ArticleBMJ open2020
Comparing physician associates and foundation year two doctors-in-training undertaking emergency medicine consultations in England: a mixed-methods study of processes and outcomes.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 5 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
- Impact of physician assistants on quality of care: rapid review.BMJ (Clinical research ed.) · 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
- The cost-effectiveness of physician assistants/associates: A systematic review of international evidence.PloS one · 2021Pooled it
- Perspectives on the impact of the inclusion of non-medical practitioners in the skill mixed staffing teams of English emergency departments: a qualitative study.BMC health services research · 2026Article
- 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
- 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
- The contribution of physician associates or assistants to the emergency department: A systematic scoping review.Journal of the American College of Emergency Physicians open · 2023Article
- 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
- Preparing physician associates to prescribe: evidence, educational frameworks and pathways.Future healthcare journal · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
objectivesTo compare the contribution of physician associates to the processes and outcomes of emergency medicine consultations with that of foundation year two doctors-in-training.
designMixed-methods study: retrospective chart review using 4 months' anonymised clinical record data of all patients seen by physician associates or foundation year two doctors-in-training in 2016; review of a subsample of 40 records for clinical adequacy; semi-structured interviews with staff and patients; observations of physician associates.
settingThree emergency departments in England.
participantsThe records of 8816 patients attended by 6 physician associates and 40 foundation year two doctors-in-training; of these n=3197 had the primary outcome recorded (n=1129 physician associates, n=2068 doctor); 14 clinicians and managers and 6 patients or relatives for interview; 5 physician associates for observation. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was unplanned re-attendance at the same emergency department within 7 days. SECONDARY OUTCOMES: consultation processes, clinical adequacy of care, and staff and patient experience.
resultsRe-attendances within 7 days (n=194 (6.1%)) showed no difference between physician associates and foundation year two doctors-in-training (OR 0.87, 95% CI 0.61 to 1.24, p=0.437). If seen by a physician associate, patients were more likely receive an X-ray investigation (OR 2.10, 95% CI 1.72 to 4.24), p<0.001), after adjustment for patient characteristics, triage severity of condition and statistically significant clinician intraclass correlation. Clinical reviewers found almost all patients' charts clinically adequate. Physician associates were evaluated as assessing patients in a similar way to foundation year two doctors-in-training and providing continuity in the team. Patients were positive about the care they had received from a physician associate, but had poor understanding of the role.
conclusionsPhysician associates in emergency departments in England treated patients with a range of conditions safely, and at a similar level to foundation year two doctors-in-training, providing clinical operational efficiencies.
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