Physician Assistants in Rural Emergency Medicine: A Literature Review
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Date
2024-05-15
Authors
Gessner, Olivia
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Abstract
Introduction: Physician assistants (PAs) work as extensions of the supervising physician(s) to make decisions regarding the designation of tasks and encounters. They commonly see the same patient acuity mixture as the physician and work across different medical disciplines, notably the emergency department. No current review explores the collection of research on PAs working in rural emergency departments (EDs) within North America.
Objective: This review will examine the role of PAs in rural EDs within North America. With this, decisions surrounding the expansion of the PA profession can be evidence-based and consistent with best practices. This paper will determine the areas of research surrounding the role of PAs in rural EDs that have been concentrated on and identify gaps in the research, as well as identify outcomes resulting from PA practice in this setting.
Methods: A literature search using Embase and Ovid-MEDLINE databases was performed using key terms pertaining to physician assistants working in rural emergency departments. Nine articles were found to meet the inclusion criteria and were analyzed for this review.
Results: Nine studies explored different aspects of PA roles and practice in rural EDs across North America. Three themes around PA roles, level of autonomy and outcomes are used to describe the nature of PA practice in rural EDs. The findings suggest that rural ED PAs provide care to a wide variety of patient presentations with varying levels of autonomy. Although the PA role appears to largely be accepted and commonly has positive effects on the ED, more research needs to be done in this area.
Conclusions: These findings suggest key factors that require future research in both Canada and the United States. For this relatively novel profession in Canada to grow into a staple in the current health system, primary research on PAs working in settings such as rural emergency departments should be prioritized.