OPINION: Making most of physician assistants will improve care and cut costs

This Opinion article was originally published in the Edmonton Journal on Friday, September 27, 2019.

The Alberta government should be applauded for providing $3 million in new funding for nurse practitioners (NPs). Patients in underserved parts of Alberta deserve timely access to care, which is a benchmark of any provincial health system, and this will certainly help.

And as the MacKinnon Report rightly notes, there is more that Alberta Health can do to save money without compromising patient care. This includes using the full scope of practice of health care professionals like NPs and physician assistants (PAs) to deliver some services at a lower cost.

What was missing from Health Minister Tyler Shandro’s important announcement were actions to improve the use of PAs in Alberta. By expanding the number of positions available to PAs, regulating PAs under the College of Physicians and Surgeons of Alberta, and introducing a PA educational program to train PAs, the province would be catching up with other parts of Canada and countries around the world.

PAs are advanced-practice professionals who are educated in the medical model, which means our training is aligned with how doctors are educated. Our intensive 24-month education program begins with instruction in basic medical sciences and is followed by clinical rotations in specialties like general surgery, emergency medicine, and family medicine, to name just a few.

We work autonomously under the supervision of licensed physicians to extend the services they provide. With a scope of practice that mirrors that of our supervising doctors, we bring exceptional versatility and flexibility to health care. And just like our NP colleagues, we are widely considered essential to making health care more accessible.

How? To start, PAs help doctors accept more patients into their practice, shorten the time for a first appointment, and give them more time to spend with their complex patients.

In the surgical setting, adding PAs to joint-replacement teams has allowed one surgeon to run two operating rooms in a single day, increasing the volume from three to seven primary joints per day. With Alberta’s wait times for hip and knee surgeries spiking, the expansion of PAs in orthopaedic surgery alone makes sense.

study from the Conference Board of Canada shows that the Canadian health-care system could save over $600 million if the use of PAs increases across the country.

Across Canada, the shift to team-based care is well underway. Patients expect that a diverse group of health-care professionals will work together to give them the best possible care. And technologies like electronic medical records and virtual-care platforms should only make this collaboration easier.

An important step that Premier Jason Kenney’s government can take to advance team-based care is to regulate PAs under the College of Physicians and Surgeons of Alberta. Regulation will protect patients, let us work at the “top of our scope” and make it easier for us to do everything from providing prescriptions to discharging patients from the hospital.

Expanding the use of PAs in areas of unmet need is another common-sense approach. Specialties like mental health, addiction medicine, seniors care, and rural medicine are crying out for skilled health care professionals to help cope with long wait times.

As the MacKinnon Report shows, Alberta spends far more money on health care than other provinces. And amid the uncertainty of how we will meet, and pay for, the rising demand for services, it’s clear that qualified and cost-effective health-care professionals like PAs must be an essential part of the plan.

When Alberta PAs can work at our full scope, we’ll help strengthen team-based care, shorten wait times, save money, and boost the productivity of physicians. It’s time for Alberta to make the most of what PAs can offer.

Kirsten Luomala is a neurosurgery physician assistant at the University of Alberta Hospital and the Alberta provincial director at the Canadian Association of Physician Assistants.