A comparative observational design was used, based on consultation records and a linked medical record review and patient satisfaction survey. The study was set in 12 volunteer general practices, six employing PAs and six not employing PAs, matched by practice size, sociodemographics of the practice population, and urban/rural geographical environment in the south, east, and southwest of England. Details of the staff in practices with and without PAs are given in Table 1.
How this fits in
Physician associates (previously known as physician assistants) are a new professional group in UK general practice, and evidence is required on their outcomes and costs. For patients attending for same-day or urgent appointments, PAs attended a younger patient group who present with less medically acute problems and fewer long-term conditions, compared to those attended by GPs. After adjusting for case-mix, there was no difference between PA 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 report high levels of satisfaction with PA and GP consultations. The average PA consultation was longer than with a GP, although costs per consultation with a PA were lower.
