October 9th, 2021 

Michael Multan: Why physician assistants can help revolutionize healthcare in B.C.

Canadian certified physician assistants undergo two years of rigorous post-university training, can work in all areas of medicine, and free up supervising doctors to focus on more challenging clinical problems.WIKIMKEDIA COMMONS/OHIODOMINICAN

By Michael Multan

Before medical school, I partially trained as a physician assistant. Having lived both sides of the coin, I think more British Columbians should learn about this important role that could be part of revolutionizing healthcare that is often challenged by finite budgets. As British Columbia looks to improve healthcare, I urge all of us to learn about this important role.

So, what is a physician assistant (PA)? I think it may be more demonstrative to first understand what a physician assistant is not. A physician assistant is not an administrative assistant and not somebody who does the coffee run for the healthcare team. They are not a nurse, and they are not necessarily someone who wants become a doctor.

Simply put, a PA is a physician extender. Similar to a resident (or intern) physician like myself, they work under the supervision of an independently and fully licensed doctor. They are trained in a condensed medical-school model that spans a rigorous 24 months broken up into one year of didactic teaching and one year of clinical rotations across a standard set of healthcare environments.

There are currently three Canadian university physician-assistant programs offered by the University of Toronto, McMaster University, and the University of Manitoba. Applicants to these programs are required to have completed prior university education. 

Practically speaking, PAs can work in any area of medicine and are able to see a subset of simple follow-ups and procedures in which they have specific training. This allows their supervising doctor to spend more time on more difficult and challenging clinical problems. The more experience they get in a specific setting, the broader their scope of practice may become.

For example, in an emergency-room setting, the PA may order X-rays and initial testing on a patient with a suspected fracture, then apply the cast or consult an orthopaedic surgeon after reviewing the test results with their supervising physician. During that time, the supervising ER doc could be seeing other patients or might be able to deal with a complex trauma without having patients in the ER having to wait for things to get started. In surgery, PA’s manage surgical ward issues like pain and emergencies, while the surgeon might be tied up in the operating room.

In a crowded emergency-department setting such as at Vancouver’s St. Paul’s Hospital, physician assistants can order X-rays and testing while doctors attend to other patients.

PAs have often been described as “a lifelong resident (intern)”. Like a resident physician, they learn their scope and limits and are able to call for help as needed. Unlike a resident, their training is shorter and more general and their career more flexible.

This past summer, the College of Physicians and Surgeons of Ontario has decided that it will regulate PAs. Until now, they have been an unregulated profession in Ontario. More and more provinces are looking to this important role to help decrease surgical wait times, increase patient satisfaction, and reduce physician burnout.

In the United States, the physician-assistant profession has grown dramatically in the past few decades, and the Bureau of Labor Statistics, part of the U.S. Department of Labor, projects that PA employment will grow 31 percent between 2018 and 2028.

For those of us in B.C., we’ve likely never been treated by a PA. As someone who has lived both worlds, I urge our government to have a serious look at introducing this important role in our province. They are well-trained, safe, effective, and worth every healthcare dollar.

Dr. Michael Multan is an anatomical pathology resident at the University of British Columbia. Twitter: @MultanMichael