Physician assistants can help strengthen Ontario’s long-term care workforce

Dear Minister Fullerton and Deputy Minister Steele,

On behalf of physician assistants (PAs) across our province, we thank you for your tireless dedication to the wellbeing of Ontario’s seniors and your tremendous support of frontline health care professionals throughout the COVID-19 pandemic. Your efforts are greatly appreciated.

Given that your ministry recently asked certain long-term care (LTC) homes to submit detailed plans on how they will stabilize the spread of the virus, ensure the provision of onsite medical coverage, and keep staffing levels up, we are writing to provide information on the PA model of care in LTC.

We would be pleased to discuss this model with your officials and are requesting the opportunity to speak by phone at the earliest opportunity.

The attached briefing note and our recent position statement summarize the PA role and broadly outline the positive impact PAs have on the delivery of care in LTC homes. As you consider our recommendation to expand and further integrate PAs in eldercare, we invite you to read the messages below from PAs working at the frontline of the crisis:

“I am working within a family medicine practice in addition to my involvement within a retirement community and LTC home. Since April 2020, we have had approximately 70 cases of COVID-19 within our residence. I am the sole clinician coming in to assess COVID patients. My physician has been supervising remotely, as they do not want to be exposed to the virus.

I am assessing all these patients, performing NP swabs, and performing follow-up visits as well as communicating with families. For patients who rapidly deteriorate, I have performed palliation and comfort measures within their home to avoid transfer to hospital, as per their wishes and goals of care.

I have personally sat with many of them as their journey ended, as their family could not be present due to current circumstances. Without PA support within my retirement community, the nursing staff and families would be left unsupported and without a doubt patient care would have suffered.”

Joshua Diamante, Physician Assistant
Family Medicine and Long-Term Care

“With the increased demands on my supervising physicians at the local rural hospital to support COVID-19 measures, I am increasingly the physical presence within our long-term care home.

My role has evolved since the start of the pandemic and involves supporting the care of all 200+ residents within the long-term care facility. I often function as the first point of contact for assessments, maintain lines of communication with families regarding goals of care, transition residents to palliative care, help develop protocols related to preventing the spread of COVID-19, and facilitate twice weekly physician rounds through video conferencing.

As a PA in long-term care, I am undoubtedly part of the pandemic health care workforce and it has been a privilege to care for this vulnerable population and their families during this unprecedented time.”

Jessica O’Neil, Physician Assistant
Family Medicine and Long-Term Care

Since the outset of the pandemic, we have seen your ministry act quickly to protect our most vulnerable citizens. With officials projecting that Ontario could be dealing with the effects of COVID-19 for up two years, now is the time to consider new workforce strategies that will effectively strengthen our LTC system over the long term.

Today, CAPA submits our brief in the spirit of collaboration and innovation. We strongly believe that by integrating the PA model of care, your government can improve medical coverage, efficiently use skilled resources, and increase capacity during a surge in COVID-19 cases.

Thank you in advance for your consideration. And, more importantly, on behalf of our members we thank you again for your leadership and compassion during this very difficult period.


Sahand Ensafi, CCPA
Provincial Director, Ontario

Patrick Nelson
Executive Director