ArticleBMJ open2016
Determinants of the sustained employment of physician assistants in hospitals: a qualitative study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- How Government Policies and Organisational and Sectoral Circumstances Influence Nurse Practitioner and Physician Assistant Employment and Training: A Realist Analysis Using Surveys.Journal of advanced nursing · 2026Article
- Developing and integrating physician assistants/associates in UK hospital teams: a realist review of lessons from international experiences.BMC medicine · 2025Review
- Article
- A survey exploring factors affecting employment of physician associates in Ireland.Irish journal of medical science · 2023Article
- Introducing physician associates to hospital patients: Development and feasibility testing of a patient experience-based intervention.Health expectations : an international journal of public participation in health care and health policy · 2021Article
- Article
- Understanding patients' satisfaction with physician assistant/associate encounters through communication experiences: a qualitative study in acute hospitals in England.BMC health services research · 2019Article
- Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: a realist evaluation case study.BMJ open · 2019Article
- Analysis of the level of clinical skills of physician assistants tested with simulated intensive care patients.Journal of evaluation in clinical practice · 2018Article
- The involvement of physician assistants in inpatient care in hospitals in the Netherlands: a cost-effectiveness analysis.BMJ open · 2017Observational
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo identify determinants of the initial employment of physician assistants (PAs) for inpatient care as well as of the sustainability of their employment.
designWe conducted a qualitative study with semistructured interviews with care providers. Interviews continued until data saturation was achieved. All interviews were transcribed verbatim. A framework approach was used for data analysis. Codes were sorted by the themes, bringing similar concepts together.
settingThis study was conducted between June 2014 and May 2015 within 11 different hospital wards in the Netherlands. The wards varied in medical speciality, as well as in hospital type and the organisational model for inpatient care.
participantsParticipant included staff physicians, residents, PAs and nurses.
resultsThe following themes emerged to be important for the initial employment of PAs and the sustainability of their employment: the innovation, individual factors, professional interactions, incentives and resources, capacity for organisational change and social, political and legal factors.
conclusions10 years after the introduction of PAs, there was little discussion among the adopters about the added value of PAs, but organisational and financial uncertainties played an important role in the decision to employ and continue employment of PAs. Barriers to employ and continue PA employment were mostly a consequence of locally arranged restrictions by hospital management and staff physicians, as barriers regarding national laws, PA education and competencies seemed absent.
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