Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Am J Ophthalmol. 2018 Jun;190:125-133. doi: 10.1016/j.ajo.2018.03.033. Epub 2018 Mar 28.
To describe the impact of a physician assistant (PA) in an academic ophthalmology consult service.
Evaluation research.
A PA was integrated into our ophthalmology consult service to enhance resident education. First-year resident annual surgical logs before and after the introduction of the PA were reviewed. Residents were anonymously surveyed for their perceptions regarding the impact of the PA integration on their residency experience. Consult wait time was compared for residents and the PA. Internal financial metrics for the PA were reviewed for a cost scenario analysis using 2016 national salary data for PAs.
The PA made approximately 28 days per year for each first-year resident available for alternative clinical assignments, which resulted in a 75% increase in total first-year resident annual surgical volume. The majority of residents (93%) strongly agreed that having a PA improved both their ophthalmic education (by enabling them to spend time on other clinical assignments) and their service-to-education balance on the consult rotation. Adjusted median consult wait time for residents was 28 minutes longer (P < .001) than for the PA. A PA would likely need to see an average of 8-12 patients per day to be cost neutral to a consult service.
Integrating a PA into an ophthalmology consult service can optimize the resident clinical service-to-education balance, reduce consult wait time, and be financially feasible. PAs trained in ophthalmology present a unique opportunity for all institutions that require clinical ophthalmology expertise.
描述医师助理（PA）在学术眼科咨询服务中的影响。
评估研究。
将一名 PA 整合到我们的眼科咨询服务中，以加强住院医师教育。回顾了引入 PA 前后第一年住院医师的年度手术记录。对住院医师进行了匿名调查，了解他们对 PA 整合对住院医师经历的影响的看法。比较了住院医师和 PA 的咨询等待时间。使用 2016 年全国 PA 薪资数据，对 PA 的内部财务指标进行了成本情况分析。
PA 每年为每位第一年住院医师提供约 28 天的替代临床任务时间，这使得第一年住院医师的总年度手术量增加了 75%。大多数住院医师（93%）强烈认为，有一名 PA 改善了他们的眼科教育（使他们能够将时间用于其他临床任务），并改善了他们在咨询轮转中的服务与教育平衡。调整后的住院医师中位数咨询等待时间比 PA 长 28 分钟（P <.001）。PA 每天需要看平均 8-12 名患者才能使咨询服务收支平衡。
将 PA 整合到眼科咨询服务中可以优化住院医师的临床服务与教育平衡，减少咨询等待时间，并且在财务上是可行的。在需要临床眼科专业知识的所有机构中，接受过眼科培训的 PA 提供了一个独特的机会。
