Role of physician assistants in rural hospital settings in the Virgin Islands: A case study

Abstract

A qualitative exploratory case study was undertaken to explore the role of physician assistants (PAs) in a small, rural hospital in the Virgin Islands. The concept of task transfer was examined to determine if PAs could take on more roles assumed by physicians. The study involved the perceptions and experiences of 16 physicians, 11 PAs, 12 hospital administrators, and 10 potential patients. Emerging themes fell into three categories: benefits and challenges of working with PAs, role of PAs, and acceptance of PAs. Within these categories, the following themes were identified: limited/basic PA roles, reduction of the physician workload, and variable PA competency levels. Subthemes to emerge included the role of PAs, improving patient care, filling shortages, the supervision of PAs, developing protocols for duty, and establishing a procedure for delegation of responsibilities. The conclusion was that in patient service in rural areas, maximizing the efficiency of a PA could be improved when task transfer was implemented as a means to the division of labor. The results of this study may assist legislators when re-evaluating and revising physician assistant scope of practice policies.