Comox Valley resident Trevor Stone is frustrated.
The Canadian veteran has a service to provide, but in British Columbia he’s deemed unqualified.
Stone is a physician assistant who joined the military as a medic. After several years of growing his skill set and practical experience, he qualified for the physician assistant course, at that time exclusively offered through the military. The course is a 24- to 26-month curriculum that includes a year of hands-on training.
He describes the job as being “an extra set of eyes and ears for the doctors that we work under.”
“In a military setting, obviously physicians are very (stationary). They don’t have the ability to go out into the front lines, whereas we can go out closer to the front lines. We also serve in autonomous capacities on ships, submarines, service vessels deployed in northern remote locations in Canada and throughout the world. The key is that we work under the supervisory auspices of a physician.”
While the genesis of the profession in Canada is in the military, it is now practised outside the Forces. Certification courses are available in Manitoba and Ontario, including one at McMaster University, which describes the profession on its website as “health care professionals who work with physicians to provide health care. Under the overall supervision of a physician, PAs take histories, conduct physical examinations, order and interpret tests, diagnose and treat illnesses, counsel on preventive health care, and may assist in surgery.”
After retiring from the Canadian military in 2006, Stone entered the civilian workforce as a physician assistant in Manitoba. Fourteen years later he moved to Vancouver Island to be closer to family and found out his qualifications are meaningless in B.C., which doesn’t recognize PAs as qualified civilian healthcare workers.
He said his own correspondence with provincial government sources have been less than promising.
“Even when I was still in the military, we were hearing comments like ‘we can’t even get nurse practitioners to reach their scope of practice, and until that happens, we are not entertaining any other professions. It seems to go back for several decades, but that doesn’t wash with me. There have to be other reasons. But the only reason I can think of is it has to be the policy writers in the province. I personally think they are trying to somehow protect one profession over the other, and that’s wrong. That’s not teamwork.
“It’s not the rank-and-file, not the healthcare workers who don’t want us there. It’s the policy writers. That’s my theory.”
Comox PA has worked in Manitoba and Alberta
Comox resident Lisa Stewart attained her PA certification through the University of Manitoba 12 years ago.
She was a paramedic in Victoria when she made the decision to return to school. After completing the university program, Stewart began her career in Manitoba, then moved to Calgary, where she worked as a plastic surgery PA. Stewart recently returned to the Island and said her hope is to resume her career here. For now, she waits.
Stewart knew going in that the profession was not yet recognized in B.C., but was under the impression that would eventually change.
“My (Canadian Armed Forces) reserve unit was in Victoria, I knew PAs, I worked with them, and that’s what got me interested in the PA trade,” said Stewart. “At that time, everyone was very positive, back in 2010, that PAs would be recognized in B.C. So when I went to school in Manitoba, it was my hope that I would be able to move back to B.C. and start practising here. I thought, OK it might take a little longer than two years, but with all the expansion of the profession in other parts of Canada it just seemed natural that B.C. would join in. … But it still hasn’t happened. I’ve been kind of stonewalled by my own province.”
Stewart continues to advocate for PAs in the province. She sits on the board of the Canadian Association of Physician Assistants as the director for B.C.
“We have approached the minister of health in the past, but nothing has come to fruition,” she said. “We have been told that the physician assistant profession is just not a priority at this time. No formal reason has been given.”
Black Press reached out to the ministry of health for response and was told the situation is being “monitored.”
“The introduction of a new health profession requires careful consideration, management and significant resources to properly understand and address the inevitable team function issues that emerge from overlapping scopes of practice,” the ministry said in a prepared email statement.
“The ministry recognizes the contributions physician assistants make to health care delivery as physician extenders. We continue to monitor their implementation in other provinces, and appreciate the dedication to service embodied by physicians assistants who served in Canada’s Armed Forces.”
Local politicians respond
Courtenay-Comox MLA Ronna-Rae Leonard said she is working with the ministry to resolve it.
“Physician assistants are skilled and capable, and I thank them for their service in the military,” she said. “I am committed to advocating for the needs of my riding, and am regularly engaging with both PAs and the ministry of health to find solutions that fit the healthcare needs of Courtenay-Comox.”
North Island-Powell River MP Rachel Blaney, who serves as the veteran affairs critic, said a resolution is needed.
“These are folks who are extremely highly trained… across the planet, people have great things to say about our military’s level of training. I think this needs to be explored… We know that the need is so high, across all of Canada. I hope this comes together quickly, because these are some of the most highly trained people we have in our country, and we desperately need help in terms of our healthcare system, so let’s make it work.
“Having worked with so many veterans, and also just being at the 19 Wing and doing activities there, these people are so efficient and well trained. We should be using them … they are so needed.”
Waiting it out
In the meantime, certified healthcare workers sit on the sidelines in this province knowing their skill sets are accepted elsewhere in the country.
“I can’t put it into words how frustrating it is that we are still not able to work,” said Stone. “There is a problem here, and I and my colleagues deserve to be working anywhere we can in this province, alongside nurse practitioners, physicians, and other healthcare workers. There has been nothing more demoralizing for me and my colleagues … we can’t even give immunizations.”
Stewart concurred with Stone’s sentiments.
“When I look around and I see the need for even just one healthcare provider (in a given situation), it is incredibly frustrating,” echoed Stewart. “To know the skills that a PA has, to know how positive this profession has been in bridging the gap in other provinces, knowing that we can do the same thing here and B.C. … why are we not working?”
Part two of this series will look into specifics regarding how, and where, PAs could be of immediate help in alleviating the healthcare crisis in B.C.