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Physician assistants say they could help ease pressure on Nova Scotia health system

With Nova Scotia's medical staff shortages, long surgery wait times and lingering barriers to primary care, physician assistants say they are an untapped resource in the province
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HALIFAX — With Nova Scotia's medical staff shortages, long surgery wait times and lingering barriers to primary care, physician assistants say they are an untapped resource in the province.

Physician assistants are trained, primarily by the military, to manage treatment plans, prescribe some medications, perform some medical procedures and assist in surgery while working under a doctor. But they are not widely regulated to work in Nova Scotia’s health system.

Outside of the military, there are just three physician assistants working in Nova Scotia. They were hired as part of a three-year pilot project that began in 2020 in an orthopedic department.

Peter Thibeault, the Nova Scotia director of the Canadian Association of Physician Assistants, said he doesn’t understand why the “immeasurable” value of physician assistants, known as PAs, is not being recognized in the province. 

“PAs can work in all different areas of medicine,” Thibeault said in an interview Wednesday. “I don’t know what’s the holdup.”

He said PAs should be working across the health system — in primary care clinics, emergency departments and operating rooms — in order to cut down wait times and support doctors. In an operating room, for example, physician assistants can assist a surgeon by handing them medical tools, controlling bleeding and closing incisions.

As of April 1, there were 88,300 Nova Scotians on the province’s primary care wait-list, a record high. In March 2022, there were 27,000 Nova Scotians waiting for surgery, according to results from a freedom of information request by the Nova Scotia NDP.

Thibeault, a Nova Scotian who worked as a military physician assistant for more than 30 years, had to find work outside the province when he retired from military service. He works for three-week stints at a gold mine in northern Ontario. When he’s off work, he returns to his home in West St. Andrew’s, N.S.

He’d prefer to work close to home, he said, and as the physician assistant association representative for Nova Scotia, he hears from many others in the same boat. He guesses there are at least 10 physician assistants who would like to be working in Nova Scotia but can’t. 

“PAs are trying to come home to Nova Scotia, but it’s hard,” he said. His association knows of 32 PAs who live in Nova Scotia, the vast majority of whom work for the military. 

Provincial governments or colleges of physicians and surgeons in New Brunswick, Manitoba, Alberta and Ontario have made provisions for physician assistants to work in civilian facilities.

Kevin Dickson, the president of the Canadian Association of Physician Assistants and one of two PAs who works in a Fredericton emergency department, said physician assistants play a role in improving the lives of both patients and doctors.

“In a busy emergency department, if there’s a PA working alongside a physician, then there’s some relief,” Dickson said in an interview Tuesday. 

“There’s that secondary goal of just making the work environment a little bit better for physicians, and that improves retention,” he said. 

When asked about the progress toward regulating PAs in Nova Scotia, Health Minister Michelle Thompson said in a statement the province is looking at the scope of practice of all health-care workers, including physician assistants.

She noted that the existing three-person physician assistant program, which was launched by the former Liberal government, is “in the middle” of its three-year period. 

“The outcomes from the experience of the pilot will help determine next steps,” she said.

This report by The Canadian Press was first published May 5, 2022.

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This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.

Lyndsay Armstrong, The Canadian Press

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