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NS Health Steps Up Efforts to Integrate PAs into Primary Care | Radio-Canada News


An effort to place physician assistants in primary care practices across the province requires more work than assigning them to emergency departments, but Nova Scotia health officials say the move could have considerable advantages.

Since a call for interest last year, Nova Scotia Health has placed physician assistants in two primary care practices, hired three more who will start later this year and opened positions in 16 more practices.

“Primary care is the foundation (of the health care system) and if that can enable access or attachment and allow more people to quickly access a primary care home, then that in will be worth it,” said Dr. Todd Howlett, emergency medicine physician. physician and health authority’s medical director of innovation, said in a recent interview.

A physician assistant, or PA, trains according to the medical school model and practices medicine under the supervision of a licensed physician. They can handle simple cases, order and review tests, prescribe certain medications, and assist during surgical procedures.

After years of little interest in granting Nova Scotia this role, even though the role is well established in other parts of the country, in the Canadian military and in the United States , the province largely adopted it.

Growing use in Nova Scotia

A pilot project in 2019 placed three physician assistants in the orthopedics division of the QEII Health Sciences Centre. Physician assistants then began working in emergency departments, and Dalhousie University launched its own training program this year.

Howlett said matching PAs with primary care practices can mean resolving workload issues experienced by some doctors. This could mean shorter wait times for patients to see a healthcare provider, or an extended working life for doctors who are considering retirement.

The challenges facing the province’s primary care system are well documented. Last month, more than 156,000 people needed a family medicine office, according to the provincial registry.

At a recent meeting of the legislature’s standing committee on health, Dr. Leisha Hawker, former president of Doctors Nova Scotia, said physician stress and burnout are “at an unprecedented level, while the well-being of doctors is at an unprecedented level.” “

Challenges Facing Doctors

Aging patient and doctor populations are contributing to strain on the system, Hawker told lawmakers.

“Nearly a quarter of our doctors are 60 and older and planning to retire in the next few years,” she said.

As health sector recruitment teams work hard to attract more doctors to Nova Scotia, Hawker noted that as of early March, there were 213 physician vacancies, including 129 in family medicine.

Howlett said the key to success when it comes to integrating PAs into family medicine practices is a good fit between them and the doctor they will be working with.

“The magic of PAs is the relationship they develop with the physician,” he said.

“So we spend a lot of time making sure the fit is good.”

Recruitment projects in the United States

Meanwhile, efforts to attract more PAs into emergency departments also continue.

When the province took this first step last year, the plan was to have four PAs working in the emergency department at Dartmouth General Hospital and four at Shore Shore Regional Hospital in Bridgewater.

So far, only two jobs are active in Dartmouth and one is expected to start this spring in Bridgewater. Two PAs also work in the emergency department at Cumberland Regional Hospital in Amherst and one at Cape Breton Regional Hospital.

Howlett said the goal remains to expand the use of PAs in Nova Scotia’s emergency departments, but the role faces the same human resource challenges as the rest of the health system’s jobs .

Health officials are seeing strong interest from PAs working in the United States, and Howlett and other officials will travel south of the border later this year for a recruiting trip.

“We had ambitious goals and, like anything else, when you do this and you don’t get the numbers, you re-evaluate.”


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