On July 14, 1999, the government of Manitoba passed the clinical assistant (CA) registration amendment under the Medical Act. This allowed for the licensing of registered clinical assistants. This was later amended in 2009 to permit practice under the title of Physician Assistant. Regulation 183/99, also known as “Clinical Assistants and Physician Assistants Regulation”, was registered under the Manitoba Medical Act by the Council of the College of Physicians and Surgeons of Manitoba (CPSM) on December 23, 1999. This regulation allows for the registration of physician assistants on the Physician Assistant Register. More information can be found on the CPSM website.
In May 2006, the Ministry of Health and Long-Term Care announced its decision to begin including physician assistants in the provincial health care system as a way of addressing the shortage of doctors. This coincided with the launch of HealthForceOntario, which now heads the strategy for health human resources. A demonstration project was launched in 2006 as a way of evaluating the impact of PAs on the Ontario health care system. The project is being led by the Ministry in collaboration with the Ontario Medical Association (OMA). Despite these advances, physician assistants in Ontario remain unregulated. In January 2012, CAPA submitted an application to the Health Professions Regulatory Advisory Council (HPRAC) for Regulation of the Physician Assistant profession in Ontario. On November 30, 2012 the Ministry of Health and Long-Term Care decided against regulation of the Physician Assistant profession. This decision was based on HPRAC’s recommendation that public safety and quality of care are sufficiently upheld at this time through the delegation model under the supervision of a licensed physician. The MOHLTC is proposing that a compulsory registry be established under the direction of the College of Physician and Surgeons of Ontario. A mandatory registry will strengthen the existing process and is a way to provide additional oversight to the PA profession and well as provide assurance that all PAs in Ontario have met common entry-to-practice requirements and that they participate in continuing education. More information about Physician Assistants can be found in the College of Physicians and Surgeons of Ontario (CPSO)’s policy on Delegation of Controlled Acts and on the Ontario Physician Assistant Scope of Practice Statement and Physician Assistant Competency Profile.
In 2009, the College of Physicians and Surgeons of New Brunswick (CPSNB) amended the New Brunswick Medical Act in order to include physician assistants in their health care model. Section 32.1 of the Act now allows PAs to be licensed, provided they register with the CPSNB. In addition, Regulation 14 was created in January 2010 in order to dictate the terms of practice for PAs in the province.
On December 3, 2010, the Council of the College of Physicians and Surgeons of Alberta (CPSA) passed bylaw 24(6), allowing physician assistants (PAs) to operate under the responsibility of a regulated member. Accordingly, the CPSA created a new voluntary and non-regulated membership category for PA. More information, including registration criteria for the CPSA and their responsibility regarding PAs, can be found on their website. Additionally, a list of restricted activities can be found in schedule 7.1 (see page 43) of Alberta’s Government Organization Act. An application for Regulation of the PA profession in Alberta was submitted in November 2013; CAPA recently received the Minister of Health’s decision advising that they are in favour of regulating PAs in this province. The College of Physicians and Surgeons of Alberta will be the regulatory body overseeing the profession, however, the government has not yet issued a public statement therefore an announcement is not expected until the fall of 2014.
The final evaluation of the Physician Assistant Demonstration Project is available here.
The province of British Columbia does not currently have any legislation accommodating physician assistants in their health care system. However, in 2005, the British Columbia Medical Association (BCMA) demonstrated support for the profession by first producing a policy paper entitled “Working Together: Enhancing Multidisciplinary Primary Care in BC”, backing the use of PAs. In November 2009, it was followed by a policy statement that also supported the profession.