The Physician Assistant

Presentation Objectives• What is a PA?

• What can they do?

• PA in Canada

• Liability

• The Value of PAs

• A Physician Assistant is a health care provider who extends the hand of the supervising physician

• They are trained under the medical model:– in understanding the pathophysiology of disease– formulating an impression and differential diagnosis– and developing a treatment plan

• They were developed within the Canadian Forces to provide full spectrum medical care as part of a physician led team

What is a PA?

• The PA:

– Works under delegation of a supervising licensed physician

– Can be entrusted to make certain decisions and to take certain actions autonomously at the discretion of the supervising physician

– Dependent Practitioner - The physician retains overall responsibility for direction of the PA’s activities and accountability for healthcare delivered

• The PA is not intended to supplant or substitute the physician as the principal medical decision-maker

• The activities of the PA are at all times subject to:– The direction of the supervising physician– Relevant government legislation and regulations– The policies of the PA’s employer

• PAs working with the supervising physician can enhance access to quality care for patients

• PAs in Canada have been formally trained and educated to meet the national standard set by CAPA

• The National Competency Profile and Scope of Practice was developed in conjunction with the CFPC, CMA, and RCPSC

• The Physician Assistant Certification Council of Canada administers and maintains the PA certification process and ensures that the PA meets the standard set out in the national competency profile for the profession

Duties Generally Performed by PAs• Medical histories and performing comprehensive

physical examinations

• Complete admission and discharge procedures for hospital stays

• Refer patients for consultation with specialists

• Send patients for laboratory tests, X-ray, and other diagnostic procedures

What Can a PA Do?

• Assist the physician in developing and implementing a patient management plan

• Record progress notes in isolated and in-patient care settings

• Perform and interpret common laboratory, radiological, ECG, and other routine diagnostic procedures used to identify patho-physiological processes

• Prescribe medication in accordance with medical directives

• Surgical Assist

PAs in Canada• There are upwards of 300 Physician Assistants practicing in

Canada in both civilian settings and within the Canadian Forces

• 4 provinces recognize PAs as a profession

• 4 nationally recognized reputable academic institutions offer PA programs

• In the US there are almost 84, 000 PAs practicing in healthcare settings and 156 accredited programs

PA Accredited Programs• Canadian Forces Health Services Training Centre

• University of Manitoba PAEP

• McMaster University Medical Sciences PA Program

• Consortium for PA Education at the University of Toronto/Northern Ontario School of Medicine/Michener Institute for Applied Health Sciences

Liability• The supervising physician is covered by

Canadian Medical Protective Association liability insurance plan when working with a PA

• PAs need liability coverage which should be covered by their employer

• Liability coverage can be obtained through the Canadian Association of Physician Assistants

The Value of PAs• Integrating PAs into health care will increase level of

service for patients

• Collaborative approach that reduces the workload placed on the physician

• The PA profession is designed to work in a team-based setting which fosters inter-professional collaboration among other health care providers

Questions?

Physician Assistants Optimizing Patient Care