Nurse practitioners and physician assistants (PA) are increasingly being used in hospital emergency departments (ED).
According to the latest information, PAs now treat approximately 10% of the total patient population that visit EDs each year. Yet these clinicians are sometimes viewed as a professional threat by ED physicians, perhaps because of fears of malpractice. A recent study published in the Journal of the American Academy of Physician Assistants examined how physicians perceive PAs in the ED and whether they believe PAs to be a malpractice risk.
Researchers mailed a 16-item questionnaire to a random sample of 1,000 active members of the American College of Emergency Physicians in 2004 and then again five years later. Results from both surveys were fairly consistent. The percentage of doctors who disagreed or strongly disagreed that PAs are more likely than physicians to commit medical malpractice was 72% in 2004 and 68% in 2009. Similarly, most physicians disagreed or strongly disagreed that PAs were more likely than doctors to be sued as a result of medical malpractice (84% in 2004, 82% in 2009).
According to the survey results, physicians in both surveys felt that the factors that would most significantly decrease the risk of malpractice by PAs were more clinical experience in emergency medicine, completion of a post-graduate residency program, and appropriate supervision by physicians.
Some positive trends were seen during the five-year period between surveys: The number of physicians who reported practicing with PAs increased by 26%, and the number of doctors who were directly supervising PAs in the ED increased by 19%. Even better, the number of physicians who believed that PA’s decrease patient wait times in the ED increased by 13% and the number of doctors who believe that PAs increase patient satisfaction increased by 10%.
Based on the results of the study, the authors wrote, “most emergency physicians agree that the increased utilization of PAs in the ED may improve patient communication, decrease wait times, increase patient satisfaction, and therefore decrease malpractice risk.” In addition, the authors concluded, “as physicians gain both clinical experience and experience working with PAs, their perception of malpractice risk imposed by the PA in the ED significantly decreases.”