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The Value of Physician Assistants in the Canadian Health Care System

Nov 18, 2016
Thy Dinh
Health Economics and Policy

In Canada, physician assistants (PA) are a relatively new health provider group despite having a long history of involvement with the Canadian military and abroad. PAs are largely unregulated in Canada, with the exception of Manitoba and New Brunswick.

In two recent Conference Board reports, we detailed the role of PAs within health systems, reviewed the effectiveness literature on the impact of PAs, and provided an estimate of the value of increasing the use of PAs in Canada from a health system efficiency perspective.

The Role of PAs

PAs are considered to be physician extenders. They practice under the supervision of a physician, and their scope of practice is highly dependent upon their individual PA-to-physician relationships. PAs are currently employed across many different health care delivery settings but have been found to work predominately in primary health care (or general practice/family medicine) and in emergency medicine.

The work of a PA can include conducting patient interviews, histories, and physical examinations; performing selected diagnostic and therapeutic interventions; providing medical orders and prescriptions; and counselling on preventive health care.

The Effectiveness of PAs

The evidence concerning the effectiveness of PAs has been sparse, with most coming from the United States. However, our review found several studies that established the value of PAs from an effectiveness and efficiency perspective, including reduced resident workload, improved discharge rates, decreased length of stay and time to consultation, reduced wait times, and improved surgical productivity.

The Economic Impact of Increasing PA Use in Canada

Our modelling study found that potential cost savings could be generated by the increased use of PAs across the country in three areas of medical practice: primary care, emergency care services, and orthopaedics. The analysis predicted that shifting certain physician tasks to PAs could create cost-savings for the health care system ranging from $22 million to more than $1 billion between 2017 and 2030, depending on the level of PA productivity.

Next Steps in This Research Series

As part of a larger research series supported by the Canadian Association of Physician Assistants, two subsequent research briefings will be published. These briefings will examine different funding models that may support better integration of PAs into the Canadian health care system, summarize the research findings across previous briefings, and establish key research and policy considerations for the future.

National PA Day in Canada is November 27

Related Infographics

Understanding the Role of Physician Assistants Within Health Systems

Physician Assistants Can Reduce Costs for the Health Care System

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