Analysis of a rural family-practice-based evening clinic staffed by a PA

A family practice in rural Breckenridge, Colorado began an evening clinic during the winter months of 1981-82 to serve the extra 1,000 to 2,000 residents that that community accommodated each year during the ski season. The clinic was staffed by a PA, who was aided by an office assistant, on weekdays from 5 P.M. to 10 P.M.; after 10 P.M., the PA took calls at home until the office again opened at 9 A.M. The pilot program was successful enough to warrant continuation. This article analyzes the Breckenridge Medical Center's experience during that first year with a PA-staffed evening clinic, in terms of morbidity profile of the after-hours cases, the amount of physician involvement required, the economic aspects of maintaining evening hours, and the ratio of day to evening patients that can be expected. The authors conclude that their extended office hours have proven to be an effective, affordable solution to their practice's after-hours medical care problem.