Monday, September 30, 2019

Special ESTH Library Bulletin: October 2019



Occasionally we produce special Current Awareness Bulletins to celebrate various promotional events.  For October 2019, we have put together a special bulletin to celebrate Physician Associates Week (7th to 13th October 2019).

This bulletin focuses on the impact of having physician associates/physician assistants (PAs) on patient care.  All the articles were published in the last three years and are open access so no passwords are required to read the full text.  This special issue bulletin also supports open access week October 21 - 27, 2019 

Physician associates appear to make a positive contribution to inpatient care
Abstract: This NIHR funded study considers the way that PAs are deployed and the appropriateness and also effectiveness of their work in relation to other team members.  A national survey shows that a small but growing number of hospitals are now using physician associates. The report concludes that the profession is being restrained by a lack of autonomy, preventing the role from fulfilling its potential.
Source: National Institute for Health Research Signal, 2019 [Freely available online]

Experience of the impact of physician associates on postgraduate medical training: a mixed methods exploratory study 
Abstract: This study sought to establish whether the introduction to new professional roles such as physicians associates to the multidisciplinary team dilutes the availability of learning opportunities, thereby detracting from postgraduate medical education.  The study involved employing 20 physicians associates in five different hospital sites to evaluate the effect on postgraduate medical education.  The overall findings support the notion
that new healthcare professionals do not detract from medical training.  The findings suggested that roles such as the physician associate have the potential to enhance postgraduate medical education. 
Source: Clinical Medicine 2019 Vol 19, No 1: 4–10 [Freely available online only]

What is the contribution of physician associates in hospital care in England? A mixed methods, multiple case study
Abstract: This study offers current insights into the deployment and contribution of PAs in medical and surgical specialties in English hospitals.  Through a national survey of medical directors participants for the survey were identified including s 43 PAs, 77 other health professionals, 28 managers and 28 patients and relatives.  The authors concluded that to realise the full potential of PAs an appropriate level of regulation and more is required.
Source: BMJ Open 2019;9:e027012. doi:10.1136/bmjopen-2018-027012 [Freely available online only]

Physician associates in England’s hospitals: a survey of medical directors exploring current usage and factors affecting recruitment
Abstract: In this study published in 2017, the authors reflect on the case for employing physicians associates in the secondary care setting in the UK by conducting a cross-sectional study using a structured self-report survey.  They explore factors supporting or inhibiting their inclusion in medical teams. 
Source: Clinical Medicine 2017 Vol 17, No 2: 126–31 [Freely available online only]
Abstract: Using a multicentre matched-controlled study in which medical doctors are employed for inpatient care were compared with a mixed model in which both medical doctors and PAs are employed.  The comparison was to determine whether there was on difference on patients’ length of stay, quality and safety of care, and patient experiences with the provided care.  The authors concluded that there was no difference between length of stay or quality of care between both groups however involvement of the PAs was associated with better experiences of patients.
Source: PLoS One. 2017 Aug 9;12(8):e0178212. doi: 10.1371/journal.pone.0178212. eCollection 2017 [Freely available online only]

Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach
Abstract: This study investigates the barriers and facilitators to the integration of Physician Associates into the general practice workforce.  The study concludes that there are a number of complex factors that may hinder the introduction of Physician Associates into UK primary care.  A conceptual model is introduced to help integration.
Source: British Journal of General Practice, November 2017, 67(664): e785-e791[Freely available online only]

Patients’ experiences of consultations with physician associates in primary care in England: A qualitative study
Abstract: Physician Associates (PAs) are new to English general practice and set to expand in numbers.  This qualitative study which used semi-structured interviews with a thematic analysis explored the patients' perspective of consulting with PAs  in general practice.  The study involved thirty volunteer patients out of 430 who had consulted PAs for a same-day appointment and had returned a satisfaction survey.  The patients were from six general practices in England that employ PAs. Patients reported both positive and negative experiences with PA consultation.  Negative experiences included the limitations of the PA role which required additional GP consultations.  The study concluded that patients saw PAs as an appropriate general practitioner substitute.  Patients' experience could inform delivery redesign.
Source: Health Expectations 2017 Oct; 20(5): 1011-1019 [Freely available online only]


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