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
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