Branch practice: Physician Assistant relieves doctors

Dortmund. In Epe, a district of Gronau in Westphalia, a special kind of practice ensures primary care: a team practice made up of medical assistants, physician assistants and doctors. On two afternoons, only the non-medical team is present, but they work in close coordination with the responsible doctors.

The practice is a branch of the Gesenhues & Partner group practice in Ochtrup. It began patient care in June 2024 and is funded by the substitute health insurance companies as a model project.

The Ochtrup practice has been providing care to patients from Epe for some time, reported general practitioner Dr. Sebastian Gesenhues at the "Summit 2025" of the Association of Statutory Health Insurance Physicians of Westphalia-Lippe (KVWL) in Dortmund. However, home visits are not possible. "That's when the idea arose to open a branch practice on site for patients who can no longer come to us."

The PA as the face of the practice

There are always doctors in the practice in the mornings. Physician Assistant (PA) Jule Hörmann is responsible for operations on two afternoons. "She is supposed to be the face of the practice," said the family doctor. Most patients who come in the afternoon have an appointment, and the doctor and PA discuss them beforehand. "Typical reasons for treatment are follow-up checks or changing bandages," explained Hörmann.

If patients come unannounced, Hörmann usually consults the practice in Ochtrup by telephone. The two practices are also connected via telemedicine. "I often conduct the anamnesis interview with new patients."

The PA likes working independently in the branch practice. "You become more independent and develop a different standing when dealing with patients." She has not received any negative reactions so far. "The patients are happy to have a connection at all," she emphasized.

“I still make the diagnosis, albeit with a time delay”

There is no patient who is not presented to him, said family doctor Gesenhues. Hörmann neither makes diagnoses nor initiates treatment. "I still make the diagnosis, albeit at a later time," he said.

KVWL Vice President Dr. Volker Schrage opposed describing such models as "doctor-free practices." It is about delegating services. "Ultimately, it is always a matter of doctor's responsibility," he said. Schrage believes it is important to define exactly what PAs can and cannot do. "In some regions, we cannot avoid doing something like this."

Family doctor Schrage himself also relies on the team model with his Münsterland group practice in Legden. One of his MFAs is currently completing her PA degree. MFA Alexandra Heflik has completed further training to become a digital manager. She is responsible for IT and digitization issues in the practice. Among other things, she coordinated the change in the practice management system in the practice.

Relief from the Digi Manager

This way, the colleagues would have their hands free to take care of the patients, said Heflik. "It's good when everyone has their own area and still works as a team."

If MFAs have the opportunity to undergo such training, they should do so, she recommended. "The MFAs that existed 20 years ago no longer exist."

The system change was a "huge thing" for the practice, which was founded in 1988, reported Schrage. "It can only succeed with this kind of help," he believes. "Having someone with this kind of training on hand is worth its weight in gold."