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.
On June 1st, 2021, Bill 283 passed third reading in the Ontario Legislature. Following this on June 3rd, the bill received Royal Assent, when the Lieutenant Governor signed the bill, officially making it law. We are working closely with government and CPSO to establish regulation for PAs in Ontario. Currently there is no regulation that states a PA must be certified; however, certification (CCPA or PA-C) may be required at the discretion of an employer.
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.
In late fall of 2020, the Alberta Government passed legislation under the Health Professions Act allowing CPSA to begin regulating Physician Assistants (PAs) effective April 1, 2021. As professionals supervised by physicians, PAs will follow all CPSA Standards of Practice and comply with all continuing competence requirements. Prior to 2021, CPSA worked with PAs on a voluntary basis since 2011. More information about PAs in Alberta, including their responsibilities, can be found on cpsa.ca.
In Nova Scotia, the government has launched a pilot project at the Nova Scotia Health Authority for three PAs to work in orthopaedic surgery to help tackle hip and knee surgery wait times. CAPA continues to advocate for broader integration of PAs across Nova Scotia's health system, as well as regulation of the profession.
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.