Abstract
This paper draws from research commissioned by the Scottish Executive Health Department (SEHD). It provides a case study in the introduction of a new health care worker role into an already well established and "mature" workforce configuration It assesses the role of US style physician assistants (PAs), as a precursor to planned "piloting" of the PA role within the National Health Service (NHS) in Scotland.The evidence base for the use of PAs is examined, and ways in which an established role in one health system (the USA) could be introduced to another country, where the role is "new" and unfamiliar, are explored.The history of the development of the PA role in the US also highlights a sometimes somewhat problematic relationship between P nursing profession. The paper highlights that the concept of the PA role as a 'dependent practitioner' is not well understood or developed in the NHS, where autonomous practice within regulated professions is the norm. In the PA model, responsibility is shared, but accountability rests with the supervising physician. Clarity of role definition, and engendering mutual respect based on fair treatment and effective management of multi-disciplinary teams will be pre-requisites for effective deployment of this new role in the NHS in Scotland.
Highlights
This paper draws from research commissioned by the Scottish Executive Health Department (SEHD)
It assesses the role of US style physician assistants (PAs), as a precursor to planned "piloting" of the PA role within the National Health Service (NHS) in Scotland
Work suggested that the substitution ratio of PAs and nurse practitioner (NP) for physicians was between 0.5 and 0.75
Summary
Owing to the difference in the length of education between PAs and physicians, the PA provides 5 years of patient care valued at $380,000 (1999 rates) before the http://www.human-resources-health.com/content/5/1/13 physician completes a primary care residency, and enters health care practice. He concluded that these factors, plus the compensationto-production ratio (this compares the salary and benefit cost to employ a PA [compensation] with the revenue generated for their services) establish the PA as one of the most cost-effective health care clinicians from the employer's perspective [[29], p.51].
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