Remarks to B.C.’s Finance Committee on Budget 2021

Below are remarks delivered on June 10, 2020 by Eric Demers, Past-President, to British Columbia’s Select Standing Committee on Finance and Government Services.

Good Morning and thank you, Mr. Chair and Honourable Members, for the chance to speak to you today about our recommendations on the introduction of physician assistants, more commonly known as PAs, in B.C.

I am the Past-President of the Canadian Association of Physician Assistants. We’re the voice of more than 700 PAs who work in public health systems and the Canadian Armed Forces. Here in B.C., we have almost 30 PAs, most of whom serve in the Forces.

Before I tell you what a PA is and the value we can bring to the health system, I want to share part of my story.

I served for 23 years in the Canadian Armed Forces. First, I was a Medical Technician, aka a medic, and later I progressed in my career and my medical training to become a certified PA. I trained to provide medical support to Canadian troops and populations in need. In armed conflicts, disasters, and domestic operations like the Olympics and G8 summits. I spent three years serving on submarines where I was the only PA on board and the lone medical professional providing primary and specialized care to the crew of more than 50 sailors.

I was also deployed to places like Libya, where as a PA I oversaw the health needs for the diplomatic mission and its security. And during my time as a medic I had the honour to deploy many times, including to Afghanistan, and care for our ill and gravely injured.

It has been challenging to be in Victoria and not have the opportunity to care for those in my community, never more so than during this pandemic. And that’s because PAs are not recognized here and cannot work here, despite the obvious need and strong support from Doctors BC, the College of Physicians and Surgeons of British Columbia, the BC Care Providers Association, the BC Rural Health Network, and others.

So instead of contributing in my community during the worst public health crisis we’ve ever seen, I travel across borders, as an essential worker, to deliver healthcare in a remote area.  I’m part of a team that includes B.C. physicians who supervise PAs from afar.

But if I, or any of my colleagues, could work here to our full scope of practice, here is how we could help:

Rural emergency departments in places like Ashcroft could stay open on weekends, instead of the closures we see thanks to doctor shortages. That’s because PAs can help manage departments, with local doctors providing oversight and available for urgent cases.

There would be more flexibility in the type of provider that can be recruited by rural and remote communities, including some First Nations communities. A full-time PA provides important continuity in areas where locum doctors may come and go. And with a broad scope of practice, PAs can help with everything from emergency services, women’s health, mental health, and chronic disease management.

And in long-term care the workforce would be strengthened. Studies show that PAs on staff in long-term care homes help reduce transfers to hospitals, improve patient safety, and save money. And we help eliminate delays in care and perform more procedures in-house.

PAs, like nurse practitioners, are advanced practice professionals. We are educated in the “medical model”, which means our training is similar to that of Canadian doctors. We work autonomously under the supervision of licensed doctors to deliver primary, acute, and specialty care in all types of clinical settings. PAs are trained to assess patients, order and interpret tests, make diagnoses, provide treatment, serve as first assist in surgery, and much more.

Today, B.C. lags behind Ontario, Manitoba, Alberta, New Brunswick, and countries like the United States, United Kingdom, Netherlands, and Germany in terms of integrating PAs in the health care workforce.

In its recommendations to governments, the Conference Board of Canada says: “PAs play a vital role in improving patient outcomes and reducing overall system costs. Canada needs to implement strategic policy and funding changes to the way that health human resources and health services are currently delivered.”

The Conference Board also reports that the Canadian health care system could save over $600 million dollars if the use of PAs increases across the country.

Today, CAPA recommends to the Committee that the provincial government recognize and regulate PAs under the College of Physicians and Surgeons of British Columbia.

We also recommend that the government earmark $6.5 million in funding to hire 50 PAs over the course of the next three years and work with doctors, health system leaders, First Nations, and other stakeholders to identify where the PA model can have the greatest impact on patient care.

And lastly, we recommend that the government explore the creation of a PA education program through UBC that could establish a homegrown pipeline of PAs.

The coronavirus pandemic has swiftly changed our long-held beliefs about how we deliver care in this province. Some say we pushed the telemedicine revolution forward by at least a decade or more.

It’s time to make the same progress in our health care workforce. The PA model can help B.C. provide more care at a lower cost, while helping doctors focus on the complex patients who truly need their expertise.

Budget 2021 is an important opportunity to change the workforce landscape in our province in a way that will benefit generations to come. Thank you.

Budget 2021 is a chance to modernize B.C.’s health care workforce ahead of a second wave of COVID-19

Canadian Association of Physician Assistants calls on Horgan government to introduce, hire, and train physician assistants as part of the provincial response to the pandemic

VICTORIA, June 10, 2020—Today, the Canadian Association of Physician Assistants urged the British Columbia government to catch up with the rest of the globe and take the long overdue step of adding physician assistants (PAs) to the province’s health care workforce.

Eric Demers, a resident of Victoria and the Association’s immediate Past-President, made the recommendation in remarks he delivered at today’s Budget 2021 Consultations, held by the Select Standing Committee on Finance and Government Services.

“The immense role that PAs can play in boosting health system capacity is among the big global lessons from the first wave of COVID-19, but here at home I’m on the sidelines,” said Demers. “Right now I can only travel to northern Canada to deliver care at remote worksites because I can’t practice locally when I’m home. It doesn’t make sense.”

PAs are advanced practice clinicians trained in the medical model to work under the supervision of a licensed doctor and provide primary, acute, and specialty care in all types of settings. Today British Columbia lags behind other Canadian provinces, and countries like the United Kingdom, the Netherlands, and the United States, in terms of using the PA model to streamline services, decrease costs, and improve the efficiency of the physician workforce.

As far back as 2013, Doctors of BC has supported the introduction of PAs through its policy statement. The Conference Board of Canada conducted an in-depth study and found that increasing the use of PAs could save the Canadian health system more than $600 million.

Unlike other new roles in health care, PAs represent a new workforce that can fill existing vacancies, instead of simply shifting gaps from one profession to another. And with a generalist training and a broad scope of practice, the government can quickly deploy PAs to fill needs across the health system.

CAPA’s pre-budget recommendations ask the government to:

  1. Regulate PAs under the College of Physicians and Surgeons of British Columbia.
  2. Provide health authorities with funding earmarked to hire 50 PAs over the next three years, at a cost of approximately $6.5 million.
  3. Work with physicians, health system leaders, First Nations, and other stakeholders to identify the specialties where PAs can have the greatest impact.
  4. Explore developing a PA Education Program at UBC to begin training homegrown PAs.

“I hear from so many PAs who would move here in a heartbeat to serve patients,” said Demers. “The government is looking for long-lasting solutions to help steer us through this crisis and we are ready to help.”

Quick Facts

  • More than 700 PAs practice across Canada in Ontario, Alberta, Manitoba, and New Brunswick.
  • Family medicine, emergency medicine, surgical specialties, and general medicine are among the many clinical settings where Canadian PAs are well-established.
  • The Conference Board of Canada recommends that governments capitalize on the potential of the PA profession by implementing strategic policy and funding changes to the way that health human resources and health services are delivered.

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:

2021 Pre-Budget Submission to the Government of British Columbia

CAPA participated in British Columbia’s Budget 2021 Consultations held by the Select Standing Committee on Finance and Government Services.

In remarks from Eric Demers, Past-President, and in our submission, we illustrate that introducing and investing in physician assistants now is essential to boosting health system capacity and building a sustainable health care workforce.

Read more in the pre-budget submission. Members are encouraged to reinforce these themes in budget-related discussions and submissions to provincial officials.

Statement on Racial Injustice and Anti-Oppression

The Canadian Association of Physician Assistants grieves with our members and joins them in speaking out against the appalling acts of anti-Black racism and violence we have all witnessed over the past several days and weeks.

These actions are completely deplorable, they are not new, and they also occur in Canada.

Physician assistants value compassion, empathy, respect for all persons, justice, and accountability. These foundational values are instilled in our training. Through our professional and personal lives, we can all contribute to efforts to eliminate health disparities in our communities.

As health care professionals, we recognize that racism affects our racialized patients who face negative outcomes and poor experiences with the health care system. We also recognize that racism affects physician assistants in daily clinical work and academia. As a member-led association, we are committed to acknowledging the impact of all forms of discrimination and oppression, accepting the responsibility to make a difference, and using our collective voice to stand against intolerance and racial injustice.


CAPA is the national professional association representing physician assistants (PAs) in Canada. We are the national voice of PAs and work to support quality standards and competencies, and help establish the profession within the national health care framework. Learn more:

The Unsinkable Doc

Sub-Lieutenant Nicole Spivey, HMCS Nanaimo’s Physician Assistant

“Is the Doc in here?” asks a member of the ship’s company as they poke their head into the wardroom.

The Doc is in.

Sub-Lieutenant (SLt) Nicole Spivey, HMCS Nanaimo’s Physician Assistant, or Doc as she is known, waves the person in. Nanaimo’s Doc is a former Medical Technician of 13 years who commissioned as a Physician Assistant in January 2020 after completing her training.

The patient takes a seat while SLt Spivey does a quick examination of what ails: a bump to the head, but it’s not too bad. A quick clean of the wound, a couple Band-Aids, and a few encouraging words and the patient is good to go. Today, it’s a minor head wound; tomorrow, who can say.

The medical needs of a ship’s company can be vast, varied, and as complex as the human beings on board. The relationship that forms between individual members and the specialists on board who nurture their welfare is unlike any other, especially with the person who provides medical care…read more in CFB Esquimalt Lookout Navy News.

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