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Parents' willingness to have their child receive care by physician assistants in a pediatric emergencydepartment

Published online by Cambridge University Press:  04 March 2015

Quynh Doan ,
Sam Sheps ,
Hubert Wong ,
Joel Singer ,
David Johnson  and
Niranjan Kissoon
Quynh Doan*
Affiliation:
Department of Pediatrics, Child and Family Research Institute, University of British Columbia, and Emergency Department, BC Children's Hospital, Vancouver, BC
Sam Sheps
Affiliation:
School of Population and Public Health, University of British Columbia, Vancouver, BC
Hubert Wong
Affiliation:
School of Population and Public Health, University of British Columbia, Vancouver, BC
Joel Singer
Affiliation:
School of Population and Public Health, University of British Columbia, Vancouver, BC
David Johnson
Affiliation:
Department of Pediatrics, University of Calgary, and Alberta Children's Hospital, Calgary, AB
Niranjan Kissoon
Affiliation:
Department of Pediatrics, University of British Columbia
*
Emergency Department, BC Children's Hospital, University of British Columbia, 4480 Oak Street, Vancouver, BC V6H 3V4; qdoan@shaw.ca

Abstract

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Objective:

To determine the willingness of parents of children visiting a pediatric emergency department to have a physician assistant (PA) assess and treat their child and the waiting time reduction sufficient for them to choose to receive treatment by a PA rather than wait for a physician.

Method:

After describing the training and scope of practice of PAs, we asked caregivers of children triaged as urgent to nonurgent if they would be willing to have their child assessed and treated by a PA on that visit: definitely, maybe, or never. We also asked the minimum amount of waiting time reduction they would want to see before choosing to receive treatment by a PA rather than wait for a physician.

Result:

We approached 320 eligible subjects, and 273 (85.3%) consented to participate. Regarding whether they would be willing to have their child receive treatment by a PA, 140 (51.3%) respondents answered definitely, 107 (39.2%) said maybe, and 26 (9.2%) said never. Most respondents (64.1%) would choose to have their child seen by a PA instead of waiting for a physician if the waiting time reduction were at least 60 minutes (median 60 minutes [interquartile range 60 minutes]). Respondents' perception of the severity of their child's condition was associated with unwillingness to receive treatment by a PA, whereas child's age, presenting complaint, and actual waiting time were not.

Conclusion:

Only a small minority of parents of children visiting a pediatric emergency department for urgent to nonurgent issues are unwilling to have their child treated by PAs.

Keywords

acceptancepediatric emergency medicinephysician assistants
Type
Original Research • Recherche Originale
Information
Canadian Journal of Emergency Medicine , Volume 15 , Issue 6 , November 2013 , pp. 330 - 336
Copyright
Copyright © Canadian Association of Emergency Physicians 2013

References

REFERENCES

1. Carret, ML, Fassa, AG, Kawachi, I. Demand for emergency health services: factors associated with inappropriate use. BMC Health Serv Res 2007;7:131–9, doi:10.1186/1472-6963-7-131.CrossRefGoogle ScholarPubMed
2. Ehrlich, NJ, Tasmin, F, Safi, H, et al. Pilot study of ER utilization at Tulsa hospitals. J Okla State Med Assoc 2004;97:64–8.Google Scholar
3. Brethour, I, Carlson, G, Patterson, G, et al. The physician assistant in primary care: a proposal for British Columbia’s health care system. Victoria (BC): BC Ministry of Health; 1994.Google Scholar
4. British Columbia Medical Association. Working together - enhancing multidisciplinary primary care in British Columbia: a policy paper by BC’s physicians. Vancouver (BC): British Columbia Medical Association; 2005.Google Scholar
5. British Columbia Medical Association. Policy statement. November 2009. Available at: http://www.bcma.org/files/Physician_Assistants.pdf (accessed June 9, 2011).Google Scholar
6. Counselman, FL, Graffeo, CA, Hill, JT. Patient satisfaction with physician assistants (PAs) in an ED fast track. Am J Emerg Med 2000;18:661–5, doi:10.1053/ajem.2000.16301.Google Scholar
7. Ellis, GL, Brandt, TE. Use of physician extenders and fast tracks in United States emergency departments. Am J Emerg Med 1997;15:229–32, doi:10.1016/S0735-6757(97)90002-4.CrossRefGoogle ScholarPubMed
8. Nyberg, SM, Waswick, W, Wynn, T, et al. Midlevel providers in a level I trauma service: experience at Wesley medical center. J Trauma 2007;63:128–34, doi:10.1097/01.ta.0000221765.90190.73.Google Scholar
9. Jones, I, Hooker, R. Physician assistants in Canada: a health policy initiative. Can Fam Physician 2011;57:e83–e88.Google Scholar
10. Ducharme, J, Alder, RJ, Pelletier, C, et al. The impact on patient flow after the integration of nurse practitioners and physician assistants in 6 Ontario emergency departments. CJEM 2009;11:455–61.Google Scholar
11. Larkin, GL, Hooker, RS. Patient willingness to be seen by physician assistants, nurse practitioners and residents in the ED: does the presumption of consent have an empirical basis? Am J Bioethics 2010;10:1–10, doi:10.1080/15265161.2010.494216.CrossRefGoogle ScholarPubMed
12. Hooker, RS, Harrison, K, Pashen, D. Are Australians willing to be treated by a physician assistant? Australas Med J 2010;3:407–13, doi:10.4066/AMJ.2010.325.CrossRefGoogle Scholar
13. Doan, QD, Hooker, RS, Wong, H, et al. Canadians’ willingness to receive care by physician assistants. Can Fam Physician 2012;58:e459–64.Google Scholar
14. Doan, Q, Sabhaney, V, Kisson, N, et al. The role of physician assistants in a pediatric emergency department: a center review and survey. Pediatr Emerg Care 2012;28:783–8, doi:10.1097/PEC.0b013e3182627ce5.Google Scholar
15. Firth, D. Bias reduction of maximum likelihood estimates. Biometrika 1993;80:27–38, doi:10.1093/biomet/80.1.27.Google Scholar
16. Moser, M, Abu-Laban, R, van Beek, C. Attitude of emergency department patients with minor problems to being treated by a nurse practitioner. Can J Emerg Med 2004;6:246–52.CrossRefGoogle ScholarPubMed