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Dr. Eric Howell, a physician hospitalist at Johns Hopkins Bayview Medical Center who is not affiliated with the study, said physician assistants and nurse practitioners already serve effectively in a number of capacities in hospitals. The key, he said, is proper training. “With all professionals, from physicians to physician assistants to anyone else working in a hospital, they need to be properly onboarded into the hospital medicine world,” he said. “Hospitals have become complicated. … With the right amount of training, mentoring and onboarding, physician assistants can be effective teams members.”
At Anne Arundel Medical Center, physician assistants are required to get specialized training at the hospital on top of the general education that is part of their degree, which is usually a master’s from a physician assistant program.
There are approximately 110,000 physician assistants in the United States. Their numbers increased 36 percent from 2010 to 2015, according to the American Academy of Physician Assistants. More than half work in hospitals and more than 6 percent work primarily in a hospitalist position at least some of the time, meaning they serve in a primary care role. Many physician assistants work in more than one institution.
In Maryland, more than 11.6 percent physician assistants work in hospital medicine, which officials said could be because of “more flexible” state laws that govern such things as how many physician assistants can work with one doctor and how much autonomy they are permitted.
“We’ve really expanded into positions that used to have physicians in those roles,” said Josanne K. Pagel, president of the academy and executive director of physician assistant services for the Cleveland Clinic Health System. “That physician assistant is your provider.”
She said a physician assistant can provide consistency when many hospitals are staffed with residents, or doctors in training, who rotate in and out of departments. She said that can improve care and patient satisfaction.
On a recent day, Kelly Corcoran, a physician assistant working as a hospitalist at Anne Arundel Medical Center, walked into a patient’s room and sat down next to Mary Franklin, who had just undergone a gastrointestinal procedure. Corcoran introduced herself, told Franklin what to expect going forward and asked if she had questions.
Corcoran turned to the patient’s daughter and asked if she had questions. Then they spent a bit of time bonding over the fact that Franklin and Corcoran were both from Cincinnati.
“When you go to see patients, you find it’s sometimes overwhelming to them because they are being seen by so many people and making life-altering decisions,” Corcoran said. “I introduce myself and explain I’m their primary care provider for the inpatient world. I try to put them at ease.”
Corcoran said many people have never heard of physician assistants, so she also takes time to explain her role and her plan for their care. Patients don’t generally ask for a physician, though some want to know why their own primary care doctor doesn’t come to the hospital to treat them.
Franklin said she wasn’t bothered that a physician assistant was in charge of her care. She’d seen a couple during her hospital stay and thought they spent more time with her than a doctor normally would.
“They seem knowledgeable and they’re easy to talk to,” Franklin said. “I feel comfortable with them.”