Patient satisfaction with physician assistants outside of the US

There is a growing disparity between the demand and supply for health workers globally which is projected to result in a health worker shortage of 15 million by 2030. The growing disparity is fueled by low health expenditure budgets, urban migration, weak incentives for entering the healthcare field, and an aging global population. The Global Health Workforce Alliance has suggested mid-level providers, like the physician assistant, as a part of the solution to the looming global shortage. However, physician assistants are not internationally recognized, which creates a challenge for implementing the profession in countries not familiar with the profession. The lack of international recognition has also made it difficult for institutions like the World Health Organization to acquire data on international physician assistant impact. Physician assistant implementation additionally faces pushback from traditional health professions. The physician assistant concept has been adopted in over 15 countries. The international adoption of the profession is relatively recent compared to the profession’s inception in the United States in the 1960s. Therefore, there is a dearth in data on the international impact of physician assistants. Patient satisfaction is an important measure for quality of care and health system performance. The few existing studies on patient satisfaction indicate that patients are satisfied with care provided by physician assistants in Canada, the United Kingdom, Ireland, Australia, New Zealand, and the Netherlands. However, there are significant design flaws in the limited research. The design flaws include not specifying which health worker was in question, use of fictional patient- provider scenarios, and use of qualitative data that can result in misleading conclusions. Thus, this proposed study will incorporate a study design that addresses design flaws in the existing research on patient satisfaction with physician assistants outside of the United States. The study will be a large-scale quantitative standardized patient satisfaction survey that will be disbursed in Canada and the United Kingdom. The study aims to measure patient satisfaction with different elements of the patient-provider encounter as well as the overall quality of care provided by the physician assistant. The study also aims to measure willingness of patients to see a physician assistant at the patient’s next medical provider encounter. Physician assistants can help to reduce the global health workforce shortage. The proposed study will address the need for understanding how patients are perceiving the impact of physician assistants during global expansion of the profession. If the findings from the proposed study align with findings from existing research, then one can infer that there is growing consumer demand for physician assistants. Evidence of growing consumer demand may influence policy surrounding acceptance and recognition of physician assistants internationally, and therefore serve as the catalyst for deploying physician assistants to help address the global health workforce shortage.

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