Some health care providers say physician assistants could help alleviate Alberta’s shortage of family doctors, and they are calling for more support from the provincial government.
Physician assistants (PAs) are trained to examine, diagnose, and treat patients under medical supervision.
Despite being recognized as regulated health professionals nearly two years ago, there are only 46 PAs registered by the College of Physicians and Surgeons of Alberta and few of them work in primary care.
“We hear the stories about people who can’t see a doctor. … They fight,” said Kirsten Luomala, an Edmonton-based PA and new president of the Canadian Association of Physician Assistants.
“Now is the time to move this forward.”
According to Luomala, PAs worked exclusively in the Canadian Armed Forces until 2013, when Alberta Health Services launched a pilot project using PAs in areas such as surgery and emergency rooms.
And while the use of PAs is increasing within AHS (e.g. in hospitals), Luomala said they are underutilized in the strained primary care system.
“We could do 75 percent of what the doctors do. We could see the less complex cases,” she said.
“We would free up the family doctor’s time. We can do some of the paperwork they’re stuck with. … You can actually expand your practice. They can take more patients.”
But the road to expanding Alberta’s pool of physician assistants — and integrating them into primary care — has been a rocky one.
“Outside of Alberta’s health services … we are not being fully utilized. And part of that is a lack of funding,” Luomala said.
In primary care, she said, a PA’s salary must be paid by either a GP or a primary care network.
“The biggest obstacle … is an effective funding model,” Luomala said.
“Collect dust” training program
Another important obstacle, according to Dr. Jon Meddings, professor and former dean of the University of Calgary’s Cumming School of Medicine, states that Alberta does not have a training program for physician assistants.
“We need a solution now,” he said. “We need to expand the type of people who provide basic services.”
There are only three accredited programs in Canada.
What’s not widely known, Meddings said, is that the University of Calgary developed a physician assistant training program in 2015.
“It’s been gathering dust for seven years,” he said.
“We have a perfectly good apprenticeship program sitting there … but the government never really said, ‘Yeah, we’re going to hire them. These are the conditions under which they are employed.’ And then ‘Please start training them,’ which we could do almost anytime,” he said.
dr Doug Myhre said he was hired by Alberta Health to develop the Bachelor of Physician Assistant program when he was associate dean at the University of Calgary.
While focusing on rural practice, Myhre said it was designed to get PAs working in both rural and urban settings.
“For the price of $2 million a year, we had a program that could do 20 PAs a year,” he said.
According to Myhre, the plan fell off the radar after it went to the Department of Advanced Education for review. At the time, PAs were unregulated in the province.
“I had support from Alberta Health and Alberta Health Services,” he said. “We also had support from across the faculty. … So it was really disappointing.”
With Alberta’s health crisis, Myhre believes now is the time to revive it.
“They’re a piece that could be really responsive and ramp up fast,” he said, noting that international medical graduates or medical staff like paramedics would be ideal students.
“I’d definitely like to see it back on the state government’s radar.”
In a statement to CBC News, the university said it was working with the provincial government on “a range of innovative educational solutions to address the shortage of health workers,” and a program for physician assistants was under consideration.
The Alberta government did not respond to questions about the funding framework or support for a local training program prior to the release.
However, a spokesman for Health Secretary Jason Copping acknowledged the benefit of healthcare professionals such as physician assistants.
“Alternative providers support physicians by providing hands-on care to patients under the physician’s direction and/or supervision. These models of care can expand the capacity of physicians,” Scott Johnston said in an email.
“Care models that integrate alternative healthcare providers contribute to physician recruitment and retention due to a more manageable patient burden and improved work-life balance.”
According to Johnston, AHS plans to add 100 new alternative providers, including physician assistants, to help at hospitals with critical staffing shortages.
On Tuesday, the UCP government pledged $243 million in new funding for basic services over three years if the budget is passed next week.
The plan also depends on the results of the provincial elections in May.
