Physicians Assistants in Cardiothoracic Surgery: A 30-Year Experience in a University Center

Abstract

The purpose of this study was to evaluate our 30 years of experience with the use of physician assistants (PAs) on a cardiothoracic surgery (CTS) service. A retrospective review of the utilization of CTS PAs was performed at a university center from 1973 to 2003. The number of PAs has increased from 2 (1973) to 23 (2003), corresponding to the increased clinical service demands with a constant resident number for the past decade. Physician assistant employment has expanded from one hospital to five hospitals in our university system where CTS is performed. The CTS service has expanded from 400 total cases per year (1973) to 4,000 cases (2002). We have had a 50% retention rate with duration of employment from 6 months to 28 years (11 PAs with service more than than 15 years). The PA role has changed little, with duties varying from history and physical examination, conduit harvesting, insertion of invasive catheters and chest tubes, surgical first assisting, closure of the chest, and optional primary intensive care unit night-time in-house call. Salary currently ranges from 55,000 dollars to 100,000 dollars depending on length of service and overall merit. Job satisfaction for PAs employed longer than 12 months has remained high. The addition of PAs to our CTS university service has allowed us to resolve many problems of work assignment and coverage and enabled us to establish effective and efficient surgical teams without increasing the number of categorical CTS residents.