Underutilization of physician assistants in physical medicine and rehabilitation.

This study was undertaken to determine the utilization of physician assistants (PAs) in physical medicine and rehabilitation (PM&R). Survey questionnaires were sent to members of the American Academy of Physical Medicine and Rehabilitation, members of the American Academy of Physician Assistants, and administrators of free-standing rehabilitation facilities. One hundred thirty-seven of 1,082 physiatrists (13% of those responding) reported PAs employed in their practice settings, 83 of 549 PAs (15% of those responding) identified PM&R as their specialty, and 17 of 65 hospital administrators, (27% of those responding) reported PAs working at their facility. Seventy-nine percent (713 of 903) of physicians and 77% (50 of 65) of administrators were unaware that PA services provided in inpatient settings are reimbursed by Medicare. Eighty-four percent (108 of 129) of physiatrists employing PAs indicated that they would continue to do so even if the supply of physiatrists were adequate. PA responsibilities were concentrated in inpatient clinical areas. It is concluded that PAs are an underutilized source of health care for rehabilitation patients. Increased professional visibility and formal specialty training are recommended to enhance their contribution to the field.