/introducing-physician-associates-to-ireland-the-story-so-far/. Accessed 20 May 2021

  17. Department of Health, Northern Ireland (2019) Physician associates students represent first for Northern Ireland.https://www.health-ni.gov.uk/news/physician-associates-students-represent-first-northern-ireland. Accessed 20 May 2021

  18. Fulton ME (2020) Designing a physician assistant curriculum consistent with the modernization of health care. J Physician Assist Educ 31:221–225. https://doi.org/10.1097/JPA.0000000000000327

    Article  PubMed  Google Scholar 

  19. Barwick TA (2019) Values sustain the profession in the long run. J Physician Assist Educ 30:132. https://doi.org/10.1097/JPA.0000000000000267

    Article  PubMed  Google Scholar 

  20. Drennan V, Halter, M, Wheeler C et al (2019) What is the contribution of physician associates in hospital care in England? A mixed methods, multiple case study. BMJ Open 9. https://doi.org/10.1136/bmjopen-2018-027012

  21. Joyce P, Hooker RSWD et al (2019) Introducing the physician associate role in Ireland: evaluation of a hospital based pilot project. J Hosp Adm 8:50. https://doi.org/10.5430/jha.v8n3p50

    Article  Google Scholar 

  22. Smalley S, Mlambo M, Gibbs A et al (2020) Opinions of supervisors of clinical associates in South African district hospitals. JAAPA 33:39–43. https://doi.org/10.1097/01.JAA.0000684132.51346.9b

    Article  PubMed  Google Scholar 

  23. Williams LE, Ritsema TS (2014) Satisfaction of doctors with the role of physician associates. Clin Med J R Coll Physicians London 14:113–116. https://doi.org/10.7861/clinmedicine.14-2-113

    Article  Google Scholar 

  24. Burrows K, Abelson J, Miller P et al (2020) Understanding health professional role integration in complex adaptive systems: a multiple-case study of physician assistants in Ontario, Canada. BMC Health Serv Res 20:1–15. https://doi.org/10.1186/s12913-020-05087-8

    Article  Google Scholar 

  25. Samsi K, Cole L, Manthorpe J (2020) Regulating Physician Associates (PAs) and Anaesthesia Associates (AAs): a rapid review. NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King’s College London. https://kclpure.kcl.ac.uk/portal/files/137648292/Samsi_et_al_202_Regulating_PAs_and_AAs.pdf. Accessed 4 June 2021

  26. Kurtzman ET, Barnow BS (2017) A comparison of nurse practitioners, physician assistants, and primary care physicians’ patterns of practice and quality of care in health centers. Med Care 55:615–622. https://doi.org/10.1097/MLR.0000000000000689

    Article  PubMed  Google Scholar 

  27. Drennan V, Gabe J, Halter M et al (2017) Physician associates in primary health care in England: a challenge to professional boundaries? Soc Sci Med 181:9–16. https://doi.org/10.1016/j.socscimed.2017.03.045

    Article  PubMed  Google Scholar 

  28. Malik B, Krishnaswamy R, Khan S et al (2019) Are physician associates less-defined force multipliers? Comparative role definition of physician associates within the hierarchy of medical professionals. Cureus 11. https://doi.org/10.7759/cureus.6469

  29. Faculty of Physician Associates. Royal College of Physicians, Regents Park, London (2021) https://www.fparcp.co.uk/about-fpa/faqs. Accessed 31 January 2021

  30. UK - An employer’s guide to physician associates (2017) https://www.rcplondon.ac.uk/news/fpa-launches-employers-guide-physician-associates. Accessed 7 January 2021

  31. Physician Associates (Regulation Bill) 2017–2019 (24 October 2018) https://services.parliament.uk/bills/2017-19/physicianassociatesregulation.html. Accessed 7 January 2021

  32. Interim NHS People plan (June 2019) https://www.longtermplan.nhs.uk/wp-content/uploads/2019/05/Interim-NHS-People-Plan_June2019.pdf. Accessed 7 January 2021

  33. Ritsema TS, Roberts KA (2016) Job satisfaction among British physician associates. Clin Med J R Coll Physicians London 16:511–513. https://doi.org/10.7861/clinmedicine.16-6-511

    Article  Google Scholar 

  34. Dyrbye L, West C, Halasy M et al (2020) Burnout and satisfaction with work-life integration among PAs relative to other workers. JAAPA 33:35–44. https://doi.org/10.1097/01.JAA.0000660156.17502.e6

    Article  PubMed  Google Scholar 

  35. Van der Biezen M, Derckx E, Wensing M et al (2017) Factors influencing decision of general practitioners and managers to train and employ a nurse practitioner or physician assistant in primary care: a qualitative study. BMC Fam Pract 18:1–10. https://doi.org/10.1186/s12875-017-0587-3

    Article  Google Scholar 

  36. Kozikowski A, Mauldin S, Jeffery C et al (2020) Consumer and patient perspectives and satisfaction with medical care provided by PAs. J Am Acad Physician Assist 33:1–1. https://doi.org/10.1097/01.jaa.0000723156.38220.70

    Article  Google Scholar 

  37. Halter M, Drennan V, Joly L et al (2017) Patients’ experiences of consultations with physician associates in primary care in England: A qualitative study. Heal Expect 20:1011–1019. https://doi.org/10.1111/hex.12542

    Article  Google Scholar 

  38. Taylor F, Halter M, Drennan VM (2019) Understanding patients’ satisfaction with physician assistant/associate encounters through communication experiences: a qualitative study in acute hospitals in England. BMC Health Serv Res 19:1–12. https://doi.org/10.1186/s12913-019-4410-9

    Article  CAS  Google Scholar 

  39. Hooker RS, Moloney-Johns AJ, McFarland MM (2019) Patient satisfaction with physician assistant/associate care: an international scoping review. Hum Resour Health 17:1–11. https://doi.org/10.1186/s12960-019-0428-7

    Article  Google Scholar 

  40. Roy C, Liang CL, Lund M et al (2008) Implementation of a physician assistant/hospitalist service in an academic medical center: impact on efficiency and patient outcomes. J Hosp Med 3:361–368. https://doi.org/10.1002/jhm.352

    Article  PubMed  Google Scholar 

  41. Glotzbecker B, Yolin-Raley D, DeAngelo D et al (2013) Impact of physician assistants on the outcomes of patients with acute myelogenous leukemia receiving chemotherapy in an academic medical center. J Oncol Pract 9. https://doi.org/10.1200/JOP.2012.000841

  42. Morgan P, Smith V, Berkowitz T et al (2019) Impact of physicians, nurse practitioners, and physician assistants on utilization and costs for complex patients. Health Aff 38:1028–1036. https://doi.org/10.1377/hlthaff.2019.00014

    Article  Google Scholar 

  43. Timmermans M, van Vught A, Peters Y et al (2017) The impact of the implementation of physician assistants in inpatient care: a multicenter matched-controlled study. PLoS ONE 12:1–15. https://doi.org/10.1371/journal.pone.0178212

    Article  CAS  Google Scholar 

  44. Drennan VM, Halter M, Joly L et al (2015) Physician associates and GPs in primary care: a comparison. Br J Gen Pract 65:e344–e350. https://doi.org/10.3399/bjgp15X684877

    Article  PubMed  PubMed Central  Google Scholar 

  45. Hooker RS, Cawley JF, Everett CM (2017) Economic assessment of physician assistants. In: Hooker RS, Cawley JF, Everett CM (eds) Physician assistants: policy and practice, 4th edn. Davis, Philadelphia, pp 184–214

    Google Scholar 

  46. Indiana last state to give PAs prescribing authority (2007) Drug topics: the voice of the pharamacist. https://www.drugtopics.com/view/indiana-last-state-give-pas-prescriptive-authority. Accessed 7 January 2021

  47. UK Parliament (18 July 2019) The regulation of physician associates (PAs). Statement made by Stephen Hammond, Minister of State for Health. https://questions-statements.parliament.uk/written-statements/detail/2019-07-18/HCWS1741. Accessed 7 January 2021

  48. Dall T, Reynolds R, Chakrabarti R et al (2020). The complexities of physician supply and demand: projections from 2018 to 2033. Report. Association of American Medical Colleges. https://www.aamc.org/media/45976/download. Accessed 7 January 2021

  49. Howarth S, Storr E, Lenton C et al (2019) Implementing the Safe and Effective Clinical Outcomes (SECO) simulation to prepare physician associate students for practice. Educ Prim Care 30:387–391. https://doi.org/10.1080/14739879.2019.1672106

    Article  PubMed  Google Scholar 

  50. Hudak NM, Pinheiro SO, Yanamadala M (2019) Increasing physician assistant students’ team communication skills and confidence throughout clinical training. J Physician Assist Educ 30:219–222. https://doi.org/10.1097/JPA.0000000000000278

    Article  PubMed  Google Scholar 

  51. Goldgar C, Michaud E, Park N et al (2016) Physician assistant genomic competencies. J Physician Assist Educ 27:110–116. https://doi.org/10.1097/JPA.0000000000000081

    Article  PubMed  PubMed Central  Google Scholar 

  52. WHO definitions of genetics and genomics (2002) https://www.who.int/genomics/geneticsVSgenomics/en/#:~:text=The%20main%20difference%20between%20genomics,and%20development%20of%20the%20organism. Accessed 7 January 2021

  53. Prince JD (2017) Precision medicine: an introduction. J Electron Resour Med Libr 14:120–129. https://doi.org/10.1080/15424065.2017.1401500

    Article  Google Scholar 

  54. Drennan VM, Halter M (2020) Building the evidence base-10 years of PA research in England. JAAPA 33:1–4. https://doi.org/10.1097/01.JAA.0000694976.90421.90

    Article  PubMed  Google Scholar 

  55. Hooker RS (2017) A chronicle of PA journals. J Am Acad Physician Assist 30:39–42. https://doi.org/10.1097/01.JAA.0000511793.82924.cf

    Article  Google Scholar 

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Malone, R. The role of the physician associate: an overview. Ir J Med Sci 191, 1277–1283 (2022). https://doi.org/10.1007/s11845-021-02661-9

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