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38 FACTORS MOTIVATING PHYSICIANS TO HIRE PHYSICIAN ASSISTANTS IN RURAL OFFICE PRACTICES

Factors motivating physicians to hire physician assistants (PA) are not well delineated, yet 23% of PA activities in primary health care settings in Iowa involve children less than 15 years old. Of 64 Iowa physicians who employed PA from 1973 to 1977 in their offices, 75% completed a ten point scale questionnaire. 37/51 (73%) of these physicians still employed PA at time of study and 8/13 (62%) had terminated PA employment. 31 of these 51 practice sites with PA in active practice had populations < 10,000. Factors which strongly motivated physicians to hire PA were MD practice from multiple offices serving populations < 5,000 (40% of sites). Other motivating factors were physician's belief that MDs should delegate certain tasks to non-MDs (65%), and also MD's desire to provide innovative care (51%), optimal care (55%), new services (33%), more of the usual service (63%), to more patients (57%), and to reduce waiting time for appointments (49%). Non-motivating factors were prior MD's work or educational experiences with similar health personnel, the MD's desire to provide services at less cost, reward faithful employee, increase earning, compete favorably with colleagues, work fewer hours, and to create time for continued education. Similar motivating factors were found among physicians who had hired and dismissed PA. These findings have educational, legislative and social implications.