An independent review commissioned by the Secretary of State for Health and Social Care in November 2024 examined the quality of care provided by physician associates and anesthesia associates, incorporating 40 studies primarily from the US.

The review, published in The BMJ, found that physician associates deliver safe and effective care when directly supervised by doctors, particularly for patients with existing diagnoses.

Prompted by concerns regarding the scope of practice and patient safety, the Academy of Medical Royal Colleges called for this review to address issues such as informed consent and the implications for medical training.

While the review indicates that physician associates can enhance access to care, it suggests that this may largely reflect overall staffing increases rather than their unique contributions.

Patient satisfaction levels for care provided by physician associates are comparable to those offered by doctors, although there is limited evidence regarding the cost-effectiveness of their services.

In the UK, physician associates are required to hold a bachelor's degree in a science or health-related field, followed by a postgraduate qualification in physician assistant studies.

The authors of the review caution that while physician associates can work effectively under supervision, unsupervised management of undifferentiated symptoms could pose risks to patient safety.

Concerns were raised in the review regarding insufficient evidence for physician associates assessing undiagnosed patients under indirect supervision, particularly in primary care settings.

The authors also noted limitations in the review's findings, including a lack of UK-based studies and the generally weak quality of the studies included.

The review compared the care quality between physician associates and doctors, focusing on various outcomes including safety and efficiency.

Physician associates, known as physician assistants in many countries, were first introduced in the US during the 1960s to address doctor shortages in rural areas and have since been adopted worldwide.

Overall, the review underscores the importance of direct supervision for physician associates to ensure patient safety and effective care delivery.