Alright, so I am back from sunny San Diego, had a good time at the annual AAPA conference. The HOD was relatively boring this year, and got to take in some of the sights.
I am about to undertake the monster, my Moby Dick, the whale that no one wants to deal with. I am about to do, and have submitted for IRB approval, a comparative effectiveness study evaluating the care provided by PA's, working autonomously, vs MD attendings. This, at least to my knowledge, has not been done in the ED setting before, and I am interested in examining the results.
In order to keep the study manageable, and in order to obtain good results, we will be limiting the study to 3 diagnoses.
1. Renal Stones
2. Thromboembolic Events
3. Asthma Excacerbations
I chose these 3 diagnoses, as they all have defined endpoints within the ED setting, and am interested in comparing clinical outcomes, ie; did the PA group treat the patients in the same manner as the physician group?, Were there any missed diagnoses? Was there an increase in complications? etc.etc.
Also, I want to examine the financial impact, ie; we claim to be more cost effective, but is the PA group ordering more tests, and/or unnecessary interventions when compared to the physician group, thereby negating the cost savings?
As my friend, and colleague James Cawley noted, you may find things that you might not like. Which, at least in my mind, is even more of a reason to do this. If we are NOT meeting benchmarks, then we need to know this.
May be interesting.
Also, we have one NP in the group, and she will be included in the study group as well.