Provincial government promises to add physician assistants to emergency departments as part of long list of projects changes to improve emergency care in Nova Scotia.
But what exactly do they do and can they help address the broader healthcare crisis?
The Canadian Association of Physician Assistants describes them as “physician assistants” who work semi-autonomously with a supervising physician to help improve patient access to health care.
Peter Thibeault, provincial director of the association, says physician assistants (PAs) have worked in the Canadian military for decades.
Manitoba was the first province to introduce them to the health care system in 1999. Today, they work in five provinces, including Nova Scotia, where Thibeault says a small number are already helping patients.
Thibeault spoke with Halifax Information Morning Portia Clark hosted Friday a northern Ontario mining camp, where he currently works.
Their conversation has been condensed and edited for clarity and length.
Information Morning – N.S.9:43How Physician Assistants Help Improve Emergency Care
Physician assistants will be part of a new plan to improve emergency care in the province. A longtime PA tells us about the expanded role they will take on.
First, remind us what Physician Assistants do. What is your scope of practice?
The scope of practice of a physician assistant is actually quite broad. We can handle anything from a patient with a cold to a really bad day in the medical world, as we call it. We can make diagnoses, consultations, prescribe medication, work with the healthcare team. There are positions to help with surgeries, perform minor procedures and do patient assessments, education…. That’s pretty broad, what APs can do.
And what is your relationship with a supervising physician?
As long as we can reach you by phone, that’s fine. You don’t have to run every case through the doctor. As long as it’s within your scope of practice and an AM feels comfortable, they can continue. I’m here, way up north as you said, and my supervising doctor is 4.5 hours away. So if I have a problem, we can just call him, discuss the whole case and come up with a game plan, either bring the patient in to see him or try another way of treating him, and go from there. It’s the same way Canadian medical assistants do it when they’re at sea aboard HMCS ships. The doctor is not there so if they need a doctor they can do the same, call and get help.
How did you come to this profession of medical assistant?
I am 32 years old in the army. I joined in 1990 and worked my way up the medical ranks and then met the criteria for an Army-run physician assistant program. (It’s not run by the military anymore, they turned it over to the universities.) And then I went to the military academy for two years, qualified as one of the first graduate medical assistants in Canada, with my comrades class, and I’ve been a PA since 2009.
You work in Ontario, as you said, but you live in Stewiacke, Nova Scotia. You’ve been saying for a long time that physician assistants can help our health care system here. And what do you think about why it hasn’t happened so far?
It is largely about education. Many people don’t know the value an AP can bring. I know in 2010 there was a big push…and then I don’t know exactly why it went off the rails. But right now it’s the will of the current government and I’m very happy about that, believe me — and I’m sure all Nova Scotians are. Right now the government wants it, and we are happy to provide Physician Assistants and the value that Physician Assistants can bring to Nova Scotians.
It looks like more of them will be working in all sorts of places. And there are already people working in Nova Scotia, right?
That’s right. I’m happy to report that there was the orthopedic pilot project, and there were three AMs working in the QEII [in Halifax]. And this pilot project is now over. They have seen the value of PAs and their positions are now permanent. So I’m very happy to hear that. And currently, Nova Scotia has hired three physician assistants for Dartmouth General Hospital, and three physician assistants will come to Bridgewater General Hospital. So there are nine of them so far. The Canadian Armed Forces employs its physician assistants at the Cobequid multi-service center to further their training. So if you were to go there, you’d probably come across a military medic maintaining their skills.
And where do you see AMs helping with the situation we find ourselves in, and not just with emergency services?
Well that’s the main thing. I know everyone’s talking about emergency rooms, but physician assistants can add more value in all aspects of medicine: family medicine practices, walk-in clinics, operating rooms, you name it. of domains. My own family doctor, his family practice, he would like a physician assistant to work there so he can see more patients faster. Because you don’t need to see a doctor for a cold, a medical assistant is more than capable of taking care of it. And if there’s something more than a cold, they can just contact their supervising physician, discuss it, and move on.
Nova Scotia has announced a series of changes to its health care system – including expanded virtual care, expanded powers for pharmacists and increased use of nurse practitioners and patient advocates – to improve health care services. hospital emergencies.
Do you see obstacles to overcome in order to implement more PAs? I mean there’s always recruiting, but other issues too?
The education component is the most important. The other thing is that there aren’t many APs. But when they launched the application or the survey to find out which physician assistants would like to come to Nova Scotia, there were 64 who responded to the survey to come and work in Nova Scotia for few positions. So it’s very promising. The other thing is that about 3,000 people applied for 69 positions at three universities in Canada. The University of Toronto, McMaster University and the University of Manitoba are the only three Canadian universities that currently offer the PA program. So it would be great if universities in Atlantic Canada that have a medical program added a PA program.
What do you say to people who may not trust a personal assistant and just want to see a doctor? I don’t know if you have encountered this case…
I have never encountered this, even when doing my student rotations. It’s just a piece of education. If people want to know what an AP is, all the information you want to know is on the website www.capa-acam.ca. There are APs all over the world, so it’s a valuable resource that can be trusted.
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