Commentaries on health services research

Abstract

This systematic review aimed to appraise the evidence of PAs' contribution to primary care; 2,167 publications were identifi ed, of which 49 met the inclusion criteria (46 were American). Half of PAs work in primary care in the US with good support and physicians willing to employ PAs. The majority of PAs' workload is managing patients with acute presentations. PAs tend to see younger patients and a different caseload than physicians do and require supervision. Studies of costs provide mixed results. Outcomes of the review identifi ed that acceptability to patients and potential patients is consistently high, and studies of appropriateness report positively. Overall, the evidence was appraised as of weak to moderate quality, with little comparative data presented and little change in research questions over time. The research evidence of the contribution of PAs to primary care was mixed and limited. However, the continued growth in PAs' employment in American primary care suggests that PAs are considered valuable. Further specifi c studies are needed about the effectiveness of PAs' contributions to the international primary care workforce.Halter M, Drennan V, Chattopadhyay K, et al. The contribution of physician assistants in primary care: a systematic review. ABSTRACTImpending physician shortages in the United States will necessitate greater reliance on PAs and NPs. But how willing are Americans to accept that change? This study examined provider preferences from the patient's perspective. Using data from the AAMC Consumer Survey, the authors found about half of the respondents preferred to have a physician as their primary care provider. However, when presented with scenarios in which they could see a PA or an NP sooner than a physician, most elected to see the PA or NP instead of waiting. Although the fi ndings provide evidence that consumers are open to the idea of receiving care from a PA or an NP, barriers such as scope-of-practice regulations still limit their widespread use. Policy makers should incorporate such evidence into solutions for the physician shortage.