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Concordance between otolaryngologic surgical procedures booked by PAs and procedures ultimately performed
Daniel R Tierney1, David A Scalzitti, Howard J Ritz
1Daniel R. Tierney practices otolaryngology in the Department of Otolaryngology-Head and Neck Surgery in the Icahn School of Medicine at Mount Sinai in New York, NY. David A. Scalzitti is an associate professor at the George Washington University School of Medicine and Health Sciences in Washington, DC. Howard J. Ritz practices otolaryngology and is associate chief medical informatics officer at Glens Falls Hospital in the Albany Med Health System in Glens Falls, NY. In the Department of Otolaryngology-Head and Neck Surgery at the Penn State Health Milton S. Hershey Medical Center in Hershey, PA, Tiffany Heikel is an advanced practice provider manager and practices otolaryngology, and Erin Groft is a lead advanced practice provider for otolaryngology. Reagan Davis is an advanced practice provider supervisor and practices otolaryngology in the Department of Otolaryngology-Head and Neck Surgery at the University of Texas Medical Branch at Galveston in Galveston, TX. The authors have not disclosed any potential conflicts of interest, financial or otherwise.
Objective:
To evaluate the concordance between otolaryngologic surgical procedures recommended by physician associates (PAs) and those ultimately performed by surgeons across multiple academic medical centers.
Methods:
A retrospective chart review was conducted across three clinical sites from January 1, 2022, to December 31, 2023. Cases were included if a PA recommended surgery and an operative report was available. Concordance was classified as full, partial, or none. Chi-square and Spearman correlation analyses were used to assess associations with clinical site, PAs' estimated years of experience, patient age, and patient diagnosis.
Results:
Of 1,595 cases booked by 16 PAs, 95.9% were fully concordant. Concordance varied by clinical site and individual PA and was positively correlated with PAs' estimated years of experience (ρ = .103; P < .001).
Conclusion:
PAs demonstrated high concordance in surgical case booking across multiple academic medical centers. These findings support PA participation in team-based preoperative surgical planning and suggest potential benefits to surgical workflows and access to otolaryngologic care.
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