CAPA Statement on Ford Government’s Exclusion of Physician Assistants from the “Pandemic Pay” Wage Increase

The Canadian Association of Physician Assistants issued the following statement after the Ontario government announced a new list of health care workers who are eligible for the COVID-19-related wage boost.

“On Tuesday the Ford government expanded the list of workers eligible for “pandemic pay” to include Paramedics, Respiratory Therapists, and Public Health Nurses, but not Physician Assistants (PAs).

During the worst public health crisis of the past century, we are concerned that this sends the wrong message to PAs working on the front lines every day and we urge the Premier and Minister of Health to reconsider.

As medically trained clinicians, PAs are trusted members of health care teams who work alongside physicians, nurses, and other professions in the same challenging conditions. Since the beginning of the outbreak, PAs have been assessing patients in emergency departments, providing medical care in critical care units, and swabbing patients in testing centres. We have PAs on dedicated COVID-19 hospital wards and being hired to help with the increased number of ICU patients. PAs in long-term care have been caring for older patients with complex needs who are at the highest risk of dying from COVID-19.

The recognition that PAs are medical professionals providing direct, frontline patient care is important to morale, especially when we are putting ourselves at risk to care for others. Like many frontline health care professionals, we are facing great challenges and making significant personal sacrifices to help keep Ontarians safe and healthy.

CAPA is the national voice for PAs and represents the interests of 500 PAs in Ontario. Since the government’s initial announcement on April 25, we have heard from our members who are shocked and disappointed by this oversight. As the voice of PAs, we will continue to advocate strongly for our profession to be appropriately recognized.”

Leslie St. Jacques, CCPA
President

Sahand Ensafi, CCPA
Provincial Director, Ontario

About the Canadian Association of Physician Assistants
The Canadian Association of Physician Assistants is the national voice of Physician Assistants in Canada. We support quality standards and competencies and help establish the profession within the national health care framework. Learn more: capa-acam.ca.

Regulate Alberta’s physician assistants to strengthen the health care workforce

April 23, 2020

Dear Minister Shandro,

On behalf of physician assistants (PAs) across Alberta, we thank you for your dedication to the wellbeing of Albertans and your support of frontline health care professionals throughout the COVID-19 pandemic. Your efforts are greatly appreciated.

We are writing today to propose enacting PA regulation as a means to strengthen the provincial health care workforce capacity, mitigate the loss of health care workers to self-isolation, and meet the demand for skilled providers during a surge in COVID-19 cases. We have outlined the current limitations PAs face and the immediate benefits of regulation in the attached briefing note.

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

CAPA is not alone in proposing solutions to mobilize the PA workforce during this pandemic. Across the United States, where more than 120,000 PAs practice, some of the states hardest hit by COVID-19 have introduced executive orders to mobilize PAs during this crisis.

An Earlier Timeline For Regulation

After our communications in March 2020 with your Chief of Staff Christopher Thresher, we understood that fall 2020 is the proposed timeline for regulation. However, we believe that the policy should be considered in the context of surge capacity planning and we recommend the swift introduction of regulation to help Alberta Health Services deploy PAs where they are most needed during the pandemic.

Beyond COVID-19: Regulation and the MacKinnon Report

The MacKinnon Report commissioned by your government rightly notes that “not all patients need to be treated by doctors or registered nurses”. The Blue Ribbon Panel highlighted the need to maximize the scope of practice of other health care professionals to help Alberta deliver better outcomes at a better cost.

Therefore, we’d like to highlight the flexible PA scope of practice, which mirrors that of the supervising physician. With regulation in place PAs could work at the “top of their scope” and this, coupled with their expertise and lower salary costs, makes our profession ideally positioned to help AHS deliver high quality, cost-effective health care.

Thank You

Today, CAPA submits our recommendation in the spirit of collaboration and innovation. We strongly believe that by regulating PAs now, AHS can improve coverage, efficiently use skilled and flexible 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, commitment, and compassion during this very difficult period.

Sincerely,

Kirsten Luomala, MPAS, CCPA
Provincial Director, Alberta
Neurosurgery Physician Assistant, Alberta Health Services

Patrick Nelson
Executive Director

Health-care workers face wrenching decisions on how to care for COVID-19 patients

Doctors and other health-care professionals on the front line of Canada’s battle with COVID-19 are facing some of the most challenging decisions caregivers have to make.

Maureen Taylor, a physician assistant specializing in infectious diseases, is caring for COVID-19 patients at Michael Garron Hospital in Toronto.

The ward is normally dedicated to respiratory and oncology patients, but these days it’s given over to COVID-19 patients who aren’t receiving intensive care — including those who aren’t well enough to benefit from a ventilator or other intensive treatments…read more and listen to this episode of CBC’s White Coat, Black Art.

To fight COVID-19, remove barriers for Ontario’s physician assistants

Dear Minister Elliott and Deputy Minister Angus,

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

We are writing today to propose policy solutions that will allow Ontario to strengthen our health workforce capacity, mitigate the loss of health care professionals to self-isolation, and meet the demand for skilled health care professionals during a surge in COVID-19 cases.

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

The attached briefing note describes our proposals in full, but they include:

  • A temporary order by the CPSO to allow PA oversight and the delegation of acts to be determined at the practice level by supervising physicians, in consultation with hospital medical leadership where necessary, without penalty.
  • The creation of temporary new fee codes or modifiers that would allow physicians to bill at a discounted rate for services and procedures rendered by PAs.

CAPA is not alone in proposing solutions to mobilize the PA workforce during this pandemic. Last month, the state of New York issued an executive order to modify laws governing PAs. Elsewhere in the United States, two other states issued executive orders related to PA oversight and COVID-19, and 14 states had previously updated their laws to relax these requirements in emergencies or disasters.

Here at home, we have seen your Ministry act quickly to address the crisis, from introducing new fee codes to support virtual care to launching efforts to recall retired health care workers back to service. With officials projecting that Ontario could be dealing with the effects of COVID-19 for up two years, now is the time to consider additional policy measures that will effectively strengthen our health system over the long term.

Today, CAPA submits our recommendations in the spirit of collaboration and innovation. We strongly believe that by enacting our proposed measures now, doctors, hospitals, and other health care organizations can improve coverage, efficiently use skilled and flexible 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, commitment, and compassion during this very difficult period.

Sincerely,

Leslie St. Jacques, CCPA
President

Sahand Ensafi, CCPA
Provincial Director, Ontario

Patrick Nelson
Executive Director

c.c.       Mr. Anthony Dale, President and CEO, Ontario Hospital Association

Dr. Sohail Gandhi, President, Ontario Medical Association

Mr. Allan O’Dette, Chief Executive Officer, Ontario Medical Association

Dr. Nancy Whitmore, Registrar and CEO, College of Physicians and Surgeons of Ontario

Dr. Brenda Copps, President, College of Physicians and Surgeons of Ontario

Mr. Patrick Dicerni, Assistant Deputy Minister and General Manager, OHIP

Ms. Rana Shamoon, Director, Health Policy, Office of the Premier of Ontario

Remote Learning Resources and COVID-19 Content from AccessMedicine

In response to the COVID-19 outbreak McGraw-Hill has created new content to help support students, faculty, and residents.

“COVID-19 Central” on AccessMedicine

COVID-19 Central” is hosted on AccessMedicine and free to use (no subscription to the medical platform to access this content).

“COVID-19 Central” will be a source of weekly updated developments and analysis in clinical medicine, public health, and industry and will be aimed at healthcare professionals, trainees, students, and librarians.  It will be open to all, regardless of Access subscription status. It will have daily contributions and resources from across the McGraw-Hill author and specialist professional community. As you may be aware, Dr Anthony Fauci is the leading spokesperson to the US government on COVID-19 and is also one of the editors of Harrisons Principles of Internal Medicine.

Distance Learning by Using AccessMedicine

A distance learning toolkit is available to help support students, faculty, and residents. With face-to-face classes now suspended, the resources listed below will serve as useful guides in making a shift from in-person to virtual classrooms. These may be shared freely with faculty, learners, and staff.

  1. Using Access to Support Distance Learning
  2. Guide to Online Resources via AccessMedicine
  3. AccessMedicine video overview of resources for distance learning
  4. AccessMedicine video overview of functionality which can enhance distance learning
  5. AccessMedicine distance learning LibGuide

In addition to these resources, there are also content maps available online. Content maps are documents that take curriculum standards from the various professional healthcare education specialties (i.e., undergraduate medical education, advanced practice nursing, physician assistant, physical therapy, pharmacy, etc. . . ) and match them with resources available to meet those standards from Access sites.