Physician AssistantsPhysician AssistantsOptimizing Patient CareOptimizing Patient Care

Presentation ObjectivesPresentation Objectives• What is a PA?• Scope of Practice• PAs in Canada• PAs benefiting the Health Care System• The Value of PAs• Advancing the PA Profession in Canada

• A Physician Assistant is university-educateduniversity-educated a health care professional who works in direct collaboration with a licensed supervising physician

• In the practice of medicinepractice of medicine, PAs have a prime role of preventing, maintaining, and treating human illness and injury

• Through the process of delegationprocess of delegation, PAs provide a broad range of health care services that are traditionally performed by physicians

What is a PA?What is a PA?

• PAs can be entrusted and authorized to make certain authorized to make certain decisionsdecisions and to carry out certain actions autonomously

• As an integral member of the health care teamintegral member of the health care team, a PA does not supplant or substitute a physician as the principal medical decision-maker

• Through a collaborative and patient-centered model collaborative and patient-centered model of careof care, PAs work with a supervising physician in a manner that greatly enhances access to quality care for patients

What is a PA?What is a PA?

• The National Competency Profile and Scope of Practice was developed in conjunction with the College of Family College of Family Physicians of CanadaPhysicians of Canada, the Canadian Medical Canadian Medical AssociationAssociation, and the Royal College of Physicians and Royal College of Physicians and Surgeons of CanadaSurgeons of Canada

• In Canada, PAs are formally trained and educated under the medical model, and they must meet the national standard set by Canadian Association of Canadian Association of Physician Physician AssistantsAssistants

• The Physician Assistant Certification Council of Canada Physician Assistant Certification Council of Canada administers and maintains the PA certification process

Scope of PracticeScope of PracticeCompetencies and OversightCompetencies and Oversight

Duties Generally Performed by PAsDuties Generally Performed by PAs

• Completing medical histories and performing comprehensive physical examinations

• Ordering, performing and interpreting common diagnostic tests including; laboratory, radiological, ECG, etc., that are used to identify pathologies and disease processes

• Completing admission and discharge procedures for hospital stays

• Referring patients for consultation with specialists

Scope of PracticeScope of Practice

• Assisting physicians in developing and implementing patient management plans

• Recording progress notes in isolated and in-patient care settings

• Prescribing medication in accordance with medical directives and local legislation

• Providing preventative health counseling

• Performing certain minor surgical procedures as well as functioning as a first assist in general or specialized surgical interventions

Duties Generally Performed by PAsDuties Generally Performed by PAsScope of PracticeScope of Practice

PAs in CanadaPAs in Canada• There are over 400 Physician Assistants practicing in

Canada, in both civilian settings and within the Canadian Forces

• 4 provinces recognize PAs as a profession, more are currently evaluating the role

• 4 nationally recognized reputable academic institutions offer PA programs

• In the US there are over 90, 000 PAs practicing in health care settings

PA Accredited ProgramsPA Accredited Programs• Canadian Forces Health Services Canadian Forces Health Services Training Centre

• University of Manitoba University of Manitoba Physician Assistant Education Program

• McMaster University McMaster University Medical Sciences PA Program

• Consortium for PA Education Consortium for PA Education (combination of the University of Toronto/Northern Ontario School of Medicine/Michener Institute for Applied Health Sciences)

PAs Benefit PAs Benefit ourour Health Care System Health Care System• Today 4.5 million people in Canada do not have a 4.5 million people in Canada do not have a

regular medical doctor regular medical doctor 1

1. “Canadian Community Health Survey”Statistics Canada

• PAs have demonstrated major enhancements in the delivery of care by improving access improving access for patients and by reducing wait timesreducing wait times

• PAs can manage up to 62 % of all patients in up to 62 % of all patients in emergency careemergency care 2

• PAs can manage up to 75 % of all visits in primary up to 75 % of all visits in primary care care without referral to physician level care 2

2. “Staffing primary care in 1990: physician replacement and cost saving”Schweitzer & Record

• In orthopaedicsorthopaedics PAs can increase the volume of increase the volume of primary joint procedures by 42 % a year primary joint procedures by 42 % a year 3

• In orthopaedicsorthopaedics PAs decrease wait times for surgeries by 14 weeks 3

3.“Experience with physician assistants in a Canadian arthroplasty program”Bohm et al.

• In Emergency Departments Emergency Departments PAs can reduce wait times reduce wait times for patients by 1.9 timesfor patients by 1.9 times and reduce reduce ““left without left without being seenbeing seen”” rates by 50% rates by 50% 4

4. “Impact on patient flow after the integration of nurse practitioners and physician assistants in Ontario emergency departments”

Ducharme et al.

PAs Benefit PAs Benefit ourour Health Care System Health Care System

The Value of PAsThe Value of PAs• Integrating PAs into health care increases the level of increases the level of

service for patientsservice for patients and addresses the challenges and shortfalls that negatively impact our health system

• Interprofessional collaborative approach Interprofessional collaborative approach that reduces the workload placed on the entire team and the physician

• PAs are trained to work in a team-based setting which fosters greater inter-professional collaboration among other health care providers

Advancing the PA ProfessionAdvancing the PA Profession• Increasing familiarity with the PA role and Scope of

Practice

• Establishing a comprehensive and sustainable funding model(s)

• Increasing the recruitment and integration of PAs in all areas of the health care system

“Barriers and Benefits to Hiring a Physician Assistant", Taylor et al.

PAs are Making a DifferencePAs are Making a Difference• Physicians support the Physician Assistant profession,

and more are requesting to work with PAs

• PAs have proven value and benefits to the health care system

• We must continue to gain the support of local and provincial governments and other key health organizations

• Your voice and your support are vital Your voice and your support are vital to ensuring that PAs can continue improving YOUR access to quality health care services

Questions?Questions?

For more information please visit our website at www.capa-acam.ca