Frustrated and tired. That’s how I’m feeling. I’m a military-trained physician assistant (PA) with over a decade of medical experience who could be helping to provide care that is so desperately needed here in Nova Scotia.
PAs are here in the province, ready and able to help connect patients to family doctors who don’t have one. To help reduce the backlog for much-needed surgeries and treatment and to help expand the availability of other physicians who are overburdened – like psychiatrists, neurologists, and geriatricians. But even though I’m trained to help and want to help, I’m unable to practise here – yet. There are many experienced PAs who have left Atlantic Canada to train and practise medicine. They would jump at the chance to return home, and their skills would offer an immediate boost to the health-care system.
While PAs were introduced in Nova Scotia in 2020 through a pilot project in orthopedic surgery, legislation still doesn’t permit us to practise in other areas of medicine. I commend the government for introducing the pilot. And given its success, it’s time to allow PAs to practise more broadly, now.
PAs are physician extenders who are trained as generalists and can assist with any task within their supervising physician’s scope of practice. In primary care, PAs make services more accessible, and in emergency departments, PAs can cut wait times by half.
The Canadian Armed Forces (CAF) knows this, which is why military PAs will be starting to work at Cobequid Multi-Service Centre in Lower Sackville this month. This is added medical training to maintain clinical readiness skills to treat patients.
The CAF has been employing PAs for over 20 years. PAs are also working in Alberta, Manitoba, Ontario and New Brunswick, plus in the natural resource oil/mineral sectors, not to mention there are over 120,000 PAs working in the U.S. Makes you wonder why not here in Nova Scotia. Research has proven time and again the value PAs bring to the table. A comprehensive study by the Conference Board of Canada confirms the effectiveness and value of PAs. On top of this, physicians here in the province are anxious and calling for PAs to be brought onboard to help with the shortage of medical workers.
The evidence is clear. The need is clear. And the help is here. So, let’s move quickly to allow PAs to practise here in Nova Scotia. We need all hands on deck.
Peter Thibeault is a physician assistant who lives in Nova Scotia and practises in Ontario. He is the Nova Scotia provincial director for the Canadian Association of Physician Assistants, the national voice of physician assistants, supporting quality standards and competencies and helping to establish the profession within the national health-care framework. To learn more, visit capa-acam.ca.
Canada needs Physician Assistants (PAs) to make health care more accessible, however, more training spots are needed to expand the PA model of care.
The process of becoming a physician is a lengthy and complex one, as outlined in an op-ed from the Star on May 25th, stating that medical schools must reflect training realities.
A key solution to increasing access to care is Physician Assistants (PAs).
PAs are physician extenders who are trained as generalists in the medical model and can assist with any task within their supervising physicians’ scope of practice.
Beyond helping improve the quality of patient care, expanding on the use of PAs will save the health system money as proven in a 2016 report from The Conference Board of Canada.
While improved access to quality care and cost-effectiveness would undoubtedly enhance the current health system, the reality is, we need more training spots for PAs, including the creation of new training programs.
Two of the three PA education programs in the country are in the province of Ontario at McMaster University and the Consortium of PA Education at the University of Toronto, however, even then the programs only graduated a combined 54 students last year despite having received over 2000 applications between the two schools.
To top-it-off, new legislation will be coming into effect that will regulate PAs under the College of Physicians and Surgeons of Ontario, resulting in even greater demand for the profession, from employers, patients, as well as aspiring PAs.
If medical schools are in tune with the health care landscape in the country, then they would jump at the opportunity to boost the number of PAs entering the workforce. Despite this model leading to increased access to care and saving the health care system money, there are not enough training spots in the province to meet the ongoing and projected employment opportunities within the current health care system. For this, educational institutions would be well-advised to take notice.
About the Author
Sahand Ensafi is a practicing Physician Assistant at UHN in Toronto and is the Ontario Provincial Director for the Canadian Association of Physician Assistants, which is the national voice of Physician Assistants in Canada, supporting quality standards and competencies and helping to establish the profession within the national health care framework.
Toronto, Ontario, 2021 — Today, in the Ontario Legislature, the Minister of Health, Christine Elliott introduced legislation, that once passed, will mean the start of regulating Ontario Physician Assistants under the College of Physicians and Surgeons of Ontario.
This important initiative is a giant step forward to modernizing the PA model in the province and will help solidify the important role that PAs are playing in hospitals, emergency departments and in primary care settings. Enhancing the PA model and regulating PAs will improve patient care, encourage more team-based care and allow PAs to work to their full scope of practice.
Regulation also means that PAs in Ontario will be required to follow standards for competency, safety and ethics like other regulated health professionals in the province.
CAPA thanks the Government of Ontario for recognizing the importance of the PA profession, making regulation a priority, and for taking this vital step at a critical time when the health care system has been stretched to the limit.
CAPA looks forward to working with the CPSO and the province to move this important step forward so that we can unlock the full potential of PAs in Ontario.
PAs are advanced practice clinicians trained in the medical model and practice medicine with a degree of autonomy negotiated with supervising Physicians to provide primary, acute and specialty care in all types of settings. They diagnose illness, develop and manage treatment plans, prescribe medication, perform procedures, act as first assist in surgery, and much more.
About the Canadian Association of Physician Assistants (CAPA)
CAPA 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.
Media Relations Contact
Kristy Corrente, Manager, Advocacy and Stakeholder Relations – East Canada
With the Government of New Brunswick recently pledging to undertake a major consultation process and vowing in a news release from January 27th that All options on table as province looks to future of health care, officials are being urged to increase the use of Physician Assistants (PAs) in the province.
In Fredericton, a handful of PAs are being used in the emergency department at the Dr. Everett Chalmers Regional Hospital to extend a physician’s reach, however, they can be used for so much more.
A PA is an advanced practice clinician who is educated in the medical school model and practices medicine under the supervision of a licensed physician with negotiated autonomy, often within a multidisciplinary health team.
PAs help bridge the health care gap by increasing access to family doctors and improving access to care in rural communities. PAs can also help drive efficiencies by providing crucial support for seniors in long-term care, in surgical suites, as well as cancer centres.
However due to the COVID-19 pandemic, the health and safety of communities are now more pressing than ever before. Yet despite this, the Government of New Brunswick still has an opportunity to improve patient care, save money, and reduce wait times by supporting the increased use of PAs.
During a time when it is critical to deliver quality care more comprehensively and in a timely fashion to keep people out of ERs and the hospital, PAs should absolutely be a part of the solution.
Scaling up the use of PAs by adding them to primary care teams means that many doctors can offer more sameday appointments and reduce the time patients spend in waiting rooms.
With that common sense says that scaling up a proven workforce is a strategic way to make change happen quickly. Using PAs to deliver the best care at the right time is an obvious way to improve the health of New Brunswickers.
Beyond helping improve the quality of patient care, adding PAs also has the potential to save money. A 2016 report from The Conference Board of Canada states that if PAs could 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.
Around the world PAs are already alleviating health care systems including in the provinces of Alberta, Manitoba, Ontario, as well as the Canadian Armed Forces. These advanced practice clinicians are changing the face of healthcare in these jurisdictions and it is time to add more PAs in the province of New Brunswick.
About the Author
Ryan Bennett is a practicing Physician Assistant in Fredericton and is the New Brunswick Provincial Director for the Canadian Association of Physician Assistants, which is the national voice of Physician Assistants in Canada, supporting quality standards and competencies and helping to establish the profession within the national health care framework.