{"id":490888,"date":"2022-09-06T18:49:48","date_gmt":"2022-09-06T15:49:48","guid":{"rendered":"https:\/\/en.buradabiliyorum.com\/how-physician-assistants-can-help-solve-canadas-health-care-crisis\/"},"modified":"2022-09-06T18:49:48","modified_gmt":"2022-09-06T15:49:48","slug":"how-physician-assistants-can-help-solve-canadas-health-care-crisis","status":"publish","type":"post","link":"https:\/\/buradabiliyorum.com\/en\/how-physician-assistants-can-help-solve-canadas-health-care-crisis\/","title":{"rendered":"#How physician assistants can help solve Canada\u2019s health-care crisis"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_84 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<label for=\"ez-toc-cssicon-toggle-item-6a262329d06f5\" class=\"ez-toc-cssicon-toggle-label\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #dd3333;color:#dd3333\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #dd3333;color:#dd3333\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/label><input type=\"checkbox\"  id=\"ez-toc-cssicon-toggle-item-6a262329d06f5\" checked aria-label=\"Toggle\" \/><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/buradabiliyorum.com\/en\/how-physician-assistants-can-help-solve-canadas-health-care-crisis\/#%E2%80%9CHow_physician_assistants_can_help_solve_Canadas_health-care_crisis%E2%80%9D\" >&#8220;How physician assistants can help solve Canada\u2019s health-care crisis&#8221;<\/a><\/li><\/ul><\/nav><\/div>\n<h1><span class=\"ez-toc-section\" id=\"%E2%80%9CHow_physician_assistants_can_help_solve_Canadas_health-care_crisis%E2%80%9D\"><\/span>&#8220;How physician assistants can help solve Canada\u2019s health-care crisis&#8221;<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<div>\n<p class=\"p1\"><span class=\"s1\">I\u2019ve been a physician<\/span> for 21 years now, working across Canada in pediatric medicine. Five years ago, I moved to the Yukon to practise. I\u2019ve witnessed firsthand the fallout resulting from a lack of medical services. I\u2019ve spent 72-hour stretches at the hospital, dealing with sick children, because there was no one else who could provide the level of care they needed. I\u2019ve been stranded with critically ill kids waiting for MedEvac, because the only way out of the Yukon if you\u2019re sick is by plane. These are the kinds of resource limitations that people in urban centres like Toronto or Calgary wouldn\u2019t normally think about; that is, until the recent spate of emergency-room closures.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<p class=\"p2\"><span class=\"s2\">In a universal health-care system, <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/general\/\" data-internallinksmanager029f6b8e52c=\"3\" title=\"General\" target=\"_blank\" rel=\"noopener\">general<\/a> <\/span>practitioners are often the only profession<span class=\"s2\">als whose services are fully covered, but they\u2019re not necessarily experts on everything. Patients might need dietitians, <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/social-mediaa\/\" data-internallinksmanager029f6b8e52c=\"1\" title=\"Social Media\" target=\"_blank\" rel=\"noopener\">social<\/a> workers or regular check-ins with a nurse, all of which can be part of integrated-care clinics. The Canadian medical community has been advocating for more of a team-based <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/download-scripts-themes-apps\/\" data-internallinksmanager029f6b8e52c=\"9\" title=\"Download Scripts &amp; Themes &amp; Apps\" target=\"_blank\" rel=\"noopener\">app<\/a>roach to health care for 25 to 30 years\u2014as opposed to siloed practices, with a single doctor at the top. The whole premise of the Canadian medical system hinges on the idea that everyone has a physician <\/span>who quarterbacks their care\u2014which, ideally, <span class=\"s2\">lessens the burden on the system. The reality is that millions of Canadians are without a family doctor. Reports of burnout among health-care professionals have increased dramatically in the last five years, and where we\u2019re seeing that most acutely is in primary care. Doctors need help, too.<\/span><\/p>\n<p class=\"p2\"><span class=\"s3\">In the rush to recruit more doctors and nurses, the role of physician assistant, or PA, has been overlooked. The position has existed in the Canadian military since the 1950s, but right now, there are only about 800 certified in all of Canada, many of whom are haphazardly employed across hospitals and smaller practices. Those numbers pale in comparison to rates in the U.S. and across parts of Europe. Right now, McMaster University, the University of Toronto and the University of Manitoba are the only Canadian schools that train physician assistants, and these four-year programs graduate a combined total of just 70 students each year. With about 2,000 applicants annually, they could consider expanding their acceptance rates.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<blockquote><p><strong>RELATED: I\u2019m a veteran ER doctor. I can\u2019t believe what I\u2019m seeing.<\/strong><\/p>\n<\/blockquote>\n<p class=\"p2\"><span class=\"s2\">In an optimal situation, every family doctor would be paired with a PA. They can take medical histories, examine patients, write prescriptions, order diagnostic tests, send referrals and stickhandle follow-up appointments. They can act as a touchpoint for patients between visits, asking simple things like, \u201cMs. Jones, how\u2019s your blood glucose this week?\u201d or managing complex care plans for chronic diseases, like obesity. A PA is effectively an extension of the doctor, who, with an assistant\u2019s help, can care for more patients without necessarily having to do it all themselves. They can just look at a PA-created care plan and say, \u201cYep, sounds good.\u201d These shadow doctors can also take care of paperwork throughout the day\u2014physicians will no longer have to go home and spend five hours on the computer after their kids go to bed. For a burnt-out doctor, it\u2019s like, \u201cWow, I like my job again!\u201d<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p2\"><span class=\"s2\">The administrative burden on doctors is far and away one of the biggest issues in primary care right now. It\u2019s also unpaid work: in Canada, the vast majority of GPs operate under a fee-for-service model, and there are no reimbursement codes for paperwork. That\u2019s a lot of free labour if you\u2019re seeing 30 or 40 patients\u2014and writing up 30 or 40 charts\u2014in a day. In fact, 50 per cent of doctors are regularly doing tasks that are well outside their scope of practice, in part because Canada is slow to fund integrated team-based care, which could cover the salary of a full-time PA.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p2\"><span class=\"s2\">In our current fee-for-service world, primary-care providers operate clinics under a small-business model. The government pays them for the services they deliver directly to patients\u2014not for assistance by other team members. From that single pool of money, doctors have to fund the entire cost of running their clinics: the rent, the staff and the equipment, right down to the internet. It\u2019s a bit like asking teachers to pay for the school building they teach in, paying them per lesson and having them use that money to fund the paper and the desks.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p2\"><span class=\"s2\">Compounding this problem is the fact that billing rates haven\u2019t kept up with the cost of providing this infrastructure, especially with rising inflation. In British Columbia, for example, the average fee for a basic check-up has only increased by six dollars in the last 20 years. So the only way to generate more revenue for your already overburdened clinic\u2014and to pay for extra <\/span>staff\u2014is to see more patients. Of course doc<span class=\"s2\">tors today are looking at that arrangement and considering a career change.<\/span><\/p>\n<p class=\"p2\"><span class=\"s3\">This payment model is a huge barrier to transforming the Canadian health-care system into something more collaborative, but there are still examples of innovation popping up. In Ontario, a fifth of the province\u2019s patients belong to family health teams, which have established salaried staff positions, subsidized by government dollars. Waitlists are long, but patients at those clinics are seeing fewer emergency-room <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/trip-and-travel\/\" data-internallinksmanager029f6b8e52c=\"10\" title=\"Trip &amp; Travel\" target=\"_blank\" rel=\"noopener\">trip<\/a>s and better health outcomes.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<blockquote><p><strong>MORE:\u00a0I\u2019ve only been a nurse for eight months. The chaos is killing me.<\/strong><\/p>\n<\/blockquote>\n<p class=\"p2\"><span class=\"s3\">Another payment framework that\u2019s been effective is capitation. Under this model, doctors <i>and<\/i> their broader teams are responsible for a set number of patients per year, and they\u2019re paid to look after each one on an annual basis. Patients with more complex needs, like the elderly, come with higher pay. In that scenario, doctors are better able to focus on caring for those patients in concert with their staff, rather than on whether they\u2019ll be able to bill for a blood-pressure check\u2014and who is even allowed to do it.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p2\"><span class=\"s2\">According to a report by the Conference Board of Canada, the estimated worth of physician assistants to the health-care system could be $1 billion in just over a decade. But their value isn\u2019t just quantifiable. It\u2019s relational, too, which is what medicine is all about. In 2022, patients are particularly vulnerable to pseudo<a href=\"https:\/\/buradabiliyorum.com\/en\/category\/sciencee\/\" data-internallinksmanager029f6b8e52c=\"5\" title=\"Science\" target=\"_blank\" rel=\"noopener\">science<\/a> from wellness influencers. Because these accounts are always available online, in a way that physicians aren\u2019t, patients are inundated with health information that\u2019s misleading and, in some cases, outright dangerous. Having a PA available who could field questions with a timely response, even via email or messaging services, would improve patient access to strong, science-based resources. PAs can be a lifeline <i>before <\/i>people get sick.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p2\"><span class=\"s2\">There are growing signs of enthusiasm around hiring PAs. Newfoundland and Labrador\u2019s health department says it\u2019s studying how this role could be implemented, but has yet to define how or when they\u2019ll be regulated and rolled out en masse. In any case, more hands means less burnout for doctors themselves. Because of our strapped system, there\u2019s less\u2014or no\u2014time for patients and doctors to build relationships.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p2\"><span class=\"s3\">The privilege of medicine is that people trust us with the most intimate details of their lives. Our role is to walk the road with them, but even doctors are sometimes forced to confront their limitations. When we\u2019re overwhelmed, we don\u2019t feel like we\u2019re doing a good job and we can\u2019t give the patient the care they need. And what\u2019s in the best interest of physicians is in the best interest of patients. In that way, our fates are intertwined.<\/span><\/p>\n<p><span class=\"s1\">Katharine Smart<b> <\/b><\/span><i>is a former president of the Canadian Medical Association. She currently practises pediatric medicine in Whitehorse.<\/i><\/p>\n<hr\/>\n<p><em>This article appears in print in the October 2022 issue of<\/em> Maclean\u2019s <em>magazine. Subscribe to the monthly print magazine for just\u00a0<a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/secure.macleans.ca\/loc\/MME\/head_subscribe\">$29.99<\/a><\/em>.<\/p>\n<p><a rel=\"nofollow noopener\" target=\"_blank\" href=\"https:\/\/canadianmags.ca\/collections\/macleans-single-issues\"><img loading=\"lazy\" decoding=\"async\" data-sizes=\"auto\" class=\"aligncenter wp-image-1239735 lazyload\" src=\"https:\/\/www.macleans.ca\/wp-content\/uploads\/2022\/08\/Cover_October_DRE.jpg\" alt=\"\" width=\"391\" height=\"534\"\/><\/a><\/p><\/div>\n<p><script async defer crossorigin=\"anonymous\" src=\"https:\/\/connect.facebook.net\/en_US\/sdk.js\"><\/script><\/p>\n<blockquote><p><strong><span style=\"color: #ff6600;\">If you liked the article, do not forget to share it with your friends. Follow us on\u00a0<span style=\"color: #ff0000;\"><a style=\"color: #ff0000;\" href=\"https:\/\/news.google.com\/publications\/CAAqBwgKMLG0nwswvr63Aw\" target=\"_blank\" rel=\"nofollow noopener noreferrer\">Google News<\/a><\/span>\u00a0too, click on the star and choose us from your favorites.<\/span><\/strong><\/p><\/blockquote>\n<blockquote>\n<p style=\"text-align: center;\">For forums sites go to <span style=\"color: #ff9900;\"><a style=\"color: #ff9900;\" href=\"https:\/\/forum.buradabiliyorum.com\/\" target=\"_blank\" rel=\"noopener\">Forum.BuradaBiliyorum.Com<\/a><\/span><\/strong><\/p>\n<\/blockquote>\n<blockquote>\n<p style=\"text-align: center;\"><strong>If you want to read more <a href=\"https:\/\/buradabiliyorum.com\/en\/category\/news\/\" data-internallinksmanager029f6b8e52c=\"2\" title=\"News\" target=\"_blank\" rel=\"noopener\">News<\/a> articles, you can visit our <span style=\"color: #ff9900;\"><a style=\"color: #ff9900;\" href=\"https:\/\/en.buradabiliyorum.com\/general\/\" target=\"_blank\" rel=\"noopener\">General category.<\/a><\/span><\/strong><\/p>\n<\/blockquote>\n<p><span style=\"color: black;\"><a style=\"color: #ff9900;\" href=\"https:\/\/www.macleans.ca\/society\/how-physician-assistants-can-help-solve-canadas-health-care-crisis\/\" target=\"_blank\" rel=\"noopener\">Source<\/a><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;How physician assistants can help solve Canada\u2019s health-care crisis&#8221; I\u2019ve been a physician for 21 years now, working across Canada in pediatric medicine. Five years ago, I moved to the Yukon to practise. I\u2019ve witnessed firsthand the fallout resulting from a lack of medical services. I\u2019ve spent 72-hour stretches at the hospital, dealing with sick&#8230;<\/p>\n","protected":false},"author":1,"featured_media":490889,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"fifu_image_url":"https:\/\/www.macleans.ca\/wp-content\/uploads\/2022\/09\/bigideaoct_featured_image-766x431.jpg","fifu_image_alt":"","footnotes":""},"categories":[1],"tags":[133002,133003,133004,102941,133005,130648],"class_list":["post-490888","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general","tag-big-idea","tag-canadian-health-care","tag-family-doctor","tag-family-doctors","tag-physician-assistant","tag-the-big-idea"],"_links":{"self":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts\/490888","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/comments?post=490888"}],"version-history":[{"count":0,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/posts\/490888\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/media\/490889"}],"wp:attachment":[{"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/media?parent=490888"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/categories?post=490888"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/buradabiliyorum.com\/en\/wp-json\/wp\/v2\/tags?post=490888"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}