Faculty of Health & Social Care Sciences, Kingston University & St George's, University of London, London, UK.
J Health Serv Res Policy. 2011 Apr;16(2):75-80. doi: 10.1258/jhsrp.2010.010061. Epub 2011 Mar 9.
Effective use of staff is a major aim in all health-care systems both to maximize their impact and to minimize costs. In England, a few general practitioners (GPs) have been recruiting physician assistants (PAs) to work in their practices, independent of any pilot schemes. Our objective was to study the motivation of GPs and practice managers who employed PAs and to understand the factors that sustained their employment.
A qualitative study using semi-structured interviews, analysed thematically, was carried out with 13 GPs and three practice managers from 15 general practices employing PAs in five areas of England.
All practices were employing USA-trained PAs. Motivating factors for their employment included increasing the general practice capacity to manage patient demand within government targets for access, broaden the skill-mix in the practice team and financial considerations. The issues that needed to be taken into account in employing PAs included: the requirement for medical supervision; the PAs current lack of a regulatory framework and prescribing authority; and some patients' lack of familiarity with the concept of the PA.
General practice employers view PAs as a positive addition to a mixed skill team for meeting patient demand within a practice's finances. There is a need to develop stronger governance and regulatory frameworks for this emerging profession.
在所有医疗保健系统中，有效利用员工是一个主要目标，既要最大限度地发挥他们的影响力，又要最大限度地降低成本。在英国，一些全科医生（GP）已经招募了医生助理（PA）在他们的诊所工作，而不受任何试点计划的限制。我们的目的是研究雇佣 PA 的 GP 和诊所经理的动机，并了解维持他们就业的因素。
采用半结构化访谈的定性研究，对来自英格兰五个地区的 15 家普通诊所的 13 名全科医生和 3 名诊所经理进行了分析。
所有的诊所都雇佣了来自美国的 PA。雇佣他们的动机包括：提高全科医生的能力，以满足政府对获得医疗服务的目标要求下的患者需求，拓宽实践团队的技能组合，以及财务方面的考虑。在雇佣 PA 时需要考虑的问题包括：医疗监督的要求；PA 目前缺乏监管框架和处方权；以及一些患者对 PA 概念的不熟悉。
全科医生雇主认为 PA 是混合技能团队的一个积极补充，可以满足实践在财务方面的患者需求。这个新兴职业需要建立更强有力的治理和监管框架。
