Physician assistants: another piece of puzzle?

New Brunswick needs to ramp up the use of physician assistants to offset long wait times at emergency rooms and allow for greater access to primary care services, says an advocacy group representing the infrequently used healthcare workers.

Patrick Nelson, executive director of the Canadian Association of Physician Assistants, visited Fredericton this week for meetings with the Horizon Health Network, the New Brunswick Medical Society and the Department of Health.

Physician assistants work under the supervision of doctors, taking care of routine patient needs so physicians can spend more time on the more complex cases. They are able to conduct preliminary assessments, provide treatment plans, order and interpret tests, and prescribe some medications.

New Brunswick is the only province in Atlantic Canada that uses physician assistants. Though, it does so sparingly.

Three physician assistants have been working in a pilot project launched in 2011 all at the Dr. Everett Chalmers Regional Hospital in Fredericton. Two work a regular rotation in the facility’s emergency room, with a third covering illnesses, vacations, and holidays.

Studies promoted by the physician assistants group suggest they can manage up to 65 per cent of the care provided in an emergency department without needing a physician referral, and up to 75 per cent in a primary care setting.

“We’re here to blow the dust off some studies and reports and knock on some doors”, Nelson said. “We want to encourage [the stakeholders] to re-evaluate and consider expanding their use.”

Dr. Graeme Young, chief of emergency medicine at Chalmers, said physician assistants have proven their worth at the hospital.

Data he provided to the physician assistants association shows the number of patients leaving the emergency department without being seen has dropped from 16 per cent to 11 per cent since their work began, and that the hospital’s “initial practitioner assessment time” has been reduced by 40 per cent.

The hospital has submitted a request for three more physician assistants, hoping to utilize them 24 hours a day, seven days a week.

Nelson said efforts to expand the program have fallen on deaf ears so far, but he’s hopeful that’s going to change.

“New Brunswick was once a leader in the country when it came to the implementation of PAs [physician assistants],” he said.

“Now I think it’s fair to say New Brunswick is no longer leading and I think it’s time they look at this option. New Brunswick suffers with access-to-timely-care problems, long wait times in emergency rooms. I understand access oncology and orthopedics. These are situations where PAs are likely the most affordable option.”

Sarah Williams, a spokeswoman for the Department of Health, said the province has been working to improve access to primary care services and reduce wait times in ERs through other means so far.

The provincial government says it doesn’t matter so much who sees the patient, as long as they get the care they need.

Dr. Lynn Murphy-Kaulbeck, president of the New Brunswick Medical Society, said the province’s doctors are open and supportive of using physician assistants within the system.

“Physician assistants … can provide added flexibility as part of the healthcare team,” she said.

There are more than 350 physician assistants working in Ontario and over 130,000 across the United States.