Primary care providers are the backbone of our healthcare system. For patients seeking medical attention, family physicians are often the first line of contact, providing a comforting face to navigate the complex and often confusing maze that we call ‘Ontario’s healthcare system’. And yet, Ontario is facing a family medicine crisis. Physician Assistants (PAs) are one solution to this crisis.
Earlier this year, the Ontario College of Family Physicians urgently called on the Ontario Government to provide support for family doctors and patients. According to their statement, over 516,000 Torontonians do not have access to a family doctor, and this number is expected to increase to nearly 1 million by the year 2026 (Ontario College of Family Physicians [OCFP], 2024). Across Ontario, this statistic is forecasted to grow to 4.4 million in two years’ time as family physicians retire or switch specialties (OCFP, 2024). According to the college, Ontario’s family medicine crisis can be attributed to several challenges in retaining primary care physicians, including overwhelming time spent on administrative tasks and lack of team supports. Last month, the Ontario Government announced plans for a pilot program where primary care providers will utilize new digital health avenues, including artificial intelligence, to help ease the administrative burden and leave more time for medicine (Ontario Newsroom, 2024). But the college notes that more needs to be done to ensure all Ontarians have access to primary care. In addition to easing the administrative burden, the college recommended creating a team-based model of primary care in which family doctors work closely alongside a team of other expert providers to free up the physician’s time for patients who need it most (OCFP, 2023). In such a context, PAs can serve as a crucial support by expanding access to primary care and improving patient outcomes.
PAs are highly trained medical professionals who work with physicians to complete patient assessments, diagnose medical conditions, formulate treatment plans, prescribe medication, and work collaboratively to empower patients with health education and counselling (Jones et al., 2021). PAs have been working in primary care medicine in the U.S. for nearly 60 years. Here in Canada, PAs were integrated into the Canadian Armed Forces in the 1980s and into the civilian healthcare system starting with Manitoba in 1999, Ontario in 2007, and other provinces were quick to follow, including British Columbia, Newfoundland and Labrador, and Prince Edward Island most recently in 2023. Since their introduction into Canada’s healthcare system, PAs have had a significant impact on improving access to primary care and easing family physician burden. In primary care, PAs can manage approximately 75 per cent of visits. (Schweitzer & Record, 1981).
In a study evaluating the efficacy of PA utilization in Canada, around 95 per cent of physicians working with PAs said that having a PA in their clinic allowed them to increase the number of patients seen per day and improve clinic efficiency overall (n = 83; Burrows et al., 2023). Around 90 per cent of physicians working with PAs noted that PAs helped to improve the quality of care provided to patients and around 88 per cent indicated that having a PA on their team improved their own overall well-being (n = 84; Burrows et al., 2023). As a PA student, I am humbled to be joining a community of providers committed to enhancing healthcare access in Canada.
Clearly, PAs have an important role to play in helping restore Ontario’s family medicine landscape. Despite their proven value, PAs continue to face barriers, including limited recognition, regulatory challenges, and sustainable funding models. It is incumbent upon our healthcare institutions, policymakers, and stakeholders to address these challenges and welcome PAs as part of the primary healthcare team to maximize their contribution to patient care. Investing in Ontario’s PAs means supporting family doctors and protecting the health of Ontario’s most vulnerable.
By Leora Goldreich
