Could physician assistants relieve pressure on N.L.'s strained health-care system?
A physician assistant in Manitoba would like to see Newfoundland and Labrador regulate the profession so she and her fiancé — who are both healthcare workers — could possibly move to the province.
Kathleen Abreo and her partner Dr. Travis Barron seriously considered moving to Newfoundland and Labrador to be closer to Barron's family in Torbay.
The couple scrapped the plan when they discovered Abreo wouldn't be able to work as a physician assistant and because Barron said he would have to take a 40 to 60 per cent pay cut to work in the province as a doctor.
"We had emailed around and actually found out that because we're not recognized, physician assistants aren't recognized in the Health Professions Act, I wouldn't be able to do anything that's construed as medicine," she said.
Abreo said she could help with the province's shortage of healthcare workers. One in four people are without a family doctor, wait times for care can be lengthy, rural emergency rooms have been facing closures due to staffing shortages all summer and nurses are leaving the profession at a high rate.
"I would love to see physician assistants [be] part of the solution in Newfoundland," she said.
Abreo said she'd also like to see the province launch a pilot program for physician assistants, like one happening in Nova Scotia, where they are assisting with knee and hip surgeries.
"That would be very interesting. That would be great," she said.
What is a physician assistant?
Physician assistants work under the supervision of a doctor and can "diagnose illness, develop and manage treatment plans, prescribe medication, perform procedures [and] act as first assist in surgery," according to the Canadian Association of Physician Assistants.
"We work generally as physician extenders….like a resident or a nurse practitioner," Abreo said.
Kevin Dickson, the association's president and a physician assistant in an emergency room in Fredericton, New Brunswick, says he helps patients with everything from respiratory illnesses, wound care, fractures and a wide variety of injury and illness.
"I can take 30 or 35 patients from the waiting room and send them home without direct physician involvement…. It's just one more person on the team that can see patients," he said.
The Canadian Armed Forces has been using physician assistants for more than 40 years, Dickson said, and it's where he started his career.
He said there are now 900 in Canada, practicing mainly in Ontario and Manitoba.
Three physician assistants are working as part of a pilot in Nova Scotia, and there are also some working in Fredericton, New Brunswick.
In Ontario, the provincial government says physician assistants are working on care teams across the province and are "helping to decrease wait times and improve patient access in high need areas including emergency medicine and primary care."
McMaster University, the University of Toronto and the University of Manitoba train physician assistants, where programs combine classroom education and hands-on experience.
Dickson said the programs graduate about 70 people each year, and he said entry into the schools is competitive, with about 2,000 applicants annually.
When it comes to pay he said they're often salaried, earning between $80,000 to $120,000.
"I'm a hospital employee," said Dickson. "In Ontario, there's a mix of programs that pay for them."
N.L. examining role PA's could play
Abreo thinks physician assistants could help alleviate some stress in Newfoundland and Labrador's health-care system.
"When you work on a team of physician assistants … you can see a lot more patients and a lot more people can get access to care. And physician assistants can really do almost anything and can work in almost any area of medicine. So it would just be a huge help," she said.
In a statement, Newfoundland and Labrador's health department says it's looking at how physician assistants could help the challenged health-care system, but can't say how long it could take to get them regulated and working here.
"Given current family physician shortages, physician assistants could be a part of the basket of solutions to increasing primary access," reads a statement from the department.
"Working within their role and scope of practice, they have [the] ability to provide safe, appropriate and quality care and the ability to extend family physician availability."
The health department said professions seeking regulation, like physician assistants, would have to apply to the Minister of Health. They said the process to regulate typically includes changing or creating new legislation.
They said they've received letters from physician assistants "requesting to be incorporated into the provincial system " and met with the Canadian Association of Physician Assistants on the issue.
Dickson said talks with this province about regulating the profession have been positive, but he's come away from meetings with no commitment from the Newfoundland and Labrador government.
Meanwhile, the department says it also met with the College of Physicians and Surgeons of Newfoundland and Labrador on the issue.
The college, which regulates the practice of medicine in the province, says the Medical Act sets their mandate and does not currently provide provisions "which would permit the college to register physician assistants."
Because of that, the college said in a statement it can't answer questions about regulating the profession in the province or how they could perform their work.
If the province did regulate physician assistants, Abreo would be interested in moving here to work.
"I think it would definitely be on the table,' she said.
