This Commentary was originally published in the New Brunswick Telegraph Journal on Wednesday, February 13, 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.

All Canadians would benefit from expanding the use of PAs to close gaps in care and save money

OTTAWA, November 27, 2018 — As Canadian physician assistants (PAs) celebrate National Physician Assistant Day on November 27, 2018, they are reminding provincial and territorial governments that including PAs on modern health care teams is fundamental to improving access to care and driving efficiencies.

“We hear about the crisis in health care every day—from long waits in emergency rooms to record levels of doctor burnout,” said Trevor Stone, President of the Canadian Association of Physician Assistants. “PAs are increasingly viewed as key to building a health workforce that can respond to these challenges and governments need to remove barriers that prevent us from practicing and serving patients.”

Just last year a report from the Conference Board of Canada called PAs “a largely untapped resource that can help governments continue to provide high levels of service while reducing overall system costs”. The report recommends that Canadian health systems optimize the use of PAs and that governments implement appropriate funding models. Globally, the flexibility and cost-effectiveness of PAs has driven their growth in the United States, the Netherlands, and the United Kingdom, to name just a few countries where they are widely integrated.

Across Canada pressure is mounting on governments to act on these recommendations. Notably, calls are the loudest in British Columbia, where groups ranging from Doctors of BC through to the BC Chamber of Commerce have long been in favour of using PAs as a concrete way to address poor access to care, especially in rural communities hardest hit by the shortage of health care providers.

PAs are skilled health care professionals who work independently under the supervision of a licensed doctor to extend productivity and allow more patients to be seen. They conduct physical exams, order and interpret tests, diagnose illnesses, and prescribe medications. Today there are over 600 certified PAs practicing in New Brunswick, Ontario, Manitoba, and Alberta and they play a central role in the Canadian Armed Forces, where they care for Canada’s military personnel at home and abroad.

“It’s clear that now more than ever Canada needs PAs,” said Stone. “Putting PAs with the right skills in the right settings, starting with rural communities, is an obvious way to save money and improve the health of Canadians.”

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.

Media Contact: Andrea Tiwari, Director, Communications and Stakeholder Relations, atiwari@capa-acam.ca or 613 614 6863.