New Role, New Country: introducing US physician assistants to Scotland
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BioMed Central
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New Role, New Country: introducing US physician assistants to Scotland James Buchan*1, Fiona O'May1 and Jane Ball2 Address: 1Queen Margaret University, Clerwood Terrace, Edinburgh EH12 8TS, UK and 2Employment Research, Hove, East Sussex, BN3 5DQ, UK Email: James Buchan* - [email protected]; Fiona O'May - [email protected]; Jane Ball - [email protected] * Corresponding author
Published: 4 May 2007 Human Resources for Health 2007, 5:13
doi:10.1186/1478-4491-5-13
Received: 11 April 2007 Accepted: 4 May 2007
This article is available from: http://www.human-resources-health.com/content/5/1/13 © 2007 Buchan et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract This paper draws from research commissioned by the Scottish Executive Health Department (SEHD). It provides a case study in the introduction of a new health care worker role into an already well established and "mature" workforce configuration It assesses the role of US style physician assistants (PAs), as a precursor to planned "piloting" of the PA role within the National Health Service (NHS) in Scotland. The evidence base for the use of PAs is examined, and ways in which an established role in one health system (the USA) could be introduced to another country, where the role is "new" and unfamiliar, are explored. The history of the development of the PA role in the US also highlights a sometimes somewhat problematic relationship between P nursing profession. The paper highlights that the concept of the PA role as a 'dependent practitioner' is not well understood or developed in the NHS, where autonomous practice within regulated professions is the norm. In the PA model, responsibility is shared, but accountability rests with the supervising physician. Clarity of role definition, and engendering mutual respect based on fair treatment and effective management of multi-disciplinary teams will be pre-requisites for effective deployment of this new role in the NHS in Scotland.
Background This paper draws from research commissioned by the Scottish Executive Health Department (SEHD). It assesses the role of US style physician assistants (PAs), as a precursor to planned "piloting" of the PA role within the National Health Service (NHS) in Scotland. As such, it reports on the evidence base for the use of PAs, and then discusses how an established role in one health system (the USA) could be introduced to another country, where the role was "new" and unfamiliar. For a comprehensive assessment and description of the development of the PA role in the USA, see the core text by Hooker and Cawley [1].
The primary focus of the paper is to identify lessons for consideration during planning and implementation of the planned "pilot", when a small number of US trained a
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