WHEREAS the Minister of Health’s mandate includes “continuing to improve emergency medical services response times, decrease surgical backlogs, and cut emergency room wait times,” “supporting primary care as the foundation of our health care system by assessing alternative models of care,” and “working to address rural health challenges such as access to health care professions”; and

WHEREAS the Alberta Health Charter includes the expectation to “have access to team-based primary care services”; and

WHEREAS one of the guiding principles in the Alberta Health Act is “that Albertans have reasonable access to timely and appropriate care, including primary care”; and

WHEREAS additional Physician Assistant positions would increase resources to primary care teams within the across Alberta in a timely and cost-effective manner;

THEREFORE, BE IT RESOLVED THAT the Rural Municipalities of Alberta (RMA) advocate that the Government of Alberta assist physicians to standardize the scope of practice for Physician Assistants employed in rural Alberta care settings to ensure they can be co-located with supervising physicians and have comprehensive medical directives; and

FURTHER BE IT RESOLVED THAT RMA advocate that the Government of Alberta allocate funding to post-secondary institutions for the development of Physician Assistant educational programs; and

FURTHER BE IT RESOLVED THAT RMA advocate that the Government of Alberta increase funding for rural Physician Assistant positions.

A Physician Assistant (PA) is a health professional trained in basic medical sciences who provides care under the supervision of a physician. The Canadian Armed Forces (CAF) established the PA title in 1984 and the position has been introduced into civilian healthcare in an increasing number of provinces since then. Alberta started its pilot program in 2013, including a PA position in the Town of Milk River within the County of Warner that worked effectively to serve the population in the clinic and emergency room.

PAs do not replace the work of physicians, but instead work as part of a healthcare team to decrease the routine workload of physicians. The scope of work for a PA may include taking complete histories on a patient, performing advanced physical examinations, doing work ups, interpreting labs, diagnosing, and prescribing medication. The treatment and methodology are reviewed by and at the discretion of the supervising physician. This supervision can be direct or indirect and the physician does not need to be co-located to the PA. This is especially important in remote areas where PAs can increase rural access to healthcare and take part in improving care for seniors in long-term care closer to home.

The current healthcare system is not serving Albertans as it should, as is evidenced by the fact that the Milk River Hospital emergency room was closed 30 times in 2023, with closures lasting from a few hours to a few days. Within Alberta there are slightly more family physicians per capita than there were a decade ago (based on fee-for-service payments under the Alberta Health Care Insurance Plan), but there have been changes in practice and culture that are not being addressed by this slight increase. Routine medical visits for prescriptions, straightforward ailments, preventative healthcare, and overseeing chronic ailment treatment plans are all tasks primary care physicians currently undertake but could be delegated to PAs. Medical directives for PAs are often institution-specific, but should be more standardized and larger in scope for rural PAs so patient care can be comprehensive and efficient.

Filling additional positions for PAs within the system will require increased education opportunities. PA training can be a bachelor’s degree or a master’s program, followed by a national level competency profile, and a national certification exam. They can be trained at schools throughout the country and will have the same level of competency and training. Education is shorter compared to the training of physicians, so issues in primary care will be addressed more quickly. There are currently only four PA training programs across Canada which offer a combined annual total of 93 seats. More programs are in development, including at the University of Calgary, but should have the full support of the Government of Alberta to move development and accreditation forward quickly.

RMA has no active resolutions directly related to this issue.