Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
Intended for Healthcare Professionals
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
  • Listen to BJGP podcast
  • Subscribe BJGP on YouTube
British Journal of General Practice
Intended for Healthcare Professionals

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • BJGP LIFE
  • MORE
    • About BJGP
    • Conference
    • Advertising
    • eLetters
    • Alerts
    • Video
    • Audio
    • Librarian information
    • Resilience
    • COVID-19 Clinical Solutions
Research

Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach

Ben Jackson, Michelle Marshall and Susie Schofield
British Journal of General Practice 2017; 67 (664): e785-e791. DOI: https://doi.org/10.3399/bjgp17X693113
Ben Jackson
Academic Unit of Primary Medical Care;
Roles: Senior clinical teacher
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michelle Marshall
Academic Unit of Medical Education, University of Sheffield, Sheffield.
Roles: Director of learning and teaching
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Susie Schofield
Centre for Medical Education, University of Dundee, Dundee.
Roles: Senior lecturer
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info
  • eLetters
  • PDF
Loading

Published eLetters

eLetter submission guidelines

Submit a Response to This Article
Compose eLetter

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com. PLEASE NOTE: your email address will be published.
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

Jump to comment:

  • Medical students: the most underutilised resource in the NHS
    Eugene Y.H. Yeung
    Published on: 04 March 2018
  • Patients acceptance of physician associates
    Andrea J. Clarke and Hugh Alberti
    Published on: 03 December 2017
  • Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach
    Sam Roberts, Laura Stroud and Helen E. Millott
    Published on: 02 November 2017
  • Published on: (4 March 2018)
    Page navigation anchor for Medical students: the most underutilised resource in the NHS
    Medical students: the most underutilised resource in the NHS
    • Eugene Y.H. Yeung, Medical Doctor, Royal Lancaster Infirmary, UK
    There are ongoing debates on whether expanding the roles of other healthcare professionals can reduce doctors' workload, and who should fund these professionals.1-4  We do not realise we have been under-using one valuable resource in the NHS: our medical students!
     
    After completing medical electives in North America, I feel impressed by how our counterparts utilise medical students at work. For example, during a hospital placement, a year 3 medical student works for free as a clinical clerk, who helps to clerk new patients, prepare discharge summaries, and manage the day-to-day care of his assigned patients. Students are required to work full-time hours, which include buddying up with the junior doctors (called ‘residents’ in North America) in their on-call shifts. In return, the junior doctors spend time supervising and teaching the students on the job. This model not only empowers students and improves their clinical experience, but also reduces the workload and reinforce continued education of doctors. Many students I encountered find these responsibilities and practical learning experience valuable to their career.
     
    I have enthusiastically shared this idea with my British colleagues, who tend to respond with ‘we are not the Americans’ that end the conversations. But I see British nursing students actively involved in patient care like a registered nurse. Recently,...
    Show More
    There are ongoing debates on whether expanding the roles of other healthcare professionals can reduce doctors' workload, and who should fund these professionals.1-4  We do not realise we have been under-using one valuable resource in the NHS: our medical students!
     
    After completing medical electives in North America, I feel impressed by how our counterparts utilise medical students at work. For example, during a hospital placement, a year 3 medical student works for free as a clinical clerk, who helps to clerk new patients, prepare discharge summaries, and manage the day-to-day care of his assigned patients. Students are required to work full-time hours, which include buddying up with the junior doctors (called ‘residents’ in North America) in their on-call shifts. In return, the junior doctors spend time supervising and teaching the students on the job. This model not only empowers students and improves their clinical experience, but also reduces the workload and reinforce continued education of doctors. Many students I encountered find these responsibilities and practical learning experience valuable to their career.
     
    I have enthusiastically shared this idea with my British colleagues, who tend to respond with ‘we are not the Americans’ that end the conversations. But I see British nursing students actively involved in patient care like a registered nurse. Recently, a British colleague shared a similar view on expanding medical students’ involvement at work, which I am elated to hear.5
     
    We can apply this practical teaching model in general practice, in which we have students to help doctors documenting in the electronic notes, seeing patients to collect detailed histories, and most importantly, building rapports with patients. Their presence can supplement the insufficient 10-minute consultation time of GPs.6 Patients may be more willing to interact with students who are assisting the doctors, than those who are simply observing and learning for their own benefits.
     
    We heard of seniors feeling upset of how unprepared the current medical graduates are.7 It is time we advocate for more respect and responsibilities to our students, which can improve their career preparation and job satisfaction.
     
    References
    1. Avery AJ. Pharmacists working in general practice: can they help tackle the current workload crisis? Br J Gen Pract 2017;67(662):390-391.
    2. Yeung EY. Explaining the role of pharmacists in multidisciplinary care. Br J Gen Pract 2017;67(663):447-448.
    3. Yeung EY. Pharmacists are not physician assistants. Br J Gen Pract 2017;67(665):548-548.
    4. Jackson B, Marshall M, Schofield S. Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach. Br J Gen Pract 2017;67(664):e785-e791.
    5. Walsh S. Do more with the students who come to our wards. London: The BMJ Opinion; 2017 Oct 23; cited [Nov 3, 2017]. Available from: http://blogs.bmj.com/bmj/2017/10/23/sebastian-walsh-patient-centred-learning/.
    6. McCartney M. Why GPs are always running late. BMJ 2017;358:j3955.
    7. Yeung EYH. How are junior doctors supposed to learn without the opportunity? BMJ 2017;359:j5057.
     
    Show Less
    Competing Interests: None declared.
  • Published on: (3 December 2017)
    Page navigation anchor for Patients acceptance of physician associates
    Patients acceptance of physician associates
    • Andrea J. Clarke, GP, Senior Medical Tutor, Newcastle University
    • Other Contributors:
      • Hugh Alberti, GP, Subdean for primary and community care, Newcastle University
    We read with interest the study by Jackson et al1 exploring the barriers and facilitators to integration of physician associates (PAs) into the general practice workforce. We have a similar interest given that the first cohort of PAs trained at Newcastle University will graduate in October 2018 and the Northeast of England has a well-known shortage of GPs. We have completed a pilot study of patients’ awareness and acceptance of PAs and PA consultations in two County Durham practices. Patients were asked to complete a short anonymous survey while waiting in the waiting room of the two practices. The survey included some information about the role and an opportunity for free text comments and there were 72 responders.
     
    The results showed that 58% of patients had not heard of a PA, in spite of the fact that both practices had a PA student attached to the practice one day a week. 65% of responding patients were accepting of a PA consultation, 18% felt they would like to know more about the role first, 14% would rather wait for a Nurse Practitioner or GP appointment even if they had to wait longer, and 3% preferred to wait for a GP only. There were some caveats around appointment choice expressed in free text comments, such as ‘it would depend on my ailment’, but in conclusion, results showed a general acceptance of PA consultations, in a population unfamiliar with the role.
     
    Our...
    Show More
    We read with interest the study by Jackson et al1 exploring the barriers and facilitators to integration of physician associates (PAs) into the general practice workforce. We have a similar interest given that the first cohort of PAs trained at Newcastle University will graduate in October 2018 and the Northeast of England has a well-known shortage of GPs. We have completed a pilot study of patients’ awareness and acceptance of PAs and PA consultations in two County Durham practices. Patients were asked to complete a short anonymous survey while waiting in the waiting room of the two practices. The survey included some information about the role and an opportunity for free text comments and there were 72 responders.
     
    The results showed that 58% of patients had not heard of a PA, in spite of the fact that both practices had a PA student attached to the practice one day a week. 65% of responding patients were accepting of a PA consultation, 18% felt they would like to know more about the role first, 14% would rather wait for a Nurse Practitioner or GP appointment even if they had to wait longer, and 3% preferred to wait for a GP only. There were some caveats around appointment choice expressed in free text comments, such as ‘it would depend on my ailment’, but in conclusion, results showed a general acceptance of PA consultations, in a population unfamiliar with the role.
     
    Our pilot study indicates few barriers for physician associates in terms of patient agreement. However, we agree with Jackson and colleagues1 that there is much work to be done in addressing the many complexities around their integration and acceptance by primary care teams themselves.
     
    References
    1. Jackson B., Marshall M., Schofield S. Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach. Br J Gen Pract 2017;67 (664)e:785-e791.
    Show Less
    Competing Interests: None declared.
  • Published on: (2 November 2017)
    Page navigation anchor for Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach
    Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach
    • Sam Roberts, Clinical Leadership Fellow, Health Education England
    • Other Contributors:
      • Laura Stroud, Professor of Public Health and Education Innovation, Leeds Institute of Health Sciences, University of Leeds
      • Helen E. Millott, Programme Lead, PG Diploma Physician Associate Studies, Leeds Institute of Medical Education, University of Leeds
    We have observed first-hand the barriers to integration of physician associates into the general practice workforce described by Jackson and collegues.1 Despite a strong emphasis on primary care within our physician associate course, a paucity of local primary care positions resulted in all but one of our first cohort of qualified physician associates being appointed to posts within two local secondary care trusts.
     
    We have appointed a clinical leadership fellow to work with stakeholders in developing roles for physician associates and we are striving to create an environment in which physician associates become an established part of the primary care workforce.
     
    Since the establishment of secondary care roles for physician associates within the two local trusts, we have observed unprecedented interest from secondary care with almost all trusts in our area planning to create roles for physician associates. We hope that we will see this process replicated in primary care and that by developing ‘pioneer programmes’ to introduce physician associates to the primary care workforce within our region, we can demonstrate to the rest of our general practice colleagues how the barriers to physician associate integration can be managed and that physician associates themselves can become the facilitators of a dynamic, sustainable general practice workforce for the future.
     
    ...Show More
    We have observed first-hand the barriers to integration of physician associates into the general practice workforce described by Jackson and collegues.1 Despite a strong emphasis on primary care within our physician associate course, a paucity of local primary care positions resulted in all but one of our first cohort of qualified physician associates being appointed to posts within two local secondary care trusts.
     
    We have appointed a clinical leadership fellow to work with stakeholders in developing roles for physician associates and we are striving to create an environment in which physician associates become an established part of the primary care workforce.
     
    Since the establishment of secondary care roles for physician associates within the two local trusts, we have observed unprecedented interest from secondary care with almost all trusts in our area planning to create roles for physician associates. We hope that we will see this process replicated in primary care and that by developing ‘pioneer programmes’ to introduce physician associates to the primary care workforce within our region, we can demonstrate to the rest of our general practice colleagues how the barriers to physician associate integration can be managed and that physician associates themselves can become the facilitators of a dynamic, sustainable general practice workforce for the future.
     
    Reference
    1. Jackson B, Marshall M, Schofield S. Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach. Br J Gen Pract 2017;67(664):e785-e791.
     
    Show Less
    Competing Interests: None declared.
Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 67 (664)
British Journal of General Practice
Vol. 67, Issue 664
November 2017
  • Table of Contents
  • Index by author
Download PDF
Download PowerPoint
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach
Ben Jackson, Michelle Marshall, Susie Schofield
British Journal of General Practice 2017; 67 (664): e785-e791. DOI: 10.3399/bjgp17X693113

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Barriers and facilitators to integration of physician associates into the general practice workforce: a grounded theory approach
Ben Jackson, Michelle Marshall, Susie Schofield
British Journal of General Practice 2017; 67 (664): e785-e791. DOI: 10.3399/bjgp17X693113
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • Abstract
    • INTRODUCTION
    • METHOD
    • RESULTS
    • DISCUSSION
    • Acknowledgments
    • Notes
    • REFERENCES
  • Figures & Data
  • Info
  • eLetters
  • PDF

Keywords

  • acceptability of health care
  • general practice
  • healthcare delivery
  • interprofessional relations
  • physician assistant

More in this TOC Section

  • Academic performance of ethnic minority versus White doctors in the MRCGP assessment 2016-2021: cross sectional study
  • Diagnostic delays for breathlessness: a qualitative study in primary care to understand current care and inform future pathways
  • Physical activity for chronic back pain: qualitative interviews among patients and GPs
Show more Research

Related Articles

Cited By...

Intended for Healthcare Professionals

BJGP Life

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Life
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44 (0)20 3188 7400
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2023 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242