Implementation of the physician assistant in Dutch health care organizations: primary motives and outcomes.

Physician assistants (PAs) are trained to perform medical procedures that were traditionally performed by medical doctors. PAs seem to be deployed to increase efficiency, but also to ensure the quality of care. What we do not know is the primary motive to employ a PA within the Dutch health care, and whether the employment of the PA fulfills the needs. We interviewed supervising medical specialists who applied a PA in their practice about their primary motives and outcomes. The interviews were semi-structured and took one hour. Two scientists coded the findings with respect to motives and outcomes. In total 55 specialists were interviewed about their motives to employ a PA and 15 about the outcomes of employing a PA. With respect to the primary motives to employ a PA, the most frequent motive was to increase continuity and quality of care, followed by relieve of the specialist’s workload, increase in efficiency of care, and substitution of the medical resident. The outcomes were in accordance with the motives. In conclusion, the primary motive to employ a PA in Dutch health care is the increase in continuity and quality of care. Outcomes of employing a PA are in line with the motives.