Perceptions of role by Medex physician's assistants: an interview study

Abstract

The purpose of this study was to identify problems confronting the Medex in his relations with physicians, nurses, patients, and the community, including the hospital. It is assumed that once such problem areas have been identified, something can be done about them. Changes could be made, for example, in the way Medex are trained, in the types of practice they are sent to, or in the kinds of applicants accepted for training. Since material of this sort is impossible to obtain in a self administered questionnaire, personal interviews were used. The interviews, conducted by a specially trained interviewer, lasted up to 5 hr. The material is based solely on the perceptions of Medex physician's assistants and not on the perceptions of other important members of the role set such as physicians, nurses, and patients. Specific role problems are related to the Medex' overall position in the practice organization. According to the philosophy of the trainers, the Medex is supposed to function as an assistant to the physician; he is definitely not meant to function as a physician. The specific relations that Medex have developed with their physicians are varied. In one practice the Medex was treated pretty much as an employee. A second Medex, on the other hand, not only worked closely with his doctor, he also lived with him. The physician was young and informal, the relation obviously built on mutual respect and trust. Medex report relatively little conflict with their physicians. They usually feel free to disagree and they discuss their disagreements openly with the doctors. The nurse Medex relation represents a potential source of conflict. As the Medex see it, they are clearly accepted by all but a small minority of their patients. Most typically, there was some resistance at the beginning, especially among patients who had known their doctors for many years. With very few exceptions, Medex are liked and respected by their communities. In unsophisticated rural villages they are treated as if they were doctors; in the towns and cities people tend to have a more realistic idea of who they are. (15 references).