ABSTRACT
BACKGROUND: Changes in the health care system have led to reduced availability of surgical residents to function as house officers in teaching hospitals. The purpose of this cross-sectional study was to assess the level of satisfaction of patients, physicians and nurses, and ancillary providers with the care provided by the midlevel providers (MLPs) who are utilized as house officers in a Level I trauma service. This type of care model is unusual because the trauma service no longer utilizes surgical residents to provide trauma coverage. METHODS: Trauma patients admitted to the hospital during a 3-month period in 2004 were surveyed, as were physicians and hospital employees who work most closely with MLPs. RESULTS: Patients are very satisfied (84%-86%) with the care they received from the MLPs (n = 109). There were no significant differences in satisfaction with MLPs when looking at the patient's age, gender, length of stay, or whether the patient was in the intensive care unit. Analysis of physician and hospital employee satisfaction is also strongly positive overall. Of the respondents, 84% (n = 281) agreed that MLPs have made a positive impact on the care of the trauma patient, 86% agreed that MLPs are available to address patient and staff concerns, and 80% think that MLPs have made trauma care more efficient. CONCLUSION: Trauma patients and healthcare team members of the trauma service at Wesley Medical Center, an accredited Level I trauma center, are generally satisfied with care provided by MLPs.
Subject(s)
Nurse Practitioners , Patient Satisfaction , Physician Assistants , Trauma Centers , Adolescent , Adult , Attitude of Health Personnel , Child , Child, Preschool , Cross-Sectional Studies , Data Collection , Female , General Surgery/education , Hospitals, Teaching/organization & administration , Humans , Infant , Internship and Residency , Kansas , Male , Middle Aged , Quality of Health Care , WorkforceABSTRACT
Referral of a patient from a primary care provider to a referral specialist physician for consultation is an important link in the continuum of patient care. Although the relationship between the physician assistant (PA) and supervising physician has been studied extensively, the effectiveness of the relationship between the primary care PA and the referral specialist physician is unclear. The purpose of this study was to examine the attitudes of the referral specialist physician toward direct referral of patients from primary care PAs. A random sample of 5,000 specialist physicians in five specialty areas across the United States were surveyed to determine their willingness to accept referrals from PAs, their attitudes about the appropriateness of PA referrals, and reasons for dissatisfaction, if any. Data analysis revealed that specialist physicians generally are willing to accept patient referrals from primary care PAs and that specialist physicians generally are satisfied with the appropriateness and timeliness of referrals from PAs. Whether or not the specialist physician employed (supervised) a PA in his or her own practice made a significant difference in level of satisfaction with PA referral. To determine the significance of these results, more research is needed to determine specialist physician satisfaction with referrals from primary care physicians compared with PAs.
