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Physician assistants should be allowed to practise in B.C., says Greens' deputy leader

Dr. Sanjiv Gandhi said he’s had numerous emails from physician assistants looking to work in B.C. and has to turn them away, even though they could save the system money.
Dr. Sanjiv Gandhi says he worked with physician assistants for 17 years in the United States and other parts of Canada where they are permitted to practice. THE CANADIAN PRESS/HO-Green Party

Physician assistants are a “phenomenal” and money-saving resource that should be added not just in Port Hardy but everywhere, says Dr. Sanjiv Gandhi, who was appointed as the B.C. Green Party’s second deputy leader on Monday.

“Why we don’t have them in British Columbia is beyond me,” said Gandhi, who until recently served as chief of pediatric cardiovascular and thoracic surgery at B.C. Children’s Hospital and as clinical professor of surgery at UBC School of Medicine.

Gandhi says he worked with physician assistants for 17 years in the United States and other parts of Canada where they are permitted to practice.

Port Hardy physician Dr. Alex Nataros said Friday he is prepared to pay for a physician assistant when, as of July 1, he becomes the only ER doctor in the town of 4,000.

Physician assistants — sometimes referred to as physician extenders because they work under doctors to perform multiple tasks — can assist doctors in offices or in surgery and write prescriptions after two years of training at one of three universities in Manitoba, Hamilton or Toronto.

“They can complement physicians in the clinic, in the intensive care unit, in the emergency room, in the operating room,” said Gandhi.

Gandhi said when he was in the operating room, he would have the same PA or two who would develop a niche in that area — as opposed to having a surgical assistant, “another surgeon who is billing at a rate significantly higher than you would pay a physician assistant.”

“I would much rather work with PAs every day than anybody else,” said Gandhi. “They knew my next step. I didn’t really have to instruct them on anything. It made the operation go very smoothly. And when you get to know them and you do it daily, day after day after day, it achieves better outcomes.”

Physician assistants are trained with a baseline scope of practice, and once paired with a physician, develop skills in that area.

Whether it’s a doctor’s clinic or an ER or intensive care unit, with physician assistants “you’re getting continuity of care with similar individuals for a cheaper price,” said Gandhi.

Gandhi said he’s had numerous emails from PAs looking to work in B.C. and has to turn them away.

“It’s a way to expand the repertoire of health professionals in this province and something that’s a no brainer, he said. “There should be zero impediment to that.”

Comox physician assistant Trevor Stone, 60, was a medic in the Canadian Forces in Victoria when he took a condensed 26-month physician assistant program. Many physician assistants were trained through the Canadian Armed Forces, which uses them on its ships, submarines and bases.

When Stone retired from the Forces in 2006, he said he was forced to work in Winnipeg because there was no position for him in B.C. He assisted surgeons in reconstructive plastic surgery.

Physician assistants are regulated in Manitoba, Alberta, Ontario and New Brunswick. Other provinces are conducting pilot programs.

Stone said with the many challenges facing the health-care system, physician assistants are definitely one of the solutions.

“It’s just frustrating,” said Stone. “Over the last three years I could have at least been sticking needles in people in vaccination clinics, or I could have been helping out in some menial way with my medical experience, or I could have working as a physician assistant in a primary care clinic or in plastic surgery.”

Stone said there are about 900 certified physician assistants working in Canada.

In B.C., however, “[We’ve got nothing but silence and that’s been the most frustrating and insulting thing,” he said.

In November, the province announced it will create new health worker designation called “associate physicians.”

This category is for internationally trained doctors who are not yet qualified to practise as full-fledged doctors in B.C. However, they can do work similar to physician assistants.

The College of Physicians and Surgeons of British Columbia proposed the new role in April 2020.

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