Physician assistants coming to Nova Scotia to target hip, knee waits

The Nova Scotia Health Authority has finally been given the green light to hire physician assistants in a pilot project.

While many Nova Scotians have likely never heard of the job, they'll understand the impact: physician assistants could shorten wait times for hip and knee replacement surgeries.

Dr. Bill Oxner, chief of orthopedic surgery at the QEII Hospital in Halifax, describes this as a turning point for the health-care system.

"It's the way of the future," he said. "They do this in Manitoba very well, and they do it in Ontario, and they do it in some form or another in most, if not all of the provinces."

The physician assistants will work in the hip and knee orthopedic program, be tasked with helping surgeons in the operating room, and meeting with patients before and after surgery. They'll also have the ability to prescribe some medications under the surgeon's supervision.

Some of their tasks are comparable to a nurse practitioner, but nurse practitioners can work independently, while physician assistants cannot.

Starting with 3 new hires

The health authority will be filling three roles immediately for the three-year pilot project.

Oxner has no doubt this is just a start, and the role will find a permanent place in Nova Scotia's health-care system. The position is also common in the United States and the Canadian military.

"We know that they work and medical literature shows increased physician productivity, and I believe they also increase the quality of care that we provide," he said.

Oxner said his colleagues first started looking at the physician assistant model a decade ago, but the idea gained steam in the last few years.

Part of the delay was that the health authority had to iron out details with the Health Department and the College of Physicians and Surgeons of Nova Scotia.

The college can't regulate or license physician assistants, but it will allow doctors to delegate some clinical activities. It said it will be up to the province to decide if the program will continue at the end of the trial.

Health Minister Randy Delorey wasn't available for an interview, but in a statement he said he's looking forward to seeing the results of the pilot.

"Innovation is essential when it comes to addressing wait times," he said.

'A wake-up call'

For Oxner, the timing couldn't be better. His department had a scare last year when Saudi Arabia threatened to pull its medical residents over a diplomatic dispute.

He said there are about six Saudi trainees in his department and losing them would have caused significant delays in surgeries.

During that time, he said they realized Manitoba was the only province that wasn't worried, as it has a strong physician assistant program. Oxner said in general surgery alone, Manitoba has about 16 physician assistants.

"I think that was a wake-up call to all of us to say, you know, we need to work on strategies to make ourselves independent of that potential threat, which could come again this year for all we know," he said.

Oxner expects there to be a significant number of applicants, who must be accredited under the Canadian Association of Physician Assistants.

"There's a lot of physician assistants who are Nova Scotians working in other provinces and even in the United States that have contacted us on a regular basis," he said.

The health authority said it hopes to train the new staff this fall and have them on the job by the new year.