Its time for Physician Assistants to become integrated in the health care system
by Emily Hartley
Thousands of people are without a primary care provider in Canada while the demand for health care is growing at twice the rate of the population, mainly due to the aging population, according to the Conference Board of Canada. Between 2021 and 2025, it is estimated that nearly 1500 additional physicians will be needed annually to cover the increased demand.
Physicians are overworked and burnt out, creating even longer wait times for patients.
There is relief: Physician Assistants (PAs).
There are approximately 650 PAs practicing Canada-wide, with approximately 400 in Ontario, according to the Canadian Association of Physician Assistants (CAPA). However, most people don’t even know what they are.
PA's are medically trained clinicians who work in conjunction with physicians in a variety of different health care settings to conduct physical exams, prescribe medications, assist in surgery, order and interpret diagnostic tests, among other responsibilities. PAs can shorten wait times, increase efficiency, and increase the number of patients seen per day according to CAPA. Training and hiring more should be an essential part of filling the gaps within the Canadian health care system.
PAs could alleviate this pressure by having certain tasks delegated to them, leaving physicians available to treat more complex patient care cases. It makes a lot of sense.
PAs are not trying to replace physicians, but rather assist in the growing demand for health care services. Currently, there are four accredited PA programs in Canada: The Consortium of PA Education (with the University of Toronto, Northern Ontario School of Medicine, and The Michener Institute for Education at UHN), McMaster University, University of Manitoba, and through the Canadian Armed Forces. The length of PA programs is 24 months for accreditation. PAs can therefore play a timely role in the solution of shortages in health care providers by being an effective resource for primary care providers.
Finally, there is the factor of cost to the health care system. With the assumption that the addition of PAs will increase physician productivity, hiring PAs in areas such as primary care, emergency care, and orthopedics can save health care dollars according to CAPA. As PAs become more integrated into the health care system and optimize their skills, it is estimated that their productivity gains may be even greater, becoming more efficient as time progresses. PAs therefore enhance patient care in collaboration with physicians by making medical care more accessible and timely without compromising quality of care.
While some may be concerned that PAs are not qualified enough to provide adequate care, it is important to note that the PA programs in Canada include didactic learning and hands-on clinical experience. Students take part in clinical rotations with multidisciplinary teams in several disciplines including family medicine, general surgery, orthopedics, internal medicine, emergency medicine, and pediatrics, among others. Upon graduation of a PA program, the students complete the PA Certification Exam, and, if successful, become Canadian Certified Physician Assistants (CCPAs).
While practicing as a PA, they must also maintain their certification with several requirements as well as renew their Canadian Association of Physician Assistant (CAPA) membership. While PAs do graduate as generalists, many continue to learn specialized skills by working in conjunction with their supervising physician and adopting skills within their scope of practice.
PAs may be part of the health care solution. It is definitely something to thing about.
Emily Hartley is a second-year physician assistant student at the University of Toronto, presently based in Ottawa. She moved to Ontario after completing her Bachelor of Science degree in Medicinal Chemistry from the University of New Brunswick. Upon graduation in 2021, Emily plans to reside in Ontario to work as a PA.
- Canadian Associated of Physician Assistants [Internet]. Canada: Canadian Associated of Physician Assistants; 2020. PA facts; 2020 [cited 2020 July 14]. Available from: https://capa-acam.ca/about-pas/pa-fact-sheet/
- Desormeaux M, Stewart M, Grimes K, Prada G. Gaining Efficiency: Increasing the use of physician assistants in Canada. Ottawa: The Conference Board of Canada; 2016. 37 p.
- Issue Brief: Physician Assistants. Canada: Canadian Associated of Physician Assistants; Sep 2019. 9 p.