Physician Associates Offer Safe and Effective Patient Care Under Medical Supervision

Recent findings published in The BMJ reveal that physician associates (PAs), also known as physician assistants in many countries, can deliver safe and effective healthcare when working under the direct supervision of qualified physicians. The rapid review analyzed 40 studies across developed nations, primarily in North America and Europe, assessing the quality, safety, and patient satisfaction associated with PAs managing diagnosed patients. The studies indicated that patient satisfaction levels with PA-led care were comparable to those managed solely by doctors. However, evidence regarding their cost-effectiveness remains limited.

Importantly, the review found that while PAs significantly improve access to healthcare services, especially in socio-economically deprived areas, their role in assessing undiagnosed or complex patients without direct supervision is less supported by current evidence. Concerns about patient safety exist when PAs manage undifferentiated symptoms independently, emphasizing the need for clear supervision guidelines.

The introduction of PAs initially aimed to address physician workforce shortages, particularly in rural and underserved areas, starting in the 1960s in the US. Since then, their roles have expanded globally, adapting to healthcare systems facing staffing and cost challenges. In the UK, PAs require comprehensive training, including a bachelor's degree in science or health and postgraduate clinical studies.

In response to concerns about patient safety, cost, and training, the UK’s Academy of Medical Royal Colleges has called for a review of the PA role’s scope, supervision, and efficacy. A formal independent review commissioned in late 2024 aims to evaluate these aspects further, taking into account the limited UK-specific data and the predominantly international research base.

The review underscores that PAs can be valuable in well-defined, supervised roles but warns against unsupervised management of complex cases, which may compromise safety. The development of national guidelines on supervision and scope of practice is recommended to optimize the safety and effectiveness of physician associate roles.

Overall, PAs represent a promising solution to healthcare access issues but require clear regulatory frameworks to ensure patient safety and service quality.

For more details, see the full rapid review in BMJ: [DOI: 10.1136/bmj-2025-086358].

Source: https://medicalxpress.com/news/2025-07-physician-associates-safe-patients-doctor.html