Doctor's assistants--do we need them?
OBJECTIVE
To investigate the potential for the doctor's assistant role within an accident and emergency (A&E) department in relation to consultant workload.


METHODS
A time and motion evaluation of the activities of four A&E consultants before and after a doctor's assistant was established as a team member within our department. A review of the literature was undertaken to allow comparisons with the American model of the physician assistant within the emergency department.


RESULTS
The initial evaluation indicated that over 20% of the consultant's time could have been saved if an assistant were available to perform a variety of non-medical tasks. The restudy performed once the assistant was in post indicated less time was spent by the doctors in "medical" clerical duties (6.7% v 11.5% time), telephone use (5.6% v 7.7%), and venepuncture/cannula insertion (0.4% v 2.1%), and more time was spent on consultation over cases (15.3% v 11.3%) and supervision of other staff (9.3% v 4.1%). These five areas changed significantly (p = 0.005 by paired t test).


CONCLUSIONS
The doctor's assistant may have a role in reprofiling the workload of senior doctors in A&E departments in the UK. They may also have a role in reducing the pressure on junior doctors, though this effect was not evaluated.
Law
H
H
Accident and Emergency Department, St James's University Hospital, Leeds.
Sloan
J
J
D003625:Data Collection; D004636:Emergency Service, Hospital; D005069:Evaluation Studies as Topic; D006801:Humans; D010823:Physician Assistants / Q000706:statistics & numerical data* / Q000600:supply & distribution; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D006113:United Kingdom; D014481:United States; D000078329:Workforce; D016526:Workload