ArticleBMJ open2019
What is the contribution of physician associates in hospital care in England? A mixed methods, multiple case study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The impact of Medical Associate Professions (MAPs) on the productivity, quality of care, patient and healthcare workforce satisfaction, and budget implications in various healthcare settings: a systematic review.BMC health services research · 2025Pooled it
- Physician associates and anaesthetic associates in UK: rapid systematic review of recent UK based research.BMJ (Clinical research ed.) · 2025Pooled it
- Public perception of the physician associate profession in the UK: a systematic review.BMC health services research · 2024Pooled it
- More Than a Role Dispute: Physician Associates and the Changing Grounds of Medical Authority.Sociology of health & illness · 2026Article
- Unaccredited medical training in Australia: from hidden problems to practical workforce solutions.Internal medicine journal · 2026Article
- Development, integration, retention, and career progression of physician associates/assistants in UK NHS hospitals and clinical teams: a multiple-case qualitative study.BMC medicine · 2026Article
- Developing and integrating physician assistants/associates in UK hospital teams: a realist review of lessons from international experiences.BMC medicine · 2025Review
- A contentious intervention to support the medical workforce: a case study of the policy of introducing physician associates in the United Kingdom.Human resources for health · 2025Article
- Why are healthcare professionals leaving NHS roles? A secondary analysis of routinely collected data.Human resources for health · 2024Article
- Doctors', Patients' and Physician Associates' Perceptions of the Physician Associate Role in the Emergency Department.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Article
- A survey exploring factors affecting employment of physician associates in Ireland.Irish journal of medical science · 2023Article
- Patient care, integration and collaboration of physician associates in multiprofessional teams: A mixed methods study.Nursing open · 2023Article
- Facilitators to the integration of the first UK-educated physician associates into secondary care services in the NHS.Future healthcare journal · 2023Article
- Patient Experience With Primary Care Physician Assistants in Ontario, Canada: Impact of Trust, Knowledge, and Access to Care.Journal of patient experience · 2023Article
- Out-of-hours task allocation: implications for foundation training and practice.Future healthcare journal · 2022Article
- The roles of physician associates and advanced nurse practitioners in the National Health Service in the UK: a scoping review and narrative synthesis.Human resources for health · 2022Article
- The role of the physician associate: an overview.Irish journal of medical science · 2022Review
- Physician associates advance patient safety.Future healthcare journal · 2021Article
- Senior medical students as assistants in medicine in COVID-19 crisis: a realist evaluation protocol.BMJ open · 2021Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectivesTo investigate the deployment of physician associates (PAs); the factors supporting and inhibiting their employment and their contribution and impact on patients' experience and outcomes and the organisation of services.
designMixed methods within a case study design, using interviews, observations, work diaries and documentary analysis.
settingSix acute care hospitals in three regions of England in 2016-2017.
participants43 PAs, 77 other health professionals, 28 managers, 28 patients and relatives.
resultsA key influencing factor supporting the employment of PAs in all settings was a shortage of doctors. PAs were found to be acceptable, appropriate and safe members of the medical/surgical teams by the majority of doctors, managers and nurses. They were mainly deployed to undertake inpatient ward work in the medical/surgical team during core weekday hours. They were reported to positively contribute to: continuity within their medical/surgical team, patient experience and flow, inducting new junior doctors, supporting the medical/surgical teams' workload, which released doctors for more complex patients and their training. The lack of regulation and attendant lack of authority to prescribe was seen as a problem in many but not all specialties. The contribution of PAs to productivity and patient outcomes was not quantifiable separately from other members of the team and wider service organisation. Patients and relatives described PAs positively but most did not understand who and what a PA was, often mistaking them for doctors.
conclusionsThis study offers new insights concerning the deployment and contribution of PAs in medical and surgical specialties in English hospitals. PAs provided a flexible addition to the secondary care workforce without drawing from existing professions. Their utility in the hospital setting is unlikely to be completely realised without the appropriate level of regulation and authority to prescribe medicines and order ionising radiation within their scope of practice.
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