PAs in the ED: do physicians think they increase the malpractice risk?

This study evaluates emergency physicians' perceptions of the malpractice risk posed by utilization of physician assistants (PAs) in emergency departments (EDs) in 2004 and again in 2009. A 16-question survey was mailed to a random sample of 1,000 active members of the American College of Emergency Physicians in 2004 and again in 2009. In both 2004 and 2009, 70% of the emergency physicians did not believe that PAs, when properly supervised, are more likely to commit malpractice than any other clinician. In both surveys, 80% of the respondents did not believe PAs were more likely to be sued for malpractice. A significant negative correlation was found between perceived risk of malpractice by PAs and the number of years physicians had worked with PAs or had worked in emergency medicine. From 2004 to 2009, the number of respondents practicing with PAs increased by 26%, the number directly supervising a PA in the ED increased by 19%, the number who thought PAs decreased patient wait times increased by 13%, and the number who reported that PAs increased patient satisfaction increased by 10%. As physicians gain clinical experience with PAs, their perceived risk of malpractice tends to decrease. These results may have implications for the utilization of PAs, particularly as EDs become more utilized for noncritical situations.