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Drennan, Vari; Levenson, Ros; Halter, Mary; Tye, Chris (2011)
Publisher: Royal Society of Medicine
Languages: English
Types: Article
Subjects: alliedhealth, health
OBJECTIVE: Effective use of staff is a major aim in all health-care systems both to maximize their impact and to minimize costs. In England, a few general practitioners (GPs) have been recruiting physician assistants (PAs) to work in their practices, independent of any pilot schemes. Our objective was to study the motivation of GPs and practice managers who employed PAs and to understand the factors that sustained their employment. METHODS: A qualitative study using semi-structured interviews, analysed thematically, was carried out with 13 GPs and three practice managers from 15 general practices employing PAs in five areas of England. RESULTS: All practices were employing USA-trained PAs. Motivating factors for their employment included increasing the general practice capacity to manage patient demand within government targets for access, broaden the skill-mix in the practice team and financial considerations. The issues that needed to be taken into account in employing PAs included: the requirement for medical supervision; the PAs current lack of a regulatory framework and prescribing authority; and some patients' lack of familiarity with the concept of the PA. CONCLUSIONS: General practice employers view PAs as a positive addition to a mixed skill team for meeting patient demand within a practice's finances. There is a need to develop stronger governance and regulatory frameworks for this emerging profession.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Dal Poz M, Quain E, O'Neil M, McCaffery J, Elzinga G, Martineau T. Addressing the health workforce crisis: towards a common approach. Human Resources for Health 2006; 4: 21.
    • 2. Department of Health. Human Resources in the NHS Plan: More Staff Working Differently. London: Department of Health, 2002.
    • 3. Mittman DE, Cawley JF, Fenn WH. Physician assistants in the United States. BMJ 2002; 325:485-7
    • 4. Scheffler RM, Gillings DB. Survey approach to estimating demand for physician assistants. Soc Sci Med 1982; 16: 1039-47.
    • 5. National Centre for Health Statistics. Health, United States 2008. Washington: National Centre for Health Statistics, 2009.
    • 6. Ruby EB, Davidson LJ, Daly B et al: Care activities and outcomes of patients cared for by acute care nurse practitioners, physician assistants, and resident physicians: a comparison. Am J Crit Care 1998; 7:267­81
    • 7. Cawley JF, Rohrs FC, Hooker RS: Physician assistants and malpractice risk: findings from the national practitioner data bank. Fed Bull 1999; 85:242­6
    • 8. Hooker RS, Cipher DJ, Sekscenski E. Patient satisfaction with physician assistant, nurse practitioner, and physician care: a national survey of Medicare beneficiaries. J Clin Outcomes Manag 2005; 12:88-92
    • 9. Larson E, Hart LG, Ballweg R: National Estimates of Physician Assistant Productivity. J Allied Health 2001; 30:146-152
    • 10. Roblin DW, Howard DH, Becker ER, Adams EK, Roberts MH. Use of midlevel practitioners to achieve labor cost savings in the primary care practice of an MCO. Health Serv Res 2004; 39:607-625
    • 11. O'Connor TM, Hooker RS: Extending rural and remote medicine with a new type of health worker: Physician assistants. Aust J Rural Health 2007; 15:346-351
    • 12. McCabe D. The next wave: "physician extenders"? CMAJ 2007; 177:447
    • 13. Woodin J, McLeod H, McManus R. Evaluation of US-trained physician assistants working in the NHS in England : the introduction of US-trained physician assistants to primary care and accident and emergency departments in Sandwell and Birmingham: Final report. Health Services Management Centre, University of Birmingham; 2005.
    • (http://www.hsmc.bham.ac.uk/publications/Archive.shtml#2005).
    • 14. Farmer J, Currie M, West C, Hyman J, Arnott N. Evaluation Of Physician Assistants To NHS Scotland: Final Report. Inverness: UHI Millennium Institute, 2009. (http://www.nes.scot.nhs.uk/documents/publications)
    • 15. Department of Health. The Competence and Curriculum Framework for the Physician Assistant. London: Department of Health, 2006.
    • 16. Rogers EM. Diffusion of Innovations. (5th edition) New York: Free Press, 2003.
    • 17. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004; 82:581-629
    • 18. May C, Finch T, Mair F, et al. Understanding the implementation of complex interventions in health care: the normalization process model. BMC Health Services Research 2007; 7:148
    • 19. Sturges JE, Hanrahan KJ. Comparing Telephone and Face-to-Face Qualitative Interviewing: a Research Note.Qualitative Research 2004;4: 107-118.
    • 20. Hummers-Pradier E, Scheidt-Nave C, Martin H, Heinemann S, Kochen MM and Himmel W: Simply no time? Barriers to GPs' participation in primary health care research. Family Practice 2008; 25:105-12 .
    • 21. Department of Health. Priorities and Planning Framework (2003 - 2006). London: Department of Health, 2003.
    • 22. Department of Health: The NHS in England: the Operating Framework for 2007/2008. London: Department of Health, 2006.
    • 23. Huntingdon J .From Invention to Innovation pp 211-220 in Meads G (ed) Future Options for General Practice. Oxford : Radcliffe Medical Press, 2004.
    • 24. Jones R, Rosen R, Tomlin Z, Cavanagh MR, Oxley D. General practitioners with special interests: evolution and evaluation. J Health Serv Res Policy 2006; 11:106-9.
    • 25. Illife S. From General practice to Primary Care: The Industrialization of Family Medicine. Oxford: Oxford University Press, 2008.
    • 26. Exworthy M, Wilkinson EK, McColl A, et al. The role of performance indicators in changing the autonomy of the general practice profession in the UK. Soc Sci Med 2003;56:1493-504
    • 27. Working in Partnership Project [WiPP]. Minor Illness Management Case Studies undated accessed last on 15/1/10 at http://www.pagb.co.uk/information/minorillnessmanagement.html
    • 28. Royal College of General Practice. A Profile of UK General Practitioners. London : Royal College of General Practice, 2006.
    • 29. Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev 2005; 18:CD001271.
    • 30. Wanless D. HM Treasury. Securing good health for the whole population: Final report. London: HM Treasury, 2004.
    • 31. Meldrum H, Malone B . Letter to General Practitioners regarding practice nurses and the Agenda for Change. London: General Practitioners Committee of the British Medical Association, 2006.
    • 32. Lord J. Future of primary healthcare education: current problems and potential solutions. Postgraduate Medical Journal 2003; 79:553-560
    • 33. Van Der Weyden MB. Doctor displacement: a political agenda or health care imperative? Med J Aust 2008; 189:608-9
    • 34. NIHR SDO PC245 09-1801-1006. Investigating the contribution of physician assistants (PAs) to primary care in England . Drennan V, Halter M, De Lusignan S, Gage H , Gabe J and Brearley S.
    • 35. NHS Employers. Briefing Paper 52. Medical Training and Careers the Employers Vision. London: 2008.
    • 36. Hutt P. What has happened to general practice? BMJ Careers Online 13 March 2009 http://careers.bmj.com/careers/advice/view-article.html?id=20000088
    • 37. Appleby J, Crawford R, Emmerson C. How cold will it be? Prospects for NHS funding: 2011-17. London: Kings Fund
  • No related research data.
  • No similar publications.

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