N.B. facing competition to fill health-care jobs
Published Thursday May 7th, 2009
If New Brunswick wants to start hiring physician assistants, it will probably to have to recruit them in the United States, says the Atlantic chapter president of the Canadian Association of Physician Assistants.
"There are a limited number of physician assistants that are available in the civilian sector," said David Steiger, a military physician assistant based in Halifax.
There are only a few hundred physician assistants working in Canada and most of them are in the Armed Forces, Steiger said. He said there are about 136 physician assistants in the Canadian military.
There are about 60 physician assistants in Ontario and it's looking to add 40 more by September, said Steiger. Manitoba has 15 and is looking for 12 more, he said.
New Brunswick Health Minister Mike Murphy wants to bring physician assistants to the province's emergency rooms, but hasn't explained in detail what they will do.
The Liberal government is studying a report on physician assistants from the Department of Health. Legislation would have to be passed to allow physician assistants to work here.
Steiger said there are three physician assistant training programs in Canada: the Canadian Armed Forces program in Borden, Ont.; the University of Manitoba and McMaster University.
There are about 70,000 physician assistants working south of the border, he said.
Steiger said the United States civilian physician assistants program started in the 1960s when lots of military-trained medics were coming out of the armed forces during the Vietnam War.
"They developed the (civilian) program from there and it has grown by leaps and bounds," he said.
The supply of physician assistants in the United States is fairly good, said Steiger. He said what they earn depends on where they work, but it's around $75,000 to $85,000 a year. That's similar to what a nurse practitioner earns.
Steiger said there are similarities between a nurse practitioner and a physician assistant.
But a physician assistant is educated as a generalist in medicine who can then specialize in particular areas, he said.
"Physician assistants are more geared towards the emergency department than a nurse practitioner is," he said.
A physician assistant in an ER, supervised by a physician, can examine charts, see patients, do assessments, order lab tests such as X-rays, make a diagnosis and treat a condition, said Steiger.
Sarah Clarke, a physician assistant and program director of the physician assistant education program at the University of Manitoba, said there is little operational difference between a physician assistant and a nurse practitioner.
"In my own experience ... the differences in practice is much less dramatic than the theoretical differences," she said.
Clarke said physician assistants are trained in the medical model.
She said many lay people think of a nurse as a doctor with less training.
"Really that is not true," she said. "They are two separate disciplines. Nursing has its own way of approaching patient care."
The nursing model is health-maintenance focused, health-promotion focused and concentrates on development, family systems, quality-improvement issues and community health, said Clarke.
Physician and physician assistant training are more disease- and treatment-focused, she said.
Clarke acknowledged there is considerable crossover.
"A physician assistant can do whatever his or her supervising physician says he or she can do, as long as it is something the supervising physician can do and is something the supervising physician feels comfortable delegating to the PA," she said. "The term often used for that is delegated autonomy."
A lot of emergency rooms these days are starting to have fast-track clinics for people who come in with relatively non-complicated ailments, said Clarke.
"In many places those fast-track portions of the emergency room are staffed by PAs," she said.
But in other ERs, nurse practitioners run the fast-track clinic and the physician assistants are at the bedside with the physician dealing with more serious trauma cases, said Clarke.
"It depends on what different places want," she said. "PAs can be used either way."
Clarke said the physician assistant training program at the University of Manitoba is in its first year.
"We started our program in September and we accepted 12 students."
She said 11 students are still in the program.
Clark said the program is expecting another 12 this fall for a maximum of 24 in the two-year program.
"We won't be graduating students until the fall of 2010," she said.
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