Physician assistants: a personal perspective
Editor – I would like to applaud White et al on their departmental evaluation of the introduction of physician assistants (Clin Med February 2013 pp15–18). I would like to offer a personal perspective of working with a physician assistant for a year during my first year of cardiology specialty training.
I had the opportunity to work alongside a physician assistant (PA) in my first year as a cardiology registrar. The PA had held the post for just under a year when I joined the department. Their role was to work on the cardiology step-down ward and perform clinical duties such as ward rounds, patient assessment and basic clinical procedures. The PA worked at the level of a senior house officer.
Our unit had an eight-bed coronary care unit, a twelve-bed step-down ward and a variable number of outliers on other wards. The junior medical team consisted of two foundation year one doctors and two or three senior house officers (foundation year two and core medical trainees). This might sound over-staffed, but with a combination of general medical on calls, fixed leave and study leave, the unit generally ran with two junior team members. Due to the European Working Time Directive (EWTD) this meant that team members would change daily. This obviously would affect continuity of care for patients.
The PA offered the only thread of continuity for the ward. Their role was central to the effective delivery of good patient care for our inpatients. I hold the personal view that the PA was the most effective member of the team and I could depend on their clinical assessments and management plans. Moreover, our PA was always keen to learn, would work late, join the registrars with referrals and come to meetings.
In modern medicine continuity of care is often the loser to EWTD. We need high quality PAs to join the multiple professional healthcare team to deliver patient-centred care.
Footnotes
Please submit letters for the editor’s consideration within three weeks of receipt of Clinical Medicine. Letters should ideally be limited to 350 words, and sent by email to: clinicalmedicine{at}rcplondon.ac.uk
- © 2013 Royal College of Physicians
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