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

Background: Advanced practice providers (APPs) are integral to plastic surgery practices due to the frequency of staged procedures, perioperative care, and broad scope of practice. Our study evaluates the impact of APP utilization in one of the largest pediatric plastic surgery divisions in the United States.

Methods: Descriptive analyses were conducted to describe productivity trends from October 2012 to September 2023. Metrics included the number of clinic encounters, providers, operating room (OR) cases, and surgical conversion rate.

Results: In 2013, APPs completed one patient encounter for every five completed by surgeons. Since 2020, APPs have matched or exceeded the number of clinic encounters conducted by surgeons. The surgeon surgical conversion rate (surgeon clinic encounters to OR cases) increased from 0.19 in 2018 to 0.26 in 2023.

Conclusions: Enhanced utilization of APPs in the division of plastic surgery has optimized our patient care model, increasing procedural productivity for surgeons without reducing clinic volume.

Abstract: Pott puffy tumor (PPT) is a condition characterized by frontal bone osteomyelitis with subperiosteal abscess and is typically a complication of sinusitis. PPT is rare in young children due to the timing of pneumatization of the frontal sinus. This case presents a healthy toddler who developed PPT with an epidural abscess requiring surgical drainage.

Abstract: Chronic obstructive pulmonary disease (COPD) exacerbations are a leading cause of hospitalization in the United States, incurring a large financial burden on the healthcare system and placing significant strain on patient quality of life. Adding empiric antimicrobial agents, specifically macrolides, to the medical regimen of patients with severe COPD has been shown to reduce the frequency of COPD exacerbation. Although prophylactic macrolide therapy may relieve COPD burden, providers should consider the consequences of long-term antimicrobial utilization before prescribing these drugs.

Abstract: The medical field is filled with ancient and modern symbols that have cultural and historical meanings. Symbols present in logos implicitly communicate values and purpose. This article explores the medical and religious symbolism found in the two most common medical logos, the Rod of Asclepius and the caduceus, comparing the values they represent to the values of modern medical practice as defined by the Georgetown Mantra. Although the Rod of Asclepius and the caduceus are culturally recognized today as representing medical practice and healing, they in reality are associated with historical figures and stories representative of trickery, thievery, or a selective application of the healing arts. Institutions using these symbols in their logos should consider how their branding might be adjusted to communicate the values that medical professionals aim to espouse today.

Purpose: To describe the educational background, practiced clinical disciplines and procedures, efficacy, and responsibility distribution of Dutch physician assistants (PAs) working in ophthalmology.

Methods: An online survey was sent to and collected from PAs working in ophthalmology and ophthalmologists collaborating with PAs.

Results: Of 85 ophthalmology PA and 15 ophthalmologist recipients, 36 PAs and 9 ophthalmologists completed the survey. The mean age of respondents was 39 years (range, 27-54), and 23 (63.9%) were female. Most PAs (97%) had a Bachelor of Science in optometry or orthoptics. All PAs (N = 36) were involved in managing patients with common ophthalmic conditions. On average, PAs worked 32.6 hours (range, 23-36) per week and added on average 77 full-time equivalents to the Dutch ophthalmology workforce. Ophthalmologists collaborating with PAs assessed PA autonomy with a mean score of 3.9 (on a scale from 0 to 5, with 0 being a low level of autonomy and 5 being a high level of autonomy).

Conclusion: In the Netherlands, ophthalmology PAs may be considered a good partial solution for the shortage in eyecare professionals.