Physicians Assistants – is this one of the answers to our health care problem?

Historically the origins of a Physician Assistants go back to the Sumerian and Assyro-Babylonian periods from 4000 to 2000 BC, when they were referred to as the Asu or medical technicians who treated disease and injury with empirical techniques.

The clinical role of PAs includes primary, emergent, and specialty care in medical and surgical practice settings. The PAs work is primarily centered on patient care but may include educational, research and administrative activities. As part of a physician-directed team, PAs may take medical histories, conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery.

Today, Physician Assistants are highly-skilled members of the health care team who provide a broad range of medical services under the supervision of licensed physicians as part of a physician/PA team. They complement existing services and aid in improving patient access to health care. It is important to note that the PA is a physician extender, not a replacement.

The scope of the medical acts performed by the PA is carefully outlined in a practice contract or agreement between the supervising physician, the PA, and often the facility or service where the PA will work. Within the physician/PA relationship, PAs collaborate closely with their supervising physician to ensure the care and management they provide is in keeping with the physician's patient management practices.

What a PA does varies with training, experience, and clinical setting. The activities of the PA are, at all times, subject to relevant government legislation and regulations, the policies of the PA's employer, and, most importantly, the direction of the supervising physician. In general, a PA will see many of the same types of patients as the physician. The cases handled by PAs are generally the more routine medical cases. Referral to the physician is the norm for unusual or harder to manage cases. Physician Assistants are taught to "know our limits" and refer to physicians appropriately. It is an important part of PA training.

The Physician Assistant in Canada is employed primarily by the Canadian Forces. However, there are some heavy industry and remotely located companies that have hired ex-military PAs as key providers of health care to their workforce. Presently the only PA training institution in Canada is the Canadian Forces Medical Service School (CFMSS) in Borden, Ontario. A professional certification is the critical process that allows entry into practice. Canadian Academy of Physician Assistants, CAPA, has begun to move along the road that will ultimately lead to a national certification and re-certification program for Canadian physician assistants. The many facets of CAPA, its past, its future, and its ambitions are described on the website. This is where you can learn of the role played by Canadian Physician Assistants in both military and civilian health care facilities.

Is a PA one answer to our medical needs in Canada?
With so many Internationally-trained physicians immigrating to Canada, perhaps it’s time to look to our Canadian Military as a source of training and critical placement when it comes to the needs of Canadians who so desperately need healthcare professionals in their community. For more information on the CAPA


Chapter 11

Culture of Integrity


Flowing Point




OWIT's Roundtable Breakfast

Physician Assistants

Rebuilding Confidence


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