Patient satisfaction with physician assistant/associate care: an international scoping review

Abstract

BackgroundAs the role of the physician assistant/associate grows globally, one question is: what is the level of patient satisfaction with PAs? Driven by legislative enactments to improve access to care, the PA has emerged as a ready and able medical professional to address workforce shortages. The aim of this study was to review the literature on patient satisfaction of PAs.ObjectivesThe basis for this review was to clarify working definitions, synthesize the evidence, and establish conceptual boundaries around the topic of patient satisfaction with PAs. The intent was to identify gaps in the literature and offer suggested undertakings for more clarification on the subject.MethodsA scoping review was undertaken. Literature from 1968 to 2019 was searched and filtered for eligibility. Those that met criteria were categorized by date, method, geography, themes, and design.ResultsIn total, there were 987 papers or reports that were identified through bibliography database searching. Additional articles found through snowball methodology-reviewing references (n = 11). Only English language articles emerged for analysis. From this effort, 25 articles surfaced from the filtering process for final inclusion. Most (72%) of the articles came from the United States of America, three from the United Kingdom, and one each from Ireland, the Netherlands, and New Zealand. Most articles were descriptive in nature. Some variations in methods emerged.ConclusionPAs are operational in 15 nations; their acceptance appears successful and satisfaction with their care largely indistinguishable from physicians. Findings from this analysis highlight one theory that when patient’s needs are met, satisfaction is high regardless of the medical provider. Areas for further research are identified.

Predictive factors of the general public’s willingness to be seen and seek treatment from a nurse practitioner in Australia: a cross-sectional national survey

“…In our study, we found that while there is limited understanding of the NP role amongst the Australian public, this had no relationship to their willingness to receive treatment and autonomous episodes of care from an NP. Indeed, a recent international scoping review of patient satisfaction with independent care provided by adjunct health care providers, such as the physician assistants, found that people are generally satisfied with care received, regardless of medical provider [ 23 ]. Health care consumer support, willingness and acceptance for autonomous and complementary models of health care are fundamental to informing policy change [ 24 ].…”

“…The scope of the Australian NP practice includes: managing patient episodes of care, initiation and interpretation of diagnostic and pathology investigations, endorsement to prescribe medications, patient education and health promotion, admission and discharge rights and referrals for specific patient groups [ 10 , 11 , 18 – 21 ]. As increasingly more NPs are getting established in the Australian public sector workforce [ 17 , 22 ] and to a lesser extent in the private, community and primary care settings [ 12 ], the question as to what patients want continues to emerge [ 23 ].…”

“…Patient reported outcome measures such as patient experience and satisfaction are fundamental measure of quality health care [ 25 ]. Patient perception of care is important as satisfaction correlates with compliance, improved health outcomes and quality of life [ 23 ]. While consumer experience and satisfaction with the NP role is well documented in the international and Australian literature [ 9 , 11 , 26 – 36 ], much of this evidence has been collected during or following NP consultations.…”

Paramedics and Physician Assistants in Israel

“…Satisfaction came along quickly. Patients were willing to see any reliable health provider as long as their needs were met, and quality was not compromised [10].…”

Willingness of medical students to refer patients to a physician associate or a doctor based on clinical scenarios when time is a trade-off

“…Patient acceptance of PAs is positive across four continents and their willingness to see a PA is growing. [1] However, the acceptance of PAs from the perspective of medical students has not been explored. According to Stone (2018) the delivery of quality, cost-effective medical care is increasingly relying upon team-based care.…”