Physician Assistant Utilization in Inpatient Psychiatry: A Qualitative Study

Area of Science:

• Medical Professionalism
• Healthcare Administration
• Psychiatric Nursing

Background:

• National shortage of psychiatric care providers impacts access to mental health services.
• Physician assistants (PAs) represent an underutilized resource in psychiatric care, with only 1% currently practicing in the field.
• Understanding the integration and effectiveness of PAs in inpatient psychiatric settings is crucial for addressing workforce challenges.

Purpose of the Study:

• To investigate the current utilization of physician assistants (PAs) in inpatient psychiatric care settings.
• To explore factors influencing PA integration, including autonomy, reimbursement, training, and certification.
• To assess the overall satisfaction and perceived impact of PAs on psychiatric care delivery.

Main Methods:

• A qualitative research design was employed, utilizing semi-structured interviews.
• Interviews were conducted with representatives from nine healthcare facilities regarding their use of PAs in psychiatry.
• Key areas of inquiry included PA autonomy, reimbursement models, specialized training, and satisfaction levels.

Main Results:

• Four of the nine interviewed facilities currently utilize PAs in inpatient psychiatry; five have never employed them.
• Facilities using PAs reported a decrease in physician workload.
• Significant variation exists in training structures, billing practices, and required specialized certifications for PAs across facilities.

Conclusions:

• Many facilities are unaware of PA qualifications or prefer to rely solely on physicians, leading to underutilization of PAs in psychiatric care.
• Despite diverse utilization and reimbursement models, facilities employing PAs in inpatient psychiatry report high satisfaction.
• Physician assistants are capable of delivering high-quality care in inpatient psychiatric settings, offering a viable solution to workforce shortages.