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ADVANCE Blog for PAs

Research Demonstrates Cost Effectiveness of PAs

Published November 20, 2008 2:39 PM by Stephen Cornell

Duke University Health System has news of much-needed PA-related research that demonstrates the cost effectiveness of physician assistants.

"Our study asked, whether PAs increase the availability of the services offered by physicians or whether they instead provide additional care that actually increases the number of visits that a patient uses," said Perri Morgan, PhD, director of PA research for the Department of Community and Family Medicine at Duke and lead author of the study.

"We found that, on average, PAs are replacing care that would be provided by physicians rather than offering additional or redundant services to patients."

This is tremendous. The physician assistant profession needs much more of this type of research.

One thing I really like about this news release is that there's no confusing mumbo jumbo about the PA-physician team approach. There's plenty of resarch about physicians and too much physician-placating fluff about the PA-physician team.

PAs work with physicians as part of a team. Everyone gets that. Now let's move on to talking specifically and clearly about PAs.

PAs don't "extend" or "assist" physicians. In most cases, they serve in almost identical roles as physicians. Supervising physicians are available, if necessary. In most cases, they're not necessary. PAs are out there practicing medicine with signficiant autonomy. Many (most?) PAs rarely require physician backup.

"Our research showed that when PAs provided 30 percent or more of a patient's office visits in a year, there was no increase in the total number of office visits per year," Morgan said.

"The notion that PAs might serve as an addition to physician services, instead of as a substitute, has raised questions about the true cost of PAs," Morgan said.

"Our research indicates that PAs are not creating redundant services or scheduling more return visits for patients than a physician would," Morgan said. "This suggests that PAs can help fill the need for more medical providers quickly and efficiently."

As Morgan points out, the misconception that PAs merely assist physicians has slowed proper utilization of PAs. The physician assistant profession bears a good deal of responsibility for that because of its mystifying reluctance to point out that PAs in many specialties pretty much do the exact same things as their physician colleagues.

Now how about some research showing how little supervision most PAs actually need? That would really demonstrate the PA profession's potential value to the health care system.

Link

2 comments

Nice work Steve calling attention to Perri Morgan's research work. Perri is one of the few true health services researchers in the PA profession. We need more.

This is also the message articulated by Rod Hooker, another of the few true reseachers in the profession, in his editorial in this month's JAAPA. He wonders aloud why we don't have more researchers and research in the PA profession. Its a darn good question.

Jim Cawley, PA Education - Professor, GW University November 22, 2008 2:39 PM
Washington DC

Thank God for Duke.

This is what we all knew was happening and has been hushed up for years when it was said. That PAs provide physician level, cost effective care. A truly POWERFUL statement.

We need more studies, ASAP. This profession is the greatest secret in medicine. We need to come out from behind the curtain to our rightful place on the stage.

Dave

Dave Mittman, PA November 20, 2008 4:37 PM
Livingston NJ

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