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Physician Assistants in Emergency Medicine: The Impact of Their Role
Author(s) -
Hooker Roderick S.,
Klocko David J.,
Luke Larkin G.
Publication year - 2011
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2010.00953.x
Subject(s) - medicine , staffing , health care , mainstream , emergency department , scale (ratio) , quality (philosophy) , acute care , nursing , medical emergency , family medicine , philosophy , physics , theology , epistemology , quantum mechanics , economics , economic growth
ACADEMIC EMERGENCY MEDICINE 2011; 18:72–77 © 2011 by the Society for Academic Emergency Medicine Abstract Background: Emergency medicine (EM) in North America has been undergoing significant transformation since the new century. Recent health care reform has put it center stage. Access demand for acute care is increasing at the same time the number of qualified emergency physicians entering service has reached a plateau. Physician assistants (PAs), one alternative, are employed in emergency departments (EDs), but little is known about the impact of their role. Objectives: This was a literature review to identify the current role of PAs in patient treatment and the management of emergency services. Methods: All publications and designs from 1970 through 2009 were identified using multiple science citation indices. Each author reviewed the literature, and categories were developed based on consensus. Results: Thirty‐five articles and reports were sorted into categories of interest: prevalence of PAs in EDs, efficiency and quality of care, patient satisfaction, rural emergency care, and legal issues. Each category is summarized and discussed. Evidence comparing the clinical effectiveness of PAs to mainstream management of emergency care was only fair in methodologic quality. Conclusions: The use of PAs in EDs is increasing, and this expansion is due to necessity in staffing and economy of scale. Unique uses of PAs include wound management, acute care transfer management to the wards, and rural health emergency staffing. While their role seems to be expanding, this assessment identified gaps in deployment research using appropriate outcome measures in the area of clinical effectiveness of PAs.