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Various health systems are challenged by a multifaceted crisis of increased service demand and workforce shortages. The effects are devastating and may end up in decreased access to care, poor quality of patient care and extreme demands on the workforce. The introduction of the physician assistant (PA) profession provided an avenue to address such challenges in several countries. In Germany, the integration of PAs has been proceeding slowly.

To understand the integration of the profession in Germany, we conducted 15 expert interviews to reveal how the PA profession is perceived among healthcare experts as well as the barriers and facilitators of integration in inpatient care.

Our results highlight a generally positive perception of PAs, particularly in terms of workload relief and bridging the gap between healthcare professionals. Nonetheless, barriers include resistance from healthcare workers unfamiliar with the PA role, while workforce shortages and collaborative teamwork facilitate integration.

These findings lay the groundwork for potential integration-enhancing strategies in Germany.

One of the commonest excuses put forward in defence of the practice of treating milk, butter, meat, and other foods with ‘preservative’ drugs no longer possesses even the appearance of validity. Several of the large railway companies are adding refrigerator vans in considerable numbers to their rolling‐stock, and this fact should make it no longer possible for defendants to plead that the necessity of sending food‐products a long distance by rail involves the necessity of mixing preservative chemicals with them. Although the excuse referred to will not bear examination, it is a very specious one, and in those instances where evidence has not been brought forward to refute it, it has produced some effect on the minds of magistrates and others. It cannot be too often pointed out that such substances as boracic acid, salicylic acid, and formaldehyde are dangerous drugs, and that their unacknowledged presence in articles of food constitutes a serious danger to the public. Such substances are not foods, and are not natural constituents of any food. In most instances they are purposely introduced into food‐products to avoid the expense attending the proper production, preparation, and distribution of the food, or to conceal the inferior quality of an article by masking the signs of commencing decomposition or incipient putrefaction, and thus to enable a dishonest producer or vendor to palm off as fresh and wholesome an article which may be not only of bad quality, but absolutely dangerous to the consumer. The use of these substances, in any quantity whatsoever, and the sale of articles containing them, without the fullest and clearest disclosure of their presence, is as gross and as dangerous a form of adulteration as any which has at any time been exposed. In no single instance can it be shown that these drugs are, to quote the words of the Act of 1875, matters or ingredients “required for the preparation or production of a food as an article of commerce,” nor, of course, can it be contended that such substances are “extraneous matters with which the food is unavoidably mixed during the process of collection or preparation.” In reality, even under our inadequate and unsatisfactory adulteration laws, through which the proverbial coach‐and‐four can be so easily driven in so many directions, there ought to be no loophole of escape for the deliberate and dishonest drugger of foods. While the presence of preservative chemicals in any quantity whatever in articles of food constitutes adulteration, wherever the quantity is sufficient to allow the production of the specific “preservative” effect of the substance added, that fact alone is enough to make the food so drugged a food which must be regarded as injurious to the health of the consumer—in view of the inhibitory effect which, by its very nature, the antiseptic must produce on the process of digestion. To our knowledge the food market in this country is flooded with all sorts of inferior food‐products which are rarely dealt with under the Adulteration Acts, and which are loaded with so‐called preservatives. There will be no adequate protection for the public against the consumption of this injurious rubbish until the consumer sees the advantage of insisting upon an authoritative and permanent guarantee of quality with his goods, and until manufacturers of the better class at length find it to be a necessity for their continued prosperity that they should supply, apart entirely from their own statements, an independent and powerful guarantee of this kind.