Improving Health Care Access in Primary Care Through Physician Assistant (PA) Integration: A Literature Review

Abstract

Introduction: Canada is currently experiencing a shortage of primary care physicians. Lack of access to primary care results in increased morbidity, mortality, and increased burden on the healthcare system. A proposed solution has been introducing team-based care, which includes Physician Assistants (PAs). The implementation of PAs in the primary care setting and the impact on patients’ access to health services and patient care is still vastly under researched. Objective: This literature review will examine the impact of PAs in primary care settings to improve patient access specifically looking at wait times. Further, this review will examine patients’ perspectives on being treated by a PA in the primary care setting. These objectives will directly address if PAs could be a proposed solution to the primary care crisis. Methods: A literature search was completed using PubMed, and Medline databases. The search was performed using key terms about physician assistants working in primary care settings and patient perspectives. Six articles were found to meet the inclusion criteria and were analyzed for this review. Results: Six studies explored the role of PAs in primary care settings across North America and England. Four themes were found including improved patient access, patient satisfaction, patient awareness, and patient experiences. These themes were used to examine patient perspectives and the roles of PAs in supporting the primary care setting. The findings suggest that PAs improve patient access in primary care and that patients’ experiences are overall positive with PAs in the primary care setting. Conclusions: These findings suggest that PAs are a potential solution to the primary care crisis. The Physician Assistant programs are expanding across Canada, and the number of practicing PAs in Canada is set to exponentially grow. For PAs to be implemented in primary care, primary research on PAs working in these settings should be prioritized to examine the potential positive benefits on the healthcare system and primary care access.