| Summary: | <p><strong>Background:</strong> Physician associates [PAs] (also known as physician assistants) are new to the NHS and there is little evidence concerning their contribution in general practice.</p>
<p><strong>Aim:</strong> This study aimed to compare outcomes and costs of same-day requested consultations by PAs with those of GPs.</p>
<p><strong>Design and setting:</strong> An observational study of 2086 patient records presenting at same-day appointments in 12 general practices in England.</p>
<p><strong>Method:</strong> PA consultations were compared with those of GPs. Primary outcome was re-consultation within 14 days for the same or linked problem. Secondary outcomes were processes of care.</p>
<p><strong>Results:</strong> There were no significant differences in the rates of re-consultation (rate ratio 1.24, 95% confidence interval [CI] = 0.86 to 1.79, <em>P</em> = 0.25). There were no differences in rates of diagnostic tests ordered (1.08, 95% CI = 0.89 to 1.30, <em>P</em> = 0.44), referrals (0.95, 95% CI = 0.63 to 1.43, <em>P</em> = 0.80), prescriptions issued (1.16, 95% CI = 0.87 to 1.53, <em>P</em> = 0.31), or patient satisfaction (1.00, 95% CI = 0.42 to 2.36, <em>P</em> = 0.99). Records of initial consultations of 79.2% (<em>n</em> = 145) of PAs and 48.3% (<em>n</em> = 99) of GPs were judged appropriate by independent GPs (<em>P</em><0.001). The adjusted average PA consultation was 5.8 minutes longer than the GP consultation (95% CI = 2.46 to 7.1; <em>P</em><0.001); cost per consultation was GBP £6.22, (US$ 10.15) lower (95% CI = −7.61 to −2.46, <em>P</em><0.001).</p>
<p><strong>Conclusion:</strong> The processes and outcomes of PA and GP consultations for same-day appointment patients are similar at a lower consultation cost. PAs offer a potentially acceptable and efficient addition to the general practice workforce.</p>
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