Psychosocial Issues in Primary Care Physician Assistant Practice: A Descriptive Study

Abstract

Purpose: Physician assistant (PA) educators must prepare their students to effectively manage psychosocial issues. Designing a curriculum that attends to these issues presents challenges to PA faculty since study of PA involvement in patients’ psychosocial issues has been sparse. This study examines the frequency of psychosocial issues seen in primary care PA practice and the degree and manner in which PAs respond to the psychosocial issues seen. Methods: A randomly selected national sample of primary care PAs logged information about psychosocial issues encountered in their first eight patient visits on appointed dates. Information logged included psychosocial issues encountered, the PA’s level of response to each issue encountered, and referrals made to specialists. PA respondents returned study materials anonymously. Results: Study response rate was 12% (162 respondents from 1,328 randomly selected PAs). Of the 1,270 primary care visits recorded, 67.8% included at least one psychosocial issue. Behavioral health was the category of psychosocial issues most frequently logged (58%), and five issues together accounted for 41.3% of all identified issues (coping with own illness, anxiety/nerves/tension, depression, pain, and worry about health). PAs provided help in response to 93.2% of psychosocial issues identified and referred nearly a quarter of patients who presented with psychosocial issues to specialists for evaluation or treatment. Conclusions: A variety of psychosocial issues are frequently seen in primary care PA practice. Consequently, PA curricula must prepare students to recognize and respond to a wide range of psychosocial issues. Further study is warranted to confirm and build on the results of this study.