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The role of physician assistants in pediatric emergency medicine: the physician's view

Published online by Cambridge University Press:  04 March 2015

Quynh Doan ,
Shalea Piteau ,
Sam Sheps ,
Joel Singer ,
Hubert Wong ,
David Johnson  and
Niranjan Kissoon
Quynh Doan*
Affiliation:
Department of Pediatrics, University of British Columbia, Vancouver, BC
Shalea Piteau
Affiliation:
Department of Pediatrics, Queen's University, Kingston, ON
Sam Sheps
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
Hubert Wong
Affiliation:
School of Population and Public Health, University of British Columbia, Vancouver, BC
David Johnson
Affiliation:
Department of Pediatrics and Pharmacology & Physiology, University of Calgary, Calgary, AB
Niranjan Kissoon
Affiliation:
Department of Pediatrics, University of British Columbia, Vancouver, BC
*
Department of Pediatric Emergency Medicine, BC Children's Hospital, 4480 Oak Street, Vancouver, BC V6H 3V4; qdoan@cw.bc.ca or qdoan@shaw.ca

Abstract

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Objective:

To define the range of clinical conditions Canadian emergency pediatricians consider appropriate formanagement by physician assistants (PAs) and the degree of autonomy PAs should have in the pediatric emergency department (PED).

Methods:

We conducted a cross–sectional, pan-Canadian survey using electronic questionnaire technology: the Active Campaign Survey tool. We targeted PED physicians using the Pediatric Emergency Research Canada (PERC) network database (N = 297). Three outcome measures were assessed: demographic information, familiarity with PAs, and PA clinical roles in the PED. The level of PA involvement was assessed for 57 common nonemergent clinical conditions.

Results:

Of 297 physicians, 152 completed the survey, for a response rate of 51.2%. None of the 57 clinical categories achieved at least 85% agreement regarding PA management without direct physician involvement. Twenty-four clinical conditions had ≥ 15% agreement that any PA involvement would be inappropriate. For the remaining 33 clinical conditions, more than 85% of respondents felt that PA could appropriately manage but were divided between requiring direct and only indirect physician supervision. Respondents' selection of the number of conditions felt to be appropriate for PA involvement varied between the size of the emergency department (ED) in which they work (larger EDs 87.7–89.1% v. smaller EDs 74.2%) and familiarity with the clinical work of PAs in the ED (90.5–91.5% v. 82.2–84.7%).

Conclusion:

This national survey of Canadian PED physicians suggests that they feel PAs could help care for a large number of nonemergent clinical cases coming to the PED, but these clinical encounters would have to be directly supervised by a physician.

Keywords

emergency physiciansphysician assistantsphysician attitudes
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 15 , Issue 6 , November 2013 , pp. 321 - 329
Copyright
Copyright © Canadian Association of Emergency Physicians 2013

References

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