Physician Assistants as House Staff

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Traditionally, the “house staff” of a teaching hospital is made up of physician residents and fellows who care for patients under the direction and responsibility of attending physicians.  Many of these hospitals also employ PAs to work with the residents providing clinical support and continuity of care when residents move on.

Non-teaching hospitals – typically smaller, community hospitals – often utilize PAs to supplement their physician staff.  Reports of success with this model date back to the late 1970s. 

In more recent years, as certain physician residency programs have shrunk and as mandates have reduced resident hours, many more hospitals have turned to PAs to meet their workforce needs.

AAPA Issue Brief:  Reduced Resident Hours Call for Creative Solution: Hire Physician Assistants
For hospitals considering hiring PAs to serve as “house staff.” A quick review of PA education, credentials, physician supervision, and successful models in teaching hospitals and hospitals without physician residents.

Midlevel Practitioner workforce analysis at a teaching hospital
In light of resident hour reductions, researchers at Hartford Hospital (CT) have developed a methodology to determine the number of “midlevel providers” needed to meet the staffing needs of their five surgical services.  

New Britain (CT) General Hospital’s 20-year experience with PAs and residents
In 1979, New Britain General Hospital (Connecticut) created two equal teaching services — one for PAs and one for physician residents — but integrated their work. A 1999 review of a 20-year experience.

PAs finding opportunities as hospitals adjust to new rules on residents' hours
PAs are finding new employment opportunities and new responsibilities as resident hours are limited.

Yale-New Haven Hospital hires PAs to fill residency void
In preparation for reduced resident hours, Yale New-Haven Hospital increased its PA ranks in medicine and surgery.

Paradigm shift from residents to PAs at Toledo hospital
In 1998, Toledo Hospital in Toledo, Ohio, initially hired 20 PAs to cover subspecialty services that lacked residents and in a nearby clinic. By 2002 there were 62 PAs, two nurse practitioners, as the hospital shifted from an education-based to a service-based system.
 
 
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