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Experience with physician assistants in a Canadian arthroplasty program
Eric R Bohm1, Michael Dunbar, David Pitman
1The Division of Orthopedic Surgery, University of Manitoba, Winnipeg, MB. ebohm@cjrg.ca
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|March 26, 2010
Summary
Physician assistants in arthroplasty care improve surgical throughput by 42% and reduce wait times. They are cost-neutral, valued by patients and providers, and save surgeons significant time.
Area of Science:
- Orthopedic Surgery
- Health Services Research
Background:
- Increasing demand for orthopedic services in Canada strains the workforce.
- Physician assistants (PAs) offer a successful model for augmenting orthopedic care.
- The Winnipeg Regional Health Authority (WRHA) has effectively integrated PAs into arthroplasty practice.
Purpose of the Study:
- To evaluate the impact of PAs in arthroplasty from patient and provider perspectives.
- To assess the cost-effectiveness of employing PAs.
- To determine the effect of PAs on surgical throughput and patient wait times.
Main Methods:
- Time savings quantified using PA daily diaries.
- Provider and patient opinions collected via self-administered questionnaires.
- Cost analysis included forgone general practitioner (GP) surgical assist fees and PA salaries.
- Surgical throughput and wait times analyzed using WRHA waitlist data.
Main Results:
- PAs saved supervising physicians approximately 204 hours annually.
- PAs were viewed positively by surgeons, nurses, residents, and patients.
- PAs were cost-neutral compared to GP surgical assists.
- Surgical throughput for hip and knee replacements increased by 42% with PA use.
- Median wait times decreased from 44 to 30 weeks.
Conclusions:
- Physician assistants integrate effectively into orthopedic care teams.
- PAs enhance surgical volumes and reduce patient wait times.
- The integration of PAs is a cost-effective strategy for improving orthopedic surgical capacity.
