Why doesn't B.C. have physician assistants in its health-care system when other provinces do?

In the midst of a severe health-care worker shortage, British Columbians have called upon the province to utilize the role of physician assistants over the past year. 

But the provincial government has said it has no plans to introduce these workers into the health-care system. 

The B.C. Liberal caucus first asked the NDP government to allow physician assistants to work in the province last May. They renewed their call in a letter in January.

Port Hardy doctor Alex Natoros publicly advocated over the last few months for physician assistants, which he said would help him provide care in the community's understaffed emergency room. 

Last week Natoros was suspended from working in the emergency room after Island Health said it received complaints about the quality of his care. 

What is a physician assistant? 

A physician assistant is a medical professional that works under the supervisor of a physician. While they do not possess a medical degree, they are educated through a two-year graduate program under the same medical model used to train doctors.

Physician assistants can work in any clinical setting and perform a broad range of services, including conducting patient interviews and physical examinations, performing diagnostic and therapeutic interventions, prescribing most medicines, ordering and reading tests, and making referrals under the guidance of a physician.

These assistants work with varying degrees of autonomy, outlined on an individual basis in their contract. 

How do they function in other provinces? 

Physician assistants are currently utilized in Alberta, Manitoba, Ontario, and New Brunswick, with Nova Scotia and Newfoundland running pilot projects. 

There are approximately 1,000 physician assistants working across Canada, mostly in Manitoba, according to the Canadian Association of Physician Assistants. 

A recent survey conducted by the association found 15 per cent of these 800 members indicated they want to work in B.C.

There are also roughly 120 students currently enrolled in physician assistant programs, the CAPA website notes.

Three programs in the country train physician assistants: the University of Manitoba, the University of Toronto, and McMaster University in Hamilton, Ont.

The Canadian Armed Forces also uses physician assistants on its bases, in the field and on its ships and submarines.

Manitoba has used physician assistants across its health-care system since 2003. 

"The strategic use and placement of [physician assistants] can result in cost savings and increased access to health-care services, which is why Manitoba has integrated these professionals into our provincial health human resources plan," Manitoba's Shared Health wrote in a statement to CBC. 

Physician assistants in Manitoba work in a number of settings, including but not limited to surgery, family medicine, oncology, pediatrics, mental health, and emergency rooms. 

Why aren't they being used in B.C.?

B.C. currently does not have licensed physician assistants nor any post-secondary programs to provide the necessary training.

B.C.'s Ministry of Health says they are monitoring the implementation of physician assistants in other provinces.

"Enabling the practice of a new group of health-care practitioners requires careful consideration, management and significant resources to properly understand and address the team function issues that may emerge," wrote the ministry in an email statement. 

The province recently introduced the role of an associate physician: people who have medical degrees from international institutions and previous practice experience, but have not become licensed physicians in Canada. 

Health authorities review their competencies on a case-by-case basis and decide the scope of what they may do, based on their specific experience and qualifications.