Jaapa-Journal of the American Academy of Physician Assistants最新文献

Objective: The aim of this qualitative research study was to understand the barriers to PA advancement in hospital governance as perceived by PAs in current hospital leadership roles.

Methods: This qualitative study of hospital-based PA leaders used grounded theory methodology through one-on-one, informal, semistructured virtual interviews. Thematic content analysis was used to analyze and report patterns within interview data.

Results: In examining the 14 completed interviews, thematic analysis yielded 4 major themes and multiple subthemes. The predominant themes were (I) professional barriers; (II) workplace barriers; (III) personal barriers; and (IV) tools for PA advancement.

Conclusions: This study provides foundational data on perceived barriers to PA advancement in hospital governance from the perspectives of PA leaders. Gaining a deeper understanding of the challenges PAs encounter in pursuing hospital leadership roles can guide both the profession and health care organizations in implementing strategies to support PA leadership development and create more inclusive governance structures to meet the needs of a changing health care system.

Abstract: Recurrent cutaneous squamous cell carcinoma (cSCC) may rarely present with symptoms of perineural spread (PNS) or perineural invasion (PNI), which may not be noted on initial pathology. Because PNS can mimic benign neuropathies, patients with this manifestation often experience diagnostic delays, especially when PNI is not initially detected. This case report describes a patient who experienced persistent and progressive neurologic symptoms for more than a year before imaging revealed recurrent cSCC involving the cervical nerve roots, despite initial evaluations and imaging failing to detect PNS or PNI. It highlights the need to closely follow and perform repeat evaluations for patients with persistent symptoms without a definitive diagnosis.

Abstract: Since the Accreditation Council for Graduate Medical Education's restriction of residents' work hours, trauma surgery teams have begun utilizing physician associates (PAs) and nurse practitioners (NPs), collectively referred to as advanced practice providers (APPs), to compensate for resident shortages. The increased adoption of APPs in trauma surgical staffing models has led to growing interest in evaluating their impact on quality of care, clinical outcomes, and system-level performance. This literature review aims to evaluate current evidence on APP trauma surgery service outcomes and compare them with those of resident-run teams.

Abstract: Wait times for endocrinology care can delay diagnosis and management of many hormonal imbalance disorders. Physician associates (PAs) are now, more than ever, faced with the task of ordering and interpreting complex laboratory tests to diagnose these endocrine disorders in the face of specialty care shortages. When primary care providers diagnose a disorder, it speeds therapy initiation and slows or stops the risk of complications. This article aims to assist PAs in nonendocrinology settings by clarifying various confounding factors that may impede diagnosis, as well as to provide guidelines and practical advice for the diagnosis and treatment of common endocrine disorders.

Abstract: After a patient suffers a medical error or other adverse event, physician associates (PAs) and other health care providers involved in the patient's care are susceptible to experiencing their own physical and psychosocial symptoms. In this commonly occurring phenomenon, known as second victim syndrome, the health care provider becomes the second victim after the patient. This article reviews the symptoms, progression, management, and complications of second victim syndrome. Additionally, this review advocates for PA programs to integrate curricula focused on second victim experiences, equipping PA students with effective coping strategies, and for institutions to establish tiered support programs to help employees navigate the challenges of second victim experiences.

Abstract: Female chronic pelvic pain (CPP) is a common, complex, multifactorial disorder that can negatively affect sexual functioning and emotional well-being. Effective assessment necessitates a comprehensive patient history and trauma-informed physical examination. The differential diagnosis is extensive, but a methodical investigation often leads to an appropriate diagnosis. Management strategies encompass a range of pharmacologic and nonpharmacologic interventions, including neuropathic medications, hormone therapies, pelvic floor physical therapy, trigger point injections, and behavioral health interventions. A multidisciplinary, evidence-based approach is essential for patients with CPP.