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Potential for physician associates to ease pressure on primary care


A new type of “mid-level” primary care professional could offer a helpful addition to the general practice workforce in the UK at a time of repeated warnings of staffing crises, claim researchers.

They noted that one potential solution to problems of GP shortages was the development of “mid-level” professionals, such as nurse practitioners and physician assistants.

“This is the first major study of the work of physician associates in primary care”

Study authors

Physician associates – previously known as physician assistants – are a new professional group in the UK , though they are well established in the US.

They have the education and training to diagnose, treat, and refer autonomously within practice boundaries, as specified by their employing practice or local clinical commissioning group.

Researchers led by Professor Vari Drennan, from Kingston University and St George’s University London, set out to look at evidence on their outcomes and costs for the first time in the UK.

They compared six practices where physician associates were employed with six similar practices that did not have associates.

The primary outcome of the study was whether patients had a re-consultation within 14 days for the same or linked problem. Secondary outcomes were processes of care.

The study authors found no difference between physician associate and GP consultations in the rate of investigations, referral to secondary care, prescriptions issued, or the rate of patient re-consultation for the same or a closely related problem within 14 days.

Patients reported high levels of satisfaction with both forms of consultations.

The average physician associate consultation was 5.8 minutes longer than with a GP, although costs per consultation were about £6 lower.

The researchers suggested physician associates had the “potential to be an asset to the primary care workforce” in the face of shortages among the GP workforce, increasing demands and financial restraints.

The study, funded by the National Institute for Health Research, has been published in the British Journal of General Practice.

Dr Chaand Nagpaul, chair of the British Medical Associations’ GP committee, said: “Physician associates can perform a valuable role as part of a wider health team and there is some scope for them to take pressure off GPs by performing some defined clinical tasks.”

Dr Helen Stokes-Lampard, honorary treasurer of the Royal College of GPs, added that physician associates could play a “vital” role in supporting doctors and other members of the practice team.

“Widening the general practice team to include more physician associates and other roles is beneficial for patients and for general practice,” she said.


Readers' comments (7)

  • There is a clear need to meet demand and PA's could help meet that demand.
    I would take issue with the statement that PA's are in some way equated to NPs in the "mid level professionals" group. There are substantial differences. PAs do not practice independently of physicians (NPs do) they cannot do core things like prescribe currently. NPs lead services as systems leaders in some cases (not only "mid level") PA training is 2 years PG training an NP is more likely to have years of experience.
    We have enough people devaluing the profession-NT please dont add to the misperceptions of nursing!

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  • Removed due to offensive nature. Please refer to this site's terms and conditions before posting further:<br/>

  • Dear anonymous, I would like to take issue with your comment above. Please can you clarify what you mean by lethal?

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  • bob cat

    Agreed Ruth.

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  • I agree both anonymous needs to clarify their points. PAs by their very nature are post graduates often with other healthcare science backgrounds, so at least 5 years at university. They can not prescribe but neither can a lot of practice nurses, until they choose to. If it means triaging patients with more appointments for routine care and patients with greater need get to see gps then I'm all for it. We're seeing an increasing workload with decreasing budgets and resources, every little helps. NP and ANPs were resisted at first.

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  • Oh dear who is saying that PAs and NPs are lethal-how upsetting for all of us who have strived to fill the gaps for little remuneration but lots of job satisfaction. Come on Anon let us hear your views and why as it may be valuable for all of us including patients.
    Vari it would be great if you could espouse the usefulness of NPs too-especially as we work in the same place!! Many of the changes that you see today came about as a result of the hard work of NPs who have had to wrok hard to get where they are today in the face of poor media and public value.

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  • It is interesting that NP's and ANP's are barely mentioned. They have been developing for the last nearly 15 years is it now? Might be longer.

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