Could 'physician-extenders' ease Nova Scotia's health-care woes?
Some Nova Scotian physician assistants want to come home, but the province doesn't recognize the job
A Halifax woman who works at Toronto Western Hospital says she would happily move home and help fill health-care gaps — but her job isn't recognized in Nova Scotia.
Brittany Belair is a physician assistant, or PA. It's a job the Nova Scotia Department of Health says has merits and may one day be established in the province.
PAs can take on tasks similar to a medical resident. They work alongside a doctor, performing routine tasks like assessments and writing some prescriptions.
It's a role that's widely used in the United States, Ontario, Manitoba and the Canadian Forces.
"We're just another piece of the puzzle," Belair said of the role. "Our goal is not to replace physicians, but to act as physician-extenders."
Health Department considering PAs
The Canadian Association of Physician Assistants is advocating for more provinces to make room for the job. It sees Nova Scotia as a prime location to help fill ongoing gaps because of nurse and physician shortages.
Belair knows the Nova Scotia system well. She worked as a registered nurse under the former Capital Health Authority.
When she decided to go back to school, she thought about going into medicine. But the idea of a career on call swayed her to apply to the University of Toronto's PA program instead.
Belair knew that choice meant leaving Nova Scotia for good.
"I knew I had to be OK with staying in Ontario long term, but I was always hopeful that eventually Nova Scotia would get PAs back and finish my life there."
There is a chance Belair may get her wish. The Health Department says the Nova Scotia Health Authority is in the early stages of considering the role.
'We're not replacing anyone'
Belair feels that the delay in bringing PAs to Nova Scotia has been political.
"It's always scary when there's a new health practitioner of some sort coming into a province when you haven't had them before because people don't know what PAs are, so it might make them a bit nervous. But I think it's important to know we're not replacing anyone," she said.
"Everyone has their niche. Everybody is important in taking care of patients. What we really need to focus on is patient care and providing more access to care quicker and in a more cost-effective way so we can take care of Nova Scotians better."
This week, emergency physicians from across the country gathered for a national meeting in Halifax.
One of the presenters was Fred Wu, president of the Society of Emergency Medicine Physicians, who emphasized the value of the PA role in American health care.
Common practice in U.S.
Wu, who is based in California, was surprised there are so few PAs in Canada.
"Seventy per cent of U.S. emergency departments utilize PAs and [nurse practitioners]," he said.
Wu believes the job could be a natural solution to Nova Scotia's chronic shortages, especially outside cities.
"Because those rural areas are so challenging to get a physician sometimes, PAs can help fill that void. We definitely do it in the United States."
Belair says she knows two other Nova Scotian PAs who would jump at the chance to move back home. They're anxious to know if the doors will open for them.
"Nova Scotia is where we grew up. We care about the health care there."
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