Commentaries on health services research

Physician associates are new to the United Kingdom and set to expand in numbers. Little is known about the patient's perspective. A qualitative study, using semistructured interviews with thematic analysis, was undertaken with 30 volunteer patients of 430 who had consulted PAs in six general practices. Patients' conditions ranged from minor illnesses to those requiring immediate hospital admission. Understanding the PA role varied from certain and correct, to uncertain, to certain and incorrect (in which the patient believed the PA to be a physician). Most, but not all, reported positive experiences and outcomes of their consultation, with some choosing to consult the physician. Those with negative experiences described problems when the limits of the role were reached, delaying prescriptions or requiring additional physician consultations. Trust and confidence were derived from trust in the National Health Service (NHS), the general practice, and the PA. Willingness to consult a PA was contingent on the patient's assessment of the severity or complexity of the problem and the desire for provider continuity. Patients saw PAs as an appropriate general practitioner substitute. Patients' experience could inform delivery redesign.