Physician assistants reduce resident workload and improve care in an academic surgical setting

Dies, Natalie; Rashid, Saira; Shandling, Maureen; Swallow, Carol J.; Easson, Alexandra; Kennedy, Erin

doi:10.1097/01.jaa.0000476214.34937.50

Cited by 33 publications

(45 citation statements)

References 16 publications

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“…[12] Increasing clinical activity, such as patient throughput and increased productivity, has been reported as a benefit of the PA role. [16,17] Ireland is among three European countries which share the worst patient accessibility to healthcare. According to the European Health Consumer Powerhouse report, these long wait times are not as a result of scarce resources but rather poor healthcare administrations.…”

Section: Discussionmentioning

confidence: 99%

Patient willingness to be seen by a physician associate in Ireland

Joyce

Arnett

Hill

et al. 2018

IJH

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Background: The physician associate (PA) role was piloted in Dublin, Ireland between 2015 and 2017. However, the concept of a PA and the acceptance of their role in Ireland had not been explored. Objective: To investigate the willingness of Irish citizens to be seen by a PA based on medical scenarios in a typical clinical setting. Design: A mixed methods study was undertaken. A preference survey, with three medical scenarios, gave participants a choice to be treated by a PA or a doctor, with two time trade-off options offered. Responses were supported with qualitative text. Four hundred people were invited to participate as surrogate patients. Setting and participants: In 2017 a total of 270 respondents took part in the study (67.5%) in two hospitals (one private and one public) in Dublin. The mean age was 60; male (n = 142) and female (n = 128) respondents. Findings: In total, 95% of the respondents chose to see a PA over a doctor based on the scenarios presented and a wait time of 30 minutes. Wait time, trust, competency and the severity or seriousness of the medical condition were categorized into three themes for choosing the PA over the doctor. The "surrogate patient" decisions made by this sample were influenced by knowing that the PA is supervised and can check decisions with his/her supervizing physician. Conclusion: These findings are consistent with studies carried out in other countries where willingness to be seen by a PA is neither age nor gender specific. Patient preference seems to concur around the importance of trust and confidence in the medical provider.

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Section: Discussionmentioning

confidence: 99%

Patient willingness to be seen by a physician associate in Ireland

Joyce

Arnett

Hill

et al. 2018

IJH

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“…14 Congruently, physician workforce shortages were also found to delay hospital discharge after surgery. 15 Workforce data from specialty and sleep medicine clinics also demonstrated shortages. Cystic fibrosis centers reported difficulty in recruiting both physicians and nonphysician providers.…”

Section: Current Workforce Shortagesmentioning

confidence: 99%

“…On the supply side, physicians are retiring at an increased pace, 13,16,20 particularly in medical disciplines caring for patients with cardiopulmonary disease. 13,17,[20][21][22]24,25 One study suggested the improved economy as a potential reason for the increased number of health-care provider retirees, 20 whereas others referred simply to the number Providers not accepting new patients 13 Longer wait times in primary care offices/clinics 13 Lack of physician availability in acute and primary care 14 Provider shortage on the basis of geographic area 14 Delays in hospital discharge 15 Provider shortage on the basis of specialty area 16,17 -Future workforce shortage…”

Section: Future Workforce Shortagesmentioning

confidence: 99%

“…Use advanced practice providers 15 Use specialized health care teams 17 -Optimal utilization of personnel…”

Section: -Workforce Shortage Solutionsmentioning

confidence: 99%

“…Optimized care models 14,20 Optimizing deployment of personnel 20,23 Telemedicine/regionalization of care 21,24,25 -Use of NPAPP NPAPP utilization in primary and specialty clinics [15][16][17][18]27 NPAPP utilization for improved efficiency in care 15 Gap of providers can be filled by NPAPP 21,24,25 NPAPP to fill gap caused by increased access 19,20 NPAPP ¼ nonphysician advanced practice practitioner.…”

Section: -Workforce Shortage Solutionsmentioning

confidence: 99%

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Adequacy of the Provider Workforce for Persons With Cardiopulmonary Disease

Joyner

Strickland

Becker

et al. 2020

Chest

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BACKGROUND: Access and quality of health care for cardiopulmonary disease in the United States ranks poorly compared with economically similar nations. No recent comprehensive assessment of the cardiopulmonary workforce is available. This systematic review was conducted to evaluate current published evidence about the workforce caring for persons with cardiopulmonary disease.METHODS: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Structured searches of medical databases were conducted to find studies published from 2006 through 2016. Because of the paucity of quantitative data retrieved, a qualitative synthesis was conducted. Thematic analyses were performed on 15 identified articles through a process of open and axial coding.RESULTS: There is published evidence of current and projected workforce shortages in all clinical settings where care of persons with cardiopulmonary disease occurs. Advanced practice providers complete much of their cardiopulmonary training on the job. The aging population and the advent of new medical interventions are projected to increase growth in health-care demand. Some physicians limit hiring of advanced practice providers because of a deficiency in formal cardiopulmonary training.CONCLUSIONS: There is a gap in care between the needs of persons with cardiopulmonary disease and cardiopulmonary providers. Strategies resolving this problem may include one or more approaches that reduce the administrative burden associated with current care and assure the availability of suitably trained providers. CHEST 2020; 157(5):1221-1229

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