Physician Associate and General Practitioner Consultations: A Comparative Observational Video Study.

Physician associates are a relatively new workforce in UK primary care. Prior research has shown their role in the U.S., but limited data exists on their performance in the UK. Established knowledge includes their function as mid-level practitioners. No prior work had resolved their comparative effectiveness in consultations. This gap motivated a study to evaluate their clinical performance. General practitioners remain the main providers in primary care. Physician associates handle same-day appointments for new problems. This paper's contribution is a direct comparison of consultation quality between these two groups. The study addresses the need to understand their role in the evolving healthcare landscape.

This study aimed to assess the quality of consultations led by physician associates compared to general practitioners in UK primary care. The specific problem is the lack of evidence on how these consultations differ in safety and complexity. Motivation comes from the need to integrate physician associates into primary care. The authors sought to evaluate consultation quality using standardized tools. They also aimed to compare patient complaint types discussed. The study focused on whether physician associates can deliver safe, competent care. The goal was to inform workforce planning and training needs. This approach helps understand the evolving role of physician associates in general practice.

The research employed a comparative observational study design. Video recordings of consultations were collected from volunteer participants. Physician associates and general practitioners were included in the study. Recordings were made during single surgery sessions with consenting patients. Assessors were experienced general practitioners blinded to practitioner type. They used the Leicester Assessment Package for evaluation. Ratings focused on consultation elements and patient complaint types. Assessors also commented on safety and attempted to identify practitioner type.

Sixty-two consultations were assessed across five general practitioners and four physician associates. All consultations were rated as safe by the assessors. General practitioners received higher scores in all consultation elements. Physician associates saw patients with fewer presenting complaints (p<0.0001). They handled fewer chronic disease-related complaints (p=0.008). Assessors correctly identified general practitioner consultations but not physician associate ones. The Leicester Assessment Package showed limited reliability in ratings. Physician associate consultations involved a less complex patient group. They were judged competent and safe, though general practitioners were rated as more competent.

Physician associate consultations were rated as safe and competent by assessors. General practitioner consultations received higher scores in all assessed elements. The patient groups seen by physician associates were less complex. This suggests a complementary role for physician associates in primary care. The study supports their addition to the medical workforce. No prior work had resolved the comparative safety of these consultations. Assessors could not reliably identify physician associate consultations. The findings align with the authors' claim that physician associates offer a useful workforce addition.