Predictors of glucocorticoid treatment intensity after endoscopic transsphenoidal surgery in patients with non-functional pituitary adenomas: a retrospective study.

Previous work has discussed the general opportunities and challenges associated with Physician Assistants (PAs) in German outpatient care []. Building on that broader perspective, the present article adopts a narrower, safety-oriented focus by examining the supervision, delegation, and governance structures required for the safe integration of PAs into German ambulatory care. Ambulatory care systems in many high-income countries face increasing pressure from demographic change, the growing burden of chronic disease, rising patient expectations, limited appointment capacity, and increasing administrative workload. Germany is no exception. The German Medical Association reported that, as of December 31, 2025, 43,444 professionally active physicians were older than 65 years, and a further 60,826 were between 60 and 65 years of age; overall, 23.4% of the professionally active medical workforce was aged 60 years or older []. In statutory ambulatory care, the Federal Association of Statutory Health Insurance Physicians reported that the number of contracted physicians and psychotherapists increased in 2025, but the available full-time clinical capacity did not increase proportionally because of part-time employment and changing work patterns []. Although these developments do not, in themselves, justify replacing physicians, they help explain why team-based care and structured delegation are receiving increasing attention. In Germany, a PA is an academically trained health professional who supports physicians by performing delegable medical tasks within a physician-led team. Unlike physicians, PAs are not licensed to practice medicine independently and do not complete postgraduate medical specialty training. Their role is therefore not intended to provide a parallel pathway to independent medical practice.