On the other side of most B.C. borders — four U.S. states plus Alberta — patients can see a physician assistant for many health concerns.
But not in B.C., where the province does not recognize physician assistants as health professionals, even though they’re trained to do some of the same work that family doctors do.
Pressure is mounting, however, now that B.C. Green leader Andrew Weaver has become a vocal champion of physician assistants.
In a speech he gave recently to the annual conference of physician assistants in Victoria, he called them a “largely untapped resource” in B.C.
Weaver told Postmedia News that he’s a supporter because with hundreds of thousands of B.C. residents unable to find a family doctor, physician assistants “are a good way to provide highly skilled services in the medical system.”
Weaver said he’s using the agreement the Green party has with the NDP to press for recognition of physician assistants so they can practice in B.C. and be regulated by the College of Physicians and Surgeons of B.C.
The agreement calls for the expansion “of team-based health care, to ensure that people have better access to the type of care they need, including access to services from physiotherapists, nurse practitioners, midwives, dietitians, pharmacists and other health professionals.”
Physician assistants could be part of that team-based care, he said.
With family doctors in short supply in B.C., the College of Physicians and Surgeons of B.C. has said it is ready to regulate physician assistants as soon as the provincial government gives its OK.
Often called physician extenders because physicians delegate work to them, thus improving physician productivity, physician assistants have two years of training after undergraduate degrees. The program is offered in Canada by various institutions like the Universities of Toronto, McMaster University and the University of Manitoba.
Just over 600 physician assistants are working in clinics, communities and hospitals in a handful of provinces and territories, qualified to do physical examinations, take medical histories, order tests, prescribe certain medications, and assist surgeons before, during and after surgeries. Their taxpayer-funded salaries range from about $75,000 to $150,000, comparable to what nurse practitioners earn.
Physician assistants have been used extensively in the Canadian military for five decades, on military bases and missions abroad. Some companies, such as those in the energy and mining fields, employ them for occupational health, advanced first aid and other employee health care needs.
But because B.C. has not amended the Health Professions Act to recognize and regulate them, the Canadian-trained assistants can neither be used by companies here nor be hired by doctors here. (Some large medical practices use internationally trained doctors in a similar assistant role but they are not physician assistants who’ve passed the Canadian exams).
Eric Demers is one such physician assistant. He recently retired from the Canadian military after a 23-year career, the last seven as a physician assistant taking care of navy and army personnel.
He said that since he is too young to retire entirely at age 44, he wants to get back to work diagnosing, prescribing and treating under the supervision of physicians.
“I’ve had five deployments abroad to places like the Balkans, Afghanistan and Libya and I’ve served on various submarines. It’s disheartening to know that I can’t employ my skills and knowledge as a civilian.”
Demers said there are companies in B.C. that are interested in hiring physician assistants at no cost to taxpayers, so “designating or recognizing us doesn’t mean that there would be an expense to the government.”
In the military, Demers worked in hospitals in Vancouver and Nanaimo after agreements were struck between Canadian Forces and health authorities. And, when the military was called in to assist while B.C. forests were burning, “we weren’t limited to who we provided treatment to.
“So I don’t know why we are facing this challenge getting recognized by the B.C. government.
The Canadian Medical Association and Doctors of B.C. have been in favour of the physician assistants for years. At the recent annual conference of Stone’s group in Victoria, Dr. Kathleen Ross, president-elect of Doctors of B.C., said physician assistants would be “an important support for doctors and patients.”
Yet the B.C. Ministry of Health has for years put its focus on nurse practitioners as part of its team-based primary care strategy despite studies showing that a broader scope of health professionals are needed to improve access for patients.
Last year, a report from the Conference Board of Canada said physician assistants are “a largely untapped resource that can help governments continue to provide high levels of service while reducing overall system costs.”
Health minister Adrian Dix was not available for an interview. But Laura Heinze, a spokeswoman for the minister, said while the government will continue to review how physician assistants might be integrated into the health care system, “our current focus is to maximize the effectiveness of the (already regulated) professions that we have right now in B.C.”
In the legislative assembly recently, Dix repeated that nurse practitioners were the first priority but the government plans to revisit the use of the physician assistants at some point.
Trevor Stone, president of the Canadian Association of Physician Assistants, said it’s a disgrace that military veterans who served as physician assistants abroad and at Canadian Forces bases in B.C. cannot continue their careers when they return to civilian life.
“Putting physician assistants to work in British Columbia has been stalled for far too long,” he said. “We have members across the country who would come back to B.C. to work in a heartbeat. With better and faster access to care, it’s patients who would be the big winners.
“It’s time for British Columbia to catch up with Ontario, Alberta, Manitoba, New Brunswick and many other parts of the world,” said Stone, adding that using physician assistants, especially in rural communities, “is an obvious way to save money and improve the health of British Columbians, yet the government refuses to act.”
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