More nurse practitioners (NPs) and physician assistants (PA) are working in hospital emergency departments (ED). PAs now treat approximately 10% of the total patient population that visits the ED each year; yet ED physicians sometimes view these clinicians as a professional threat, data from a recent study published in the Journal of the American Academy of Physician Assistants indicate, perhaps because of malpractice fears.

Alisa Gifford, MMS, PA-C, and colleagues mailed a 16-question survey to a random sample of 1,000 active members of the American College of Emergency Physicians in 2004, and then again five years later. Results from both surveys were fairly consistent – 72% of physicians in 2004 and 68% in 2009 either disagreed or strongly disagreed that PAs are more likely than physicians to commit medical malpractice.

Similarly, most physicians disagreed or strongly disagreed that PAs were more likely than doctors to be sued as a result of medical malpractice (84% in 2004 and 82% in 2009).

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Factors that would most significantly decrease PA malpractice risk were more clinical experience in emergency medicine, completion of a post-graduate residency program and appropriate supervision by physicians, survey results indicated.

Some positive trends were seen during the five-year period between surveys:

  • The number of physicians who reported practicing with PAs increased 26%
  • The number of doctors who directly supervised PAs in the ED increased19%
  • The number of physicians who believed that PAs decrease patient wait times in the ED increased 13%
  • The number of doctors who believe that PAs increase patient satisfaction increased 10%.

“Most emergency physicians agree that the increased utilization of PAs in the ED may improve patient communication, decrease wait times, increase patient satisfaction, and therefore decrease malpractice risk,” the researcher wrote. “As physicians gain both clinical experience and experience working with PAs, their perception of malpractice risk imposed by the PA in the ED significantly decreases.”

Gifford A et al. JAAPA. 2011;24(6):34-38.