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Are Dutch patients willing to be seen by a physician assistant instead of a medical doctor?

Luppo Kuilman1*, Roos MB Nieweg2, Cees P van der Schans23, Jaap H Strijbos4 and Roderick S Hooker5

Author Affiliations

1 Master Physician Assistant Program, School of Health Care Studies, Hanze University of Applied Sciences, Groningen, Groningen, The Netherlands

2 Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Groningen, the Netherlands

3 Rehabilitation Medicine, University Hospital Groningen, Groningen, the Netherlands

4 Nij Smellinghe Hospital, Drachten, the Netherlands

5 The George Washington University, School of Public Health, Washington, DC, USA

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Human Resources for Health 2012, 10:28  doi:10.1186/1478-4491-10-28

Published: 4 September 2012



The employment of physician assistants (PAs) is a strategy to improve access to care. Since the new millennium, a handful of countries have turned to PAs as a means to bridge the growing gap between the supply and demand of medical services. However, little is known about this new workforce entity from the patient’s perspective. The objective of this study was to assess the willingness of Dutch patients to be treated by a PA or a medical doctor (MD) under various time constraints and semi-urgent medical scenarios.


A total of 450 Dutch adults were recruited to act as surrogate patients. A convenience sample was drawn from patients in a medical office waiting room in a general hospital awaiting their appointments. Each participant was screened to be naive as to what a PA and a nurse practitioner are and then read a definition of a PA and an MD. One of three medical scenarios was assigned to the participants in a patterned 1-2-3 strategy. Patients were required to make a trade-off decision of being seen after 1 hour by a PA or after 4 hours by a doctor. This forced-choice method continued with the same patient two more times with 30 minutes and 4 hours and another one of 2 hours versus 4 hours for the PA and MD, respectively.


Surrogate patients chose the PA over the MD 96 % to 98 % of the time (depending on the scenario). No differences emerged when analysed by gender, age, or parenthood status.


Willingness to be seen by a PA was tested a priori to determine whether surrogate Dutch patients would welcome this new health-care provider. The findings suggest that employing PAs, at least in concept, may be an acceptable strategy for improving access to care with this population.

Physician assistants; Trade-off; Willingness