COMMENTARY: Common sense says New Brunswick needs physician assistants

The following Commentary was written by Kevin Dickson (Provincial Director, New Brunswick) and published in The Daily Gleaner on February 14, 2019.

Scrapped surgeries, staff shortages, and poor access to care in underserved parts of the province are some of the headlines we see repeated ad nauseum in New Brunswick. Frustration is growing on all sides and rightly so.

A recent story about the cancellation of hundreds of non-urgent surgeries every month is just the latest example. Patients are concerned about wait times and doctors are demanding more support in addressing staff shortages that can contribute to these cancellations.

In light of all this, most New Brunswickers would be quite shocked to learn that there is an untapped solution at our doorstep—we just need the government to take action and scale it up.

Physician assistants, commonly known as PAs, are ready, willing, and able to help stem this crisis. PAs are skilled health care professionals who are trained to conduct physical exams, order and interpret tests, diagnose illnesses, prescribe medications, assist in surgery, and much more. They work autonomously under the supervision of a licensed doctor to “extend” the reach of doctors, freeing them up to see more patients and spend more time with patients who need the highly specialized expertise of a physician.

In an era of limited resources and doctor burnout, PAs have become a “must-have” in Canada’s primary care clinics, emergency departments, long-term care centres, and surgical suites. They are well-established in areas like orthopaedic surgery and neurosurgery, and health care teams that include PAs are loath to give them up.

Once upon a time New Brunswick was considered an early adopter, adding three PAs to the Emergency Department at the Dr. Everett Chalmers Regional Hospital to stem long wait times. They’re still there today, working almost exclusively on fast-tracking patients with less urgent needs to get them in and out quickly. But Ontario, Alberta, and Manitoba surpassed us a long time ago by scaling up PAs across their health systems to realize the benefits they offer.

What could it look like if New Brunswick expanded the use of PAs?

To start, we’d see a more efficient health system and more productive doctors. With PAs providing end-to-end support to surgical teams, tasks like post-operative evaluations, discharge planning, patient referrals, follow-up visits, and even prescription refills would be more efficient.

In rural hospitals, where family practice doctors also do double duty in the emergency department, PAs would be a game-changer. The PAs could cover some shifts, making staffing options more flexible and giving overworked physicians a day off or the ability to run their clinic with fewer interruptions and cancelled appointments.

Globally, PAs are well-integrated into health systems in the United States and across Europe. Demand for them is skyrocketing because the evidence shows they don’t threaten quality or increase costs.

Here at home the Conference Board of Canada reports that if PAs relieve more than 30 per cent of physicians’ time in all practice areas, this could represent $620 million in cost savings for the health care system.

If governments around the world are using PAs to make health teams more efficient, improve access, and save money the big question is why isn’t New Brunswick doing the same?

It’s time to rethink our long-held beliefs about how to deliver health care in this province, because common sense says it’s time for a new approach. New Brunswick needs PAs now to fill the glaring gaps in our system and make care more accessible to the people who need it.

Kevin Dickson is the New Brunswick Provincial Director for the Canadian Association of Physician Assistants and currently practices as a PA at the Dr. Everett Chalmers Regional Hospital.