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Physician associate and general practitioner consultations : a comparative observational video study

de Lusignan, Simon, McGovern, Andrew P., Tahir, Mohammad Aumran, Hassan, Simon, Jones, Simon, Halter, Mary, Joly, Louise and Drennan, Vari M. (2016) Physician associate and general practitioner consultations : a comparative observational video study. PLoS One, 11(8), e0160902. ISSN (online) 1932-6203

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Abstract

BACKGROUND: Physician associates, known internationally as physician assistants, are a mid-level practitioner, well established in the United States of America but new to the United Kingdom. A small number work in primary care under the supervision of general practitioners, where they most commonly see patients requesting same day appointments for new problems. As an adjunct to larger study, we investigated the quality of the patient consultation of physician associates in comparison to that of general practitioners. METHOD: We conducted a comparative observational study using video recordings of consultations by volunteer physician associates and general practitioners with consenting patients in single surgery sessions. Recordings were assessed by experienced general practitioners, blinded to the type of the consulting practitioner, using the Leicester Assessment Package. Assessors were asked to comment on the safety of the recorded consultations and to attempt to identify the type of practitioner. Ratings were compared across practitioner type, alongside the number of presenting complaints discussed in each consultation and the number of these which were acute, minor, or regarding a chronic condition. RESULTS: We assessed 62 consultations (41 general practitioner and 21 physician associates) from five general practitioners and four physician associates. All consultations were assessed as safe; but general practitioners were rated higher than PAs in all elements of consultation. The general practitioners were more likely than physician associates to see people with multiple presenting complaints (p<0.0001) and with chronic disease related complaints (p = 0.008). Assessors correctly identified general practitioner consultations but not physician associates. The Leicester Assessment Package had limited inter-rater and intra-rater reliability. CONCLUSIONS: The physician associate consultations were with a less complex patient group. They were judged as competent and safe, although general practitioner consultations, unsurprisingly, were rated as more competent. Physician associates offer a complementary addition to the medical workforce in general practice.

Item Type: Article
Additional Information: This work was supported by the National Institute for Health Research (NIHR: www.nihr.ac.uk) Health Services and Delivery Research (HS & DR) programme under the management of the National Institute for Health Research Evaluations, Trials and Studies Coordinating Centre (NETSCC) as part of a commissioned project (Grant number: 09/1801/1066).
Research Area: Health services research
Faculty, School or Research Centre: Faculty of Health, Social Care and Education
Related URLs:
Depositing User: Vari Drennan
Date Deposited: 12 Sep 2016 13:41
Last Modified: 26 Jun 2017 10:51
URI: http://eprints.kingston.ac.uk/id/eprint/36009

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