Canada Needs PAs

Canada’s Population is Aging 2011 2036 An aging population and the associated rise in chronic disease will increase demand for health services Physician forecasting model shows demand for health care services growing at twice the pace of population growth, thus straining the system According to these projections, the rise in health care costs due to population aging is not only growing each year, it is growing at an increasing rate (up to 1.9 per cent per year by 2020) The annual per capita cost of providing health care to Canadians over the age of 65 is five times that for those under 65. For those over 80 years, the difference is ten-fold By 2046, spending on continuing care for seniors will increase from $29.3 billion in 2011 to $184.2 billion. The health workforce implications of this are significant to meet this heightened demand for service. 5 million 14% of Population 10 million 24% of Population

Rise in Chronic Disease Chronic diseases tend to be more common in older individuals.

Physicians are the third largest expense to the Canadian health system Physicians are the third largest expense to the Canadian health system. PAs working in collaboration with physicians can be seen a viable cost effective solution and can provide a variety of services by way of delegation without the need to hire a supplementary doctor.

Can Our Health System Keep Up? Changing demographics means our already taxed health care system will be more stressed than ever Increasing budgets, and decreasing revenues is challenging provincial budgets to fund health appropriately Changes need to be made now to keep up with the projected increase in demand Physician Assistants reduce wait times, improve access and save money

What is a PA and Where Can We Find Them? PAs are highly skilled healthcare professionals who provide a broad range of medical services under the supervision of a physician. PAs act as physician extenders in a variety of health care settings PAs are trained in the medical model in university level programs through the faculties of medicine PAs can conduct physical examinations, order and interpret test, prescribe, diagnosis and come up with treatment plans

PAs work in a variety of specialties, however, are most concentrated in the Canadian Armed Forces, hospitals and community clinics. PAs would be very beneficial for all primary care settings, rural and remote communities, First Nations populations and emergency medicine.

Landscape There are approximately 550 PAs practicing across Canada PAs are practicing in the public healthcare system in AB, MB, ON and NB PAs originated in the Canadian Armed Forces in the mid-1960s The are four university level academic programs in Canada PAs are working best in the US and the Netherlands The distribution of PAs across the health system that we are starting to see in Canada is close to what we found in the US, where there is a longer history working with PAs. There are over 100,000 PAs practicing in all medical specialties but the majority of PAs work in private offices and hospitals. In terms of distribution by practice areas, the top three in the U.S. are family medicine/general practice (20 per cent), surgical subspecialties (20 per cent), and emergency medicine (14 per cent). There are over 1000 PAs in the Netherlands, where PAs where introduced in 2001 (which you will hear more after me). And In the U.K., PAs are called physician associates and are new to the National Health Service (NHS). They number 250 and work mainly in secondary care. Within hospitals, most are in general adult medicine, with 20 per cent in surgical specialties (mainly trauma and orthopaedics). Twenty-five per cent work in general practice. By 2020, the NHS wants 1000 Pas in primary care to deal with workforce challenge especially reliance on locums. So, as you can see, the trend upward in the uptake of these professionals is also happening in other countries.

Impact to the Healthcare System The Conference Board of Canada conducted a study on the value of PAs in Canada and revealed the following…

Save the Healthcare System Millions! It is important to note that PAs are often used above the 30% mark for substituted tasks. The majority of respondents felt 40 -50 % was appropriate, however, decided to investigate lower percentage scenarios to take a conservative approach. Also it should be noted that US studies show that PAs in primary care can complete up to 75% of physician task and in the ED 65%.

As you can see if PAs are being used effectively to their full scope the savings are astronomical

Increase Productivity PAs can increase productivity and reduce costs and wait times

Conclusion PAs have a valuable role to play in Canada’s health system PAs can be an efficient auxiliary for designated medical tasks PAs are cost-effective and can save the healthcare system millions PAs are becoming a trusted partner in healthcare delivery by supporting attainment of good patient outcomes in a team environment

Next Steps CAPA would like to partner with government to: Establish regulation for the profession in the province Develop compensation models for PAs Introduce a training program to ensure that there is sufficient supply of PAs to meet the needs of the population

Thank you