Are Dutch patients willing to be seen by a physician assistant instead of a medical doctor?
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RESEARCH
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Are Dutch patients willing to be seen by a physician assistant instead of a medical doctor? Luppo Kuilman1*, Roos MB Nieweg2, Cees P van der Schans2,3, Jaap H Strijbos4 and Roderick S Hooker5
Abstract Background: The employment of physician assistants (PAs) is a strategy to improve access to care. Since the new millennium, a handful of countries have turned to PAs as a means to bridge the growing gap between the supply and demand of medical services. However, little is known about this new workforce entity from the patient’s perspective. The objective of this study was to assess the willingness of Dutch patients to be treated by a PA or a medical doctor (MD) under various time constraints and semi-urgent medical scenarios. Methods: A total of 450 Dutch adults were recruited to act as surrogate patients. A convenience sample was drawn from patients in a medical office waiting room in a general hospital awaiting their appointments. Each participant was screened to be naive as to what a PA and a nurse practitioner are and then read a definition of a PA and an MD. One of three medical scenarios was assigned to the participants in a patterned 1-2-3 strategy. Patients were required to make a trade-off decision of being seen after 1 hour by a PA or after 4 hours by a doctor. This forced-choice method continued with the same patient two more times with 30 minutes and 4 hours and another one of 2 hours versus 4 hours for the PA and MD, respectively. Results: Surrogate patients chose the PA over the MD 96% to 98% of the time (depending on the scenario). No differences emerged when analysed by gender, age, or parenthood status. Conclusion: Willingness to be seen by a PA was tested a priori to determine whether surrogate Dutch patients would welcome this new health-care provider. The findings suggest that employing PAs, at least in concept, may be an acceptable strategy for improving access to care with this population. Keywords: Physician assistants, Trade-off, Willingness
Background At the turn of the century, the need for more medical doctors (MDs) in the Netherlands was predicted because an aging medical workforce and an aging population were constraining access [1]. One solution to this alignment problem was to redefine professional roles in health care and introduce a new professional: the physician assistant (PA) [2]. PA education in the Netherlands is a 30-month university program at a professional Master’s degree level. Graduates practice medicine in collaboration with and alongside MDs [3]. In the last decade, Australia, Canada, the Netherlands, and the United Kingdom have introduced PAs into their health-care system and the number of graduates is increasing steadily * Correspondence: [email protected] 1 Master Physician Assistant Program, School of Health Care Studies, Hanze University of Applied Sciences, Groningen, Groningen, The Netherlands Full list of author information is available at the end of the article
[4]. The health-care system of the United States introduced PAs in the lat
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