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Physician assistants reduce resident workload and improve care in an academic surgical setting
Natalie Dies1, Saira Rashid, Maureen Shandling
1At Mount Sinai Hospital in Toronto, Ontario, Canada, Natalie Dies and Saira Rashid practice in the Department of General Surgery; Maureen Shandling is the senior vice president of medical affairs and a practicing neurologist; Carol Swallow is the chair of the Division of General Surgery at University of Toronto, professor in the Department of Surgery, and a practicing surgical oncologist; Alexandra M. Easson is an assistant professor in the Department of Surgery and Institute of Health Policy, Management, and Evaluation and a practicing surgical oncologist; and Erin Kennedy is an associate professor in the Department of Surgery and Institute of Health Policy, Management, and Evaluation and a practicing colorectal surgeon. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Objectives:
Educational demands coupled with restricted hours reduce residents' availability to provide care at academic hospitals. Physician assistants (PAs) may address this issue. This study assessed the effect of PAs on patient discharges, resident workload, and resident perceptions of PAs on a surgical team.
Methods:
Two PAs were employed on teams caring for complex surgical patients. Measures included time of discharge order entry, hours residents spent on the electronic medical record (EMR), and resident opinions of PA effectiveness.
Results:
The teams with PAs had a 0.5% late discharge and 16% early discharge rate. Junior residents with a PA on the team spent fewer hours on the EMR. Residents reported PAs significantly improved their rotation and quality care.
Conclusions:
PAs reduce resident workload and improve care on surgical teams in a tertiary hospital.
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