CHICAGO (April 20, 2009) – New research published in the April issue of the Journal of the American College of Surgeons indicates that large numbers of physician assistants and nurse practitioners – collectively known as physician extenders (PEs) – have been hired by general surgery residency programs in the last five years to enable the resident education experience, and these professionals continue to be in demand. Most have been hired in response to work-hour restrictions imposed by the Accreditation Council for Graduate Medical Education (ACGME) in 2003.
There has been substantial debate within the health care community about the ACGME decision to limit medical residents to an 80-hour work week, primarily due to concerns that restricted hours would shortchange residents’ training. Previously, residents often worked 100 hours or more weekly.
“Our study demonstrates that PEs are a practical solution for addressing surgical resident work-hour restrictions. By relieving surgical residents of administrative tasks and routine procedures, residency programs can maximize the educational experience for these surgeons in training,” said Christopher Pezzi, MD, FACS, of Abington Memorial Hospital in Abington, PA.
To assess the use of PEs, researchers mailed a questionnaire to program directors of all ACGME-accredited general surgery residency programs. The survey assessed the number of PEs at each institution, whether PEs were hired in response to ACGME resident work-hour restrictions and if there were plans to hire more PEs in the next three years.
Sixty-five percent (n=163) of the general surgery residency programs responded to the questionnaire. Almost 80 percent (n=127) of these programs had at least one PE. Collectively, the programs that responded to the questionnaire employed a total of 840 PEs, which averages to 5.3 PEs per program (p = 0.0001). Before ACGME work-hour limitations, the average number of PEs per general surgery program was 2.0. Sixty-one percent (n=513) of PEs were hired in response to ACGME restrictions.
Data from the study showed that PEs were utilized mostly for procedural and administrative duties. PE duties included taking patient histories and performing physical examinations (84 percent), interacting with consultants (58 percent), first-assisting (52 percent) and caring for patients in the emergency room (47 percent). PEs were also responsible for paperwork, scheduling tests, assisting with billing and coding and other procedural duties.
Nearly 50 percent of the programs planned to hire PEs within the next three years if funding is available, which would translate into job openings for an additional 431 PEs.