Doctor calls on province to allow physician assistants to work in B.C.

A doctor working in Port Hardy, B.C. — one of many communities dealing with a doctor shortage — says he could see more patients and help keep the town's emergency room open if the province would let him hire physician assistants. 

Physician assistants are often referred to as "physician extenders," meaning they work under a doctor to perform many of that doctor's tasks.

They complete a specific two-year training program to be able to conduct patient interviews and exams, write prescriptions and assist in surgery. Unlike nurse practitioners, they do not practise independently — all the work they do is in the name of the doctor they work for. 

Dr. Alex Nataros, a family physician who works in a clinic in Port Hardy, also serves in long-term care in more remote communities and works on rotation in Port Hardy Hospital's beleaguered emergency room, says physician assistants essentially let him work in multiple places at once. 

He has experience working with them in rural Manitoba, one of the four provinces that currently authorizes them. The profession is also regulated in Alberta, Ontario and New Brunswick. Two other provinces, Nova Scotia and Newfoundland are running pilot projects.

"They're transformative. They allow physicians to expand their scope and really meet the needs of the population. They're a perfect fit for this context in Port Hardy."

The emergency room in Port Hardy has had intermittent closures recently, in part due to a lack of doctors. 

Physician assistants are common in the military

Physician assistants can train at one of three programs in Canada: through the University of Manitoba, the University of Toronto, and McMaster University in Hamilton, Ontario.

But many come to the work through the Canadian Armed Forces, which uses physician assistants on its bases, in the field and on its ships and submarines. 

Victoria resident Eric Demers became a physician assistant after first starting as a medic in the military. When he retired, he decided to remain on Vancouver Island. He says he wanted to work as a physician assistant, but that wasn't an option. 

"I've got the skills, I've got the experience … I'd like to help the health-care system in B.C."

Associate physicians are now allowed in B.C.

In November, the province announced it's creating a new health worker category called "associate physicians."

It covers internationally-trained doctors who are not yet qualified to practise as fully-fledged doctors in B.C. and allows them to do work similar to a physician assistant. 

In a statement, a Ministry of Health spokesperson said it understands that physician assistants can also contribute to the health-care system but that adding new health professions takes "careful consideration."

"As the Ministry works to implement this strategy, it will continue to assess the option of implementing additional professions and occupations, such as physician assistants." 

Dr. Nataros says the creation of associate physicians is a "very clear path" toward adding physician assistants to the B.C. health-care system.