Integration of a Physician Assistant Into an Ophthalmology Consult Service in an Academic Setting

Purpose: To describe the impact of a physician assistant (PA) in an academic ophthalmology consult service. Design: Evaluation research. Methods: A PA was integrated into our ophthalmology consult service to enhance resident education. First-year resident annual surgical logs before and after the introduction of the PA were reviewed. Residents were anonymously surveyed for their perceptions regarding the impact of the PA integration on their residency experience. Consult wait time was compared for residents and the PA. Internal financial metrics for the PA were reviewed for a cost scenario analysis using 2016 national salary data for PAs. Results: The PA made approximately 28 days per year for each first-year resident available for alternative clinical assignments, which resulted in a 75% increase in total first-year resident annual surgical volume. The majority of residents (93%) strongly agreed that having a PA improved both their ophthalmic education (by enabling them to spend time on other clinical assignments) and their service-to-education balance on the consult rotation. Adjusted median consult wait time for residents was 28 minutes longer (P <.001) than for the PA. A PA would likely need to see an average of 8-12 patients per day to be cost neutral to a consult service. Conclusions: Integrating a PA into an ophthalmology consult service can optimize the resident clinical service–to-education balance, reduce consult wait time, and be financially feasible. PAs trained in ophthalmology present a unique opportunity for all institutions that require clinical ophthalmology expertise.