Using PAs to substitute for house staff may not always be financially beneficial. First, for a given salary or hourly wage, PAs work a fixed schedule and may be entitled to overtime as opposed to house staff who are on a fixed salary, and who essentially work numerous hours without additional compensation for the benefit of their education. In addition, teaching hospitals receive funding from the state above and beyond resident salaries for each resident each year. Although PAs are being used more frequently in teaching hospitals, they have been used in community hospitals in New York and in other states long before New York's new regulations went into place. Figures 1-4 summarize data concerning PA practice from the American Association of Physician Assistants Census Report published in 1998.
PAs can improve continuity of patient care, providing overlap when physicians rotate call.
PAs can be advantageous for the care of hospitalized patients, allowing physicians to maintain office hours and operating room time. In some circumstances, more revenue is generated by a physician who primarily sees patients in the office. The PA can reduce inpatient rounding time for the physician by writing progress notes and by handling calls from nurses and families. It is not clear how far the role of the PA in the inpatient arena will extend. Recent reports1,2,3 have discussed roles and training programs for acute care nurse practitioners.