Examining attitudes of specialist physicians regarding physician assistant referrals

Referral of a patient from a primary care provider to a referral specialist physician for consultation is an important link in the continuum of patient care. Although the relationship between the physician assistant (PA) and supervising physician has been studied extensively, the effectiveness of the relationship between the primary care PA and the referral specialist physician is unclear. The purpose of this study was to examine the attitudes of the referral specialist physician toward direct referral of patients from primary care PAs. A random sample of 5,000 specialist physicians in five specialty areas across the United States were surveyed to determine their willingness to accept referrals from PAs, their attitudes about the appropriateness of PA referrals, and reasons for dissatisfaction, if any. Data analysis revealed that specialist physicians generally are willing to accept patient referrals from primary care PAs and that specialist physicians generally are satisfied with the appropriateness and timeliness of referrals from PAs. Whether or not the specialist physician employed (supervised) a PA in his or her own practice made a significant difference in level of satisfaction with PA referral. To determine the significance of these results, more research is needed to determine specialist physician satisfaction with referrals from primary care physicians compared with PAs.