Physician associates are a new professional group in health care teams in the National Health Service (NHS) in the United Kingdom. The Department of Health defines the physician associate as: …a new healthcare professional who, while not a doctor, works to the medical model, with the attitudes, skills and knowledge base to deliver holistic care and treatment within the general medical and/or general practice team under defined levels of supervision. (Department of Health Competence and Curriculum Framework for the Physician Associate 2006, updated 2012)
Increasing numbers of hospitals in the UK were employing physician associates in a widening range of medical and surgical specialties. However, as they are so new to the NHS, there is little evidence as to what work the physician associates undertake in the medical or surgical teams or what difference they make to patients treatment, the quality of the service or the cost. The study addressed these questions reporting in 2019.
More information about the education and work of physician associates can be found on the webpage of the Faculty of Physician Associates at the Royal College of Physicians
We used a qualitative and quantitative methods in 4 work-streams . The study started in 2015 , ended in 2018 and the final report was published in 2019.
The main papers from the study were:
From organisational case study research in six hospitals, the team found that physician associates were often credited as providing stability in the medical/surgical team. This benefited patients through continuity of presence on the inpatient wards, increasing the medical/surgical teams’ accessibility for patients and nurses. Patients themselves, while often unaware of the differences from doctors, were generally supportive of the new role.
In-depth case note reviews at six hospitals showed that the patient outcomes and consultation records of junior doctors and physician associates in the emergency department were comparable. A random sample of 613 patient records was analysed. The re-attendance rate within seven days was 9% for physician associates and 7% for FY2 doctors (odds ratio 1.33, 95% confidence interval 0.69 to 2.57).
Physician associates were often in the position to build up a solid knowledge of their working environment as their roles were frequently static and developed to fulfil specific functions within the team. This knowledge revolved around departmental policies and practices, individual consultants, as well as the hospital itself and was particularly valued by junior doctors who frequently moved hospitals.
A summary of the study can be found at NIHR Dissemination Centre Signals