Abstract
Purpose :
Physician assistants (PAs) and advanced practice providers have been utilized successfully throughout medical/surgical subspecialties to expand care teams and enhance access. Ophthalmology has not widely utilized physician extenders to date. The purpose of this assessment was to evaluate patient experience and impact on access following the deployment of a retina-trained physician assistant.
Methods :
This is a retrospective quality analysis that was determined to be exempt by the IRB. The PA was hired in December of 2021 and underwent extensive training in ophthalmic image interpretation, retinal disease management, and ophthalmic examination under the direct supervision of a retina specialist. The analysis of patient volumes and experience are taken from April 2022 through December 2022. Patient conditions that were primarily targeted for PA assessment, included dry age-related macular degeneration, non-proliferative diabetic retinopathy, epiretinal membranes, lamellar macular holes, macular edema, and select post-operative patients. On this service, the PA’s role was strictly for the medical management of retina patients. The scope of practice for the PA on this service does not include any procedures (e.g., intravitreal injections, lasers). Clinical volumes and patient satisfaction evaluations were evaluated.
Results :
The retina specialist was in clinic 2 days per week, whereas the PA was available for clinic 4.5 days per week at multiple locations. This facilitated improved same-day access and greater location flexibility for patients needing to be seen. The PA was able to increase the number of patients seen by 27% during the initial nine month experience. This provided more rapid access for allowed the doctor to overall take in more cases including surgical and clinical. Detailed review of patient feedback demonstrated very strong satisfaction and a high interest/willingness to continue to see the retina service PA in the future.
Conclusions :
This initial review of patient experience and access demonstrates that the addition of a PA to a subspecialty line can improve access and provide excellent patient experience. Additional future analyses will include evaluation of outcomes, ongoing direct patient surveys, and expanded assessment of the care delivery model.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.