医师助理视角下的 ASCO 劳动力研究：关于医师助理和护士从业者的使用。

Physician Assistant Perspective on the ASCO Workforce Study Regarding the Use of Physician Assistants and Nurse Practitioners.

机构信息

The University of Texas M. D. Anderson Cancer Center, Houston, TX, and Duke University, Durham, NC.

出版信息

J Oncol Pract. 2010 Jan;6(1):31-3. doi: 10.1200/JOP.091063. Epub 2009 Dec 23.

DOI:10.1200/JOP.091063

PMID:20539729

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2805342/

Abstract

PURPOSE

A workforce study by the Association of American Medical Colleges (AAMC) predicted a shortage of 2,350 to 3,800 oncologists, or 9.5 to 15 million visits, by 2020. Proposed solutions included use of physician assistants (PAs) and nurse practitioners (NPs). Although 56% of the oncologists reported working with PAs/NPs, the AAMC did not survey PAs or NPs. This article uses additional data to examine the role of PAs/NPs in the oncology workforce.

MATERIALS AND METHODS

American Academy of Physician Assistant (AAPA) census data and a study of PAs in oncology were used to examine these workforce issues.

RESULTS

The AAMC reported oncologists working with PAs/NPs had increased productivity compared with physicians who did not, primarily when the PAs/NPs performed advanced roles or worked in private practice. Visits handled by PAs/NPs themselves were not reported. According to the AAPA, PAs in the outpatient setting saw an average of 62.4 patients per week (inpatient PAs saw 62.2 patients per week), supporting the AAMC report that 70% to 92% of oncologists experienced increased efficiency with PAs/NPs. Whereas the AAMC reported that 46.4% of oncologists used PAs/NPs in advanced roles, Ross et al reported that more than 70% of PAs wrote chemotherapy orders (most requiring physician co-signature); more than 80% wrote prescriptions, including for controlled substances; and more than half performed invasive procedures. The AAMC reported that 13% of PAs/NPs performed research activities, and the AAPA reported that 60.5% of medical oncology PAs participated in clinical trials.

CONCLUSION

The AAMC workforce study inadequately examined the role of PAs/NPs in oncology. Given the available data in PA literature, the contribution of PAs/NPs to the workforce was substantially underestimated. In examining workforce issues, understanding opportunities for increasing collaborative practice requires the input of PAs/NPs.

摘要

目的

美国医学协会（AAMC）的一项劳动力研究预测，到 2020 年，将短缺 2350 至 3800 名肿瘤学家，或 950 至 1500 万次就诊。提出的解决方案包括使用医师助理（PA）和护士从业者（NP）。尽管 56%的肿瘤学家报告说与 PA/NP 一起工作，但 AAMC 并未对 PA 或 NP 进行调查。本文使用其他数据来研究 PA/NP 在肿瘤学劳动力中的作用。

材料和方法

使用美国医师助理学会（AAPA）的人口普查数据和对肿瘤学中 PA 的研究来研究这些劳动力问题。

结果

AAMC 报告说，与没有 PA/NP 合作的医生相比，与 PA/NP 合作的肿瘤学家的生产力有所提高，主要是当 PA/NP 担任高级职务或在私人诊所工作时。没有报告 PA/NP 自己处理的就诊次数。根据 AAPA 的说法，门诊的 PA 每周平均看 62.4 名患者（住院 PA 每周看 62.2 名患者），这支持了 AAMC 的报告，即 70%至 92%的肿瘤学家在使用 PA/NP 方面提高了效率。虽然 AAMC 报告说 46.4%的肿瘤学家在高级职位上使用 PA/NP，但 Ross 等人报告说，超过 70%的 PA 开具化疗医嘱（大多数需要医生共同签字）；超过 80%的人开具处方，包括控制药物；超过一半的人进行了侵入性操作。AAMC 报告说，13%的 PA/NP 从事研究活动，而 AAPA 报告说，60.5%的肿瘤学 PA 参与临床试验。