Evaluation of Physician Assistants in Rural Primary Care

Duttera, M. J.; Harlan, William R.

doi:10.1001/archinte.1978.03630260036013

Cited by 16 publications

(8 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The evidence about retention is limited to two small studies from the USA [44,45]. One observational study reports that 14 of 17 PAs had been working in the same practice for one year or more [44] and a qualitative interview study suggests that confidence in their ability to provide adequate health care, a desire for small town life, and residing in and being involved in the community influence PAs to remain in primary care in remote locations [45].…”

Section: Resultsmentioning

confidence: 99%

“…The largest group of papers ( n = 18) offers descriptive accounts of the type of work activities performed by PAs [44,48,51,53,55-68]; all except two [53,68] are from USA, and the majority provide no comparative data with physicians or other staff the PAs work with (Additional file 2). These studies use survey, observation and medical record review methods with small and large samples and provide widely varying levels of detail about the clinical activities, age groups and other clinical and non-clinical activities undertaken by PAs.…”

Section: Resultsmentioning

confidence: 99%

“…These studies use survey, observation and medical record review methods with small and large samples and provide widely varying levels of detail about the clinical activities, age groups and other clinical and non-clinical activities undertaken by PAs. When the patient presenting conditions are classified as acute, chronic or preventative, the majority of studies report on acute conditions [44,55,56,58-60,63,65], ranging from conditions of unknown severity on presentation [59] to minor conditions [44,55,58-60,63,65]. Preventative and well person or insurance checks are also reported to form a large proportion of the PA workload [44,51,61,62,64-66], while providing care to patients with chronic conditions is reported less frequently amongst these USA studies [56,59,61].…”

Section: Resultsmentioning

confidence: 99%

“…When the patient presenting conditions are classified as acute, chronic or preventative, the majority of studies report on acute conditions [44,55,56,58-60,63,65], ranging from conditions of unknown severity on presentation [59] to minor conditions [44,55,58-60,63,65]. Preventative and well person or insurance checks are also reported to form a large proportion of the PA workload [44,51,61,62,64-66], while providing care to patients with chronic conditions is reported less frequently amongst these USA studies [56,59,61]. Other studies make more general statements about the PAs’ type of activity [48,60] or provide long lists by condition type rather than severity [64,66].…”

Section: Resultsmentioning

confidence: 99%

“…Comparative data with other groups present a picture of different consultation types between PAs and doctors: PAs see patients of all levels of complexity but patients are selected for consultations with PAs by presenting complaint [61]; doctors working in the same general practices as PAs attend more chronic, fewer acute conditions [58,67] and more serious problems [44], and PAs see patients with a younger age profile than that of those seen by doctors [67]. Similarity of the distributions of acute, chronic and preventative conditions seen by the PA with those seen by a nurse is suggested [56].…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

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

Halter

Drennan

Chattopadhyay

et al. 2013

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundPrimary care provision is important in the delivery of health care but many countries face primary care workforce challenges. Increasing demand, enlarged workloads, and current and anticipated physician shortages in many countries have led to the introduction of mid-level professionals, such as Physician Assistants (PAs). Objective: This systematic review aimed to appraise the evidence of the contribution of PAs within primary care, defined for this study as general practice, relevant to the UK or similar systems.MethodsMedline, CINAHL, PsycINFO, BNI, SSCI and SCOPUS databases were searched from 1950 to 2010. Eligibility criteria: PAs with a recognised PA qualification, general practice/family medicine included and the findings relevant to it presented separately and an English language journal publication. Two reviewers independently identified relevant publications, assessed quality using Critical Appraisal Skills Programme tools and extracted findings. Findings were classified and synthesised narratively as factors related to structure, process or outcome of care.Results2167 publications were identified, of which 49 met our inclusion criteria, with 46 from the United States of America (USA). Structure: approximately half of PAs are reported to work in primary care in the USA with good support and a willingness to employ amongst doctors. Process: the majority of PAs’ workload is the management of patients with acute presentations. PAs tend to see younger patients and a different caseload to doctors, and require supervision. Studies of costs provide mixed results. Outcomes: acceptability to patients and potential patients is consistently found to be 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.Limitations: identification of a broad range of studies examining ‘contribution’ made meta analysis or meta synthesis untenable.ConclusionsThe research evidence of the contribution of PAs to primary care was mixed and limited. However, the continued growth in employment of PAs in American primary care suggests that this professional group is judged to be of value by increasing numbers of employers. Further specific studies are needed to fill in the gaps in our knowledge about the effectiveness of PAs’ contribution to the international primary care workforce.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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

Halter

Drennan

Chattopadhyay

et al. 2013

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

BP Control

Hla¹

1983

Arch Intern Med

View full text Add to dashboard Cite

Factors influencing consumer receptivity to the nurse practitioner

Enggist

Hatcher

1983

J Med Syst

View full text Add to dashboard Cite

This paper describes a methodology to delineate factors associated with consumer acceptance of the medical nurse practitioner (MNP). The MNP is a category of new health practitioners with proficiency in medical/health care functions traditionally performed only by physicians. A process model approach was developed to study the significance of selected sociodemographic cognitive, attitudinal, and clinical/medical factors that are expected to predispose consumer acceptance of the MNP. The survey population consists of predominantly elderly and indigent ambulatory patients to an inner-city primary care clinic. The data were collected from 156 primary care patients before and after the introduction of the MNP program. The results clearly demonstrate consumer support for the new health practitioner concept. This finding is further substantiated in the "after" study. From an analysis of symptoms experience, symptom severity, and type of symptoms, symptoms experience emerged as the strongest indicator of consumer receptivity to MNP concept. Additionally, exposure to MNP caused the consumer to become more aware of proper consumption and increased the demand for physician care and specialty care where appropriate.

show abstract

Evaluation of Physician Assistants in Rural Primary Care

Cited by 16 publications

References 8 publications

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

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

BP Control

Factors influencing consumer receptivity to the nurse practitioner

Contact Info

Product

Resources

About