Physician Assistant Utilization in Inpatient Psychiatry: A Qualitative Study

Abstract

There is a national shortage of psychiatric care providers, with approximately 1% of physician assistants (PAs) working in psychiatry. The study aimed to understand the utilization of PAs in inpatient psychiatry. Methods A qualitative study was performed utilizing semi-structured interviews focusing on PA autonomy, reimbursement, specialized certifications, training structure, and overall satisfaction with PAs in inpatient psychiatric care. Results Of the nine locations interviewed, four are currently using PAs, and five have never utilized PAs. All facilities utilizing PAs reported a decrease in physician workload with varying structures for training and billing, and required specialized certifications. Conclusion Most facilities surveyed do not utilize PAs and either preferred physicians or were unaware of the qualifications of PAs. Of the facilities utilizing PAs, there is wide variation in their utilization and reimbursement models; however, they reported a high level of satisfaction, reinforcing that PAs can provide high-quality care in inpatient psychiatric settings.

Job satisfaction and moral distress of nurses working as physician assistants: focusing on moderating role of moral distress in effects of professional identity and work environment on job satisfaction

“…Job satisfaction level of nurses working as PAs was moderate (3.08 out of 5), similar to other studies targeting nurses working as PAs in Korea [ 16 ]. However, it was lower than PAs and NPs [ 2 , 4 , 5 , 17 , 29 , 30 ]. This gap in job satisfaction between PAs in Western countries and Korea might be attributed to differences in PA model such as practice scope, education requirements, and legal and institutional recognition.…”

“…They formally become part of the qualified healthcare team (6, 9). Based on qualification through accredited education, PAs and NPs can provide high-quality of care to patients [ 4 , 5 , 17 ]. Their performance has been reported by many previous studies [ 2 , 5 , 17 ].…”

“…In countries where PAs formally work as a part of a healthcare team, PAs are systematically trained and formally qualified to perform a wide range of clinical duties, including diagnosing, treating illnesses, prescribing medications, and ordering diagnostic tests (1). Many studies have reported high levels of satisfaction with high-quality care by PAs, which are indistinguishable from physicians [ 2 , 4 – 6 ].…”

Revisiting the unmet mental health needs in Canada

“…However, a recent study in the United States found that all physicianled practices that used PAs for mental health inpatient care saw a reduced workload for the physicians and high levels of physician satisfaction in the care being provided by PAs. 22 Patient satisfaction studies in practices using PAs are limited in mental health and psychiatry; however, other studies in specialties such as emergency medicine and general surgery have demonstrated patient satisfaction and improved patient outcomes with PA integration. 9,10 Further evidence of successful PA integration into psychiatry/mental health care fields can be found in the United Kingdom.…”

Physician assistants/associates in psychiatry: a workforce analysis

“…Stefos observed that PAs significantly improved the productivity of psychiatrists within the mental health workforce in the US Department of Veteran Affairs (VA) facilities [ 26 ]. Curran and colleagues interviewed employees in inpatient psychiatric institutions in the US [ 27 ]. The authors found that facilities employing PAs reported high satisfaction and quality patient care and decreased physician workload [ 27 ].…”