Israeli Willingness to be Treated by a Physician Assistant
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ORIGINAL PAPER
Israeli Willingness to be Treated by a Physician Assistant Oren Berkowitz1 · Roderick S. Hooker2 · Rachel Nissanholtz‑Gannot1 · Avi Zigdon1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Are Israelis willing to be seen by a physician assistant (PA) instead of a doctor if they can save time? PAs were introduced into Israel emergency departments 2 years prior to this study and few if any knew about them. A survey containing a series of scenarios involving hypothetical injuries was electronically distributed in 2019; over 7000 Israeli citizens responded. They were asked to choose between seeing a PA within half an hour or waiting for a doctor (MD) in 4 h. Over 90% of the respondents chose the PA and preferences changed slightly as the time gap narrowed to 2 h. A large majority picked the PA in all three scenarios. Parsing the respondents by age, gender, and health conditions revealed little statistical differences. There was a positive correlation between the perceived urgency of the situation and choosing the PA as respondents were more likely to see a PA in more stressful scenarios (e.g., a child’s head laceration). These results suggest that most Israelis would be willing to accept care from a healthcare provider, in this case the PA, who is not a doctor, if they sense value added in the encounter, such as quicker access to care. Keywords Time trade-off · Patient preference · Patient satisfaction · Choice
Introduction Most Israelis are unfamiliar with the new healthcare provider role of physician assistant (PA). PAs were created by the Israeli health system in 2016 to meet the demand for better access to clinical services which have been problematic in the emergency department (ED) settings [1]. Israel is a country with good health outcomes and is considered to have a high-quality healthcare system [2]. All citizens receive a basic bundle of health services mandated by law and provided through a person’s choice of four national health funds. Emergency rooms in Israel are overwhelmed, despite the high quality of services in other sectors. Waiting times in the ED can span many hours and patients can sometimes linger for days until a hospital bed opens for admission. This contributes to EDs operating at over 100% capacity giving some EDs the atmosphere of a field hospital [1, 3–6]. In 2013 * Roderick S. Hooker [email protected] 1
Department of Health Systems Management, Ariel University, Ariel, Israel
15917 NE Union Rd, Unit 45, Ridgefield, WA 98642‑8706, USA
2
the Ministry of Health (MOH) convened several committees to address this challenge and a multifactorial approach was recommended. This approach involved three strategies: reducing the need for emergency services, improving the emergency service infrastructure and staffing, and incentivizing a higher turnover of hospital beds in order to free up room for ED admissions [5]. PAs were recommended by the MOH as a way to improve services in the ED. Based on observations and reports in other countries
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