• Michael R P de la Roche, Nathalie Dyer, Mark Froats, Allen Bell, Lois McDonald, Craig Bolton, Rob Devins, Ryan Hall, Jonathan Leclerc, Jann Istead, Michele Miron, Martin Badowski, Tracy Steinitz, Nathan King, and Priyanka Gogna.
• Adjunct Assistant Professor at Queen's University in Kingston, Ont, and is an active emergency physician at Quinte Health Care in Belleville, Ont. MRP.delaroche@gmail.com.
• Can Fam Physician. 2021 Feb 1; 67 (2): e61-e67.

ObjectiveTo determine the effect of a physician assistant (PA) working in a secondary care hospital emergency department (ED) on the overall performance of the ED.DesignA retrospective review of ED data from April 1, 2017, to September 30, 2017.SettingBelleville General Hospital, a secondary care hospital, ED in Ontario.ParticipantsA physician assistant, 13 emergency physicians, and 7 family physicians.Main Outcome MeasuresOverall ED performance was evaluated using metrics from the Ontario Ministry of Health and Long-Term Care: rate of patients who left without being seen, provider initial assessment time at the 90th percentile, and the average provider initial assessment time for all patients over a 6-month period.ResultsIn the PA group, there was a lower average daily left without being seen rate (3.4% vs 5.2%; P < .001), a lower provider initial assessment time at the 90th percentile (3.9 hours vs 4.5 hours; P < .001), a lower average provider initial assessment time (114.83 minutes vs 139.46 minutes; P < .001), and a lower average length of stay (313.85 minutes vs 348.91 minutes; P < .001).ConclusionThis study suggests that a PA has a statistically significant positive effect on the overall performance of an ED. Future studies should examine the effect of a PA on quality of care and hospital funding.Copyright © the College of Family Physicians of Canada.

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