Physician Assistants – A Cost Effective Solution For Ontario’s Looming Healthcare Crisis

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By Abhilash Sajja

As a resident of Brampton, I am quite concerned about the overcrowding and exhaustingly long wait-times at the Brampton Civic Hospital.

There are countless news stories on Bramptonians being placed on a stretcher in the privacy-deprived hallways due to lack of provincial funding for beds. Why is the provincial government reluctant to utilize the cost-effective solutions that can possibly solve this crisis?

In May 2006, Ontario’s Ministry of Health and Long-Term Care played a crucial role in introducing civilian “Physician Assistants” (PA) into the provincial healthcare system.

Though the title “Physician Assistant” may not ring a bell to many Canadians, the profession has existed in the Canadian Armed Forces since the 1960s.

As a first-year PA student at the University of Toronto, I am surprised by the soft stance taken by the Ontario government for the inclusion of mid-level healthcare practitioners such as PAs to control expenditure on healthcare and reduce overcrowding in the hospitals.

How are PAs a cost-effective solution?

According to the Registered Nurses Association of Ontario (RNAO), the base salary (in CAD) for a PA ranges from $75,000 to $86,700 and for the Nurse Practitioner (NP) it ranges from $74,038 to $89,203.

The salary for PAs and NPs is significantly lower than that of a physician. Introducing PAs to cover physician shortage will provide significant savings to taxpayers which can be invested in improving the infrastructure.

The cost of funding educational programs to produce healthcare professionals can be expensive. Compared to the MD and NP programs, PA programs are consolidated into a 2-year Bachelor/Master program.

It is more expensive to open new medical schools to increase the supply of physicians than to train a small cohort of PAs utilizing resources from existing medical schools. According to the Canadian government, the total cost to train a medical resident is about $74,429 to $97,753 (2003 – 2004 year) in Ontario.

This is much higher than the career start grants ($46,000 in an urban setting) offered to a newly graduated PA in 2017. In addition, it is more economical to retrain a PA to work in a different field compared to an MD or an NP because they can train on the job. Due to rapid population growth and a shortage of trained medical professionals, Canada has long wait lists for elective procedures.

One of the proposed solutions includes hiring mid-level practitioners to fill the physician shortages in underserved and remote regions. Relocating physicians to serve a limited number of patients is not an efficient practice. Mid-level practitioners can manage most of the common medical conditions and transfer the difficult cases to physicians in the more densely populated regions.

This is affordable yet offers access to medical expertise when it is required. According to HealthForceOntario, early studies on PAs and NPs found that they significantly reduce the wait times and stays in the emergency department resulting in very few patients being left unseen.

As a budding PA, I would like the government to learn from the situation in Brampton by fast tracking the inclusion of mid-level practitioners and use the savings to focus on updating the crumbling infrastructure and sustain the system for the future generations.

(Abhilash Sajja is a Physician Assistant Student University of Toronto.)

Physician Assistants – A Cost Effective Solution For Ontario’s Looming Healthcare Crisis