New Role, New Country: introducing US physician assistants to Scotland

Abstract

This paper draws from research commissioned by the Scottish Executive Health Department (SEHD). It provides a case study in the introduction of a new health care worker role into an already well established and "mature" workforce configuration It assesses the role of US style physician assistants (PAs), as a precursor to planned "piloting" of the PA role within the National Health Service (NHS) in Scotland.The evidence base for the use of PAs is examined, and ways in which an established role in one health system (the USA) could be introduced to another country, where the role is "new" and unfamiliar, are explored.The history of the development of the PA role in the US also highlights a sometimes somewhat problematic relationship between P nursing profession. The paper highlights that the concept of the PA role as a 'dependent practitioner' is not well understood or developed in the NHS, where autonomous practice within regulated professions is the norm. In the PA model, responsibility is shared, but accountability rests with the supervising physician. Clarity of role definition, and engendering mutual respect based on fair treatment and effective management of multi-disciplinary teams will be pre-requisites for effective deployment of this new role in the NHS in Scotland.

The contribution of Physician Assistants in primary care: a systematic review

“…Firstly, the review had a specific question, focusing on primary care as relevant to the UK and European definition of primary care, that is, care provided in general practice. This tightly defined focus together with the exclusion of studies where the primary care data could not be disaggregated from data in the secondary care setting [82] may have limited the available evidence. However, this approach has assisted in identifying the evidence as relevant to those countries with similar primary care systems to the UK in which PAs are starting to be employed and even trained, even though the setting for the majority of the studies was the USA.…”

Physician assistants: education, practice and global interest

“…The United Kingdom Department of Health (2005) has developed PA-type programs to train Medical Care Practitioners at several universities and is in the process of finalizing the national curriculum and developing regulations for practice of this new health professional (Westwood & Richardson 2005) and Scotland has recently completed a critical review of the concept (Buchan et al 2006) with an intent to rapidly incorporate the profession. Beginning in 2001, the Netherlands developed several university-based programs to educate PAs with plans to expand these programs in the near future (Verboon 2005).…”

Changing Territories of Health Care Professionals in Primary Care

“…GIM is the cornerstone of an integrated health care delivery system that is needed today". At the same time, European policy-makers and health insurers started to look at the North American experience to explore ways to employ non-physician groups to take over activities as independent practitioners (for example, in Scotland) [23].…”