The Role, Contribution and Utilization of Physician Assistants in Primary Care
Keywords:Physician assistants, primary care, contribution, role, utilization
To understand the role, contribution, and utilization of physician assistants in the primary care setting. This systematic review aims to provide an accurate depiction of the growth and impact of the physician assistant profession in this field of medicine.
Using electronic databases MEDLINE and EMBASE, a review was undertaken using specified search terms of articles between the years of 2010 - 2019. In this review, the eligibility criteria were English language studies conducted in North America or the United Kingdom, PAs working in primary care with recognized PA qualifications and research findings relevant to PAs that are presented separately.
At least 1029 publications were identified, of which 15 articles met the inclusion criteria. Ten of these studies were based in the United States, while five were based in the United Kingdom. PAs in primary care were found to see less complicated patients, required supervision, and improved the patient caseload for physicians. The patients’ acceptance of PAs is on the rise as more knowledge about the skills and roles become prominent.
This review highlights the role of PAs in the primary care field, though more research is needed in areas such as patient outcomes to clearly understand the contribution and utilization of PAs in primary care.
2. Mitra G, Gowans M, Wright B, Brenneis F, Scott I. Predictors of rural family medicine practice in Canada. Can Fam Physician [Internet]. College of Family Physicians of Canada; 2018 Aug;64(8):588–96. https://www.ncbi.nlm.nih.gov/pubmed/30108078
3. Hooker RS, Everett CM. The contributions of physician assistants in primary care systems. Health Soc Care Community [Internet]. John Wiley & Sons, Ltd (10.1111); 2012 Jan 1;20(1):20–31. Available from: https://doi.org/10.1111/j.1365-2524.2011.01021.x
4. Cawley JF. POLICY FORUM Physician Assistants and Their Role in Primary Care [Internet]. American Medical Association Journal of Ethics. 2012. www.virtualmentor.org
5. Jones IW, St-Pierre N. Physician assistants in Canada. J Am Acad PAs [Internet]. 2014;27(3). https://journals.lww.com/jaapa/Fulltext/2014/03000/Physician_assistants_in_Canada.2.aspx
6. de Lusignan S, McGovern AP, Tahir MA, Hassan S, Jones S, Halter M, et al. Physician Associate and General Practitioner Consultations: A Comparative Observational Video Study. PLoS One [Internet]. Public Library of Science; 2016 Aug 25;11(8):e0160902 –. https://doi.org/10.1371/journal.pone.0160902
7. Drennan VM, Chattopadhyay K, Halter M, Brearley S, de Lusignan S, Gabe J, et al. Physician assistants in English primary care teams: A survey. J Interprof Care [Internet]. Taylor & Francis; 2012 Sep 1;26(5):416–8. https://doi.org/10.3109/13561820.2012.686538
8. Dai M, Ingham RC, Peterson LE. Scope of Practice and Patient Panel Size of Family Physicians Who Work With Nurse Practitioners or Physician Assistants. http://journals.stfm.org/media/2253/dai-2018-0146.pdf
9. Jackson B, Marshall M, Schofield S. Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach. Br J Gen Pract [Internet]. 2017 Nov 1;67(664):e785. http://bjgp.org/content/67/664/e785.abstract
10. Halter M, Drennan VM, Joly LM, Gabe J, Gage H, de Lusignan S. Patients’ experiences of consultations with physician associates in primary care in England: A qualitative study. Heal Expect [Internet]. John Wiley & Sons, Ltd (10.1111); 2017 Oct 1;20(5):1011–9. https://doi.org/10.1111/hex.12542
11. Henry LR, Hooker RS. Caring for the disadvantaged: The role of physician assistants. J Am Acad PAs [Internet]. 2014;27(1). https://journals.lww.com/jaapa/Fulltext/2014/01000/Caring_for_the_disadvantaged___The_role_of.10.aspx
12. Farmer J, Currie M, Hyman J, West C, Arnott N. Evaluation of physician assistants in National Health Service Scotland. Scott Med J [Internet]. SAGE Publications; 2011 Aug 1;56(3):130–4. https://doi.org/10.1258/smj.2011.011109
13. Doescher MP, Andrilla CHA, Skillman SM, Morgan P, Kaplan L. The Contribution of Physicians, Physician Assistants, and Nurse Practitioners Toward Rural Primary Care: Findings From a 13-State Survey. Med Care [Internet]. 2014;52(6). https://journals.lww.com/lww-medicalcare/Fulltext/2014/06000/The_Contribution_of_Physicians,_Physician.12.aspx
14. Drennan VM, Halter M, Brearley S, Carneiro W, Gabe J, Gage H, et al. Investigating the contribution of physician assistants to primary care in England: a mixed-methods study. Heal Serv Deliv Res. National Institute for Health Research; 2014 May;2(16):1–136.
15. Drennan VM, Halter M, Joly L, Gage H, Grant RL, Gabe J, et al. Physician associates and GPs in primary care: a comparison. Br J Gen Pract [Internet]. 2015 May 1;65(634):e344. http://bjgp.org/content/65/634/e344.abstract
16. Kurtzman ET, Barnow BS. A Comparison of Nurse Practitioners, Physician Assistants, and Primary Care Physicians’ Patterns of Practice and Quality of Care in Health Centers. Med Care [Internet]. 2017;55(6). https://journals.lww.com/lww-medicalcare/Fulltext/2017/06000/A_Comparison_of_Nurse_Practitioners,_Physician.11.aspx
17. Liu H, Robbins M, Mehrotra A, Auerbach D, Robinson BE, Cromwell LF, et al. The Impact of Using Mid-level Providers in Face-to-Face Primary Care on Health Care Utilization. Med Care [Internet]. 2017;55(1). https://journals.lww.com/lww-medicalcare/Fulltext/2017/01000/The_Impact_of_Using_Mid_level_Providers_in.3.aspx
18. Stange K. How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants. J Health Econ [Internet]. North-Holland; 2014 Jan 1 [cited 2019 Dec 9];33:1–27. https://www.sciencedirect.com/science/article/abs/pii/S0167629613001410
19. Morgan PA, Smith VA, Berkowitz TSZ, Edelman D, Van Houtven CH, Woolson SL, et al. Impact of physicians, nurse practitioners, and physician assistants on utilization and costs for complex patients. Health Aff. Project HOPE; 2019 Jun 1;38(6):1028–36.
20. Roblin D, Liu H, Cromwell L, Robbins M, Robinson B, Auerbach D, et al. Provider type and management of common visits in primary care. Am J Manag Care. 2017 Apr 1;23.
How to Cite
Authors published in the Journal of Canada's Physician Assistants (JCanPA) retain copyright of their articles, including all drafts and final published version. By agreeing to publish in JCanPA, authors grant the journal the right of first publication and distribution rights of the articles. Authors are free to submit their work to other publications in addition to JCanPA, provided they acknowledge its initial publication in JCanPA.
JCanPA is published online in the public domain. JCanPA holds no legal responsibility as to how these materials are used by the public. Please ensure all authors, co-authors, and investigators have read and agree to these terms.