Can Physician Assistants Prescribe in Canada?
Physician Assistants are highly skilled healthcare professionals who work closely with physicians and are trained to provide medical services to patients.
It is within a PA’s scope of practice to and do prescribe medications, treatment, modalities and interventions.
Each province in Canada has its own legislation and regulations concerning prescription authority for physician assistants. So, it's crucial to familiarize yourself with the specific guidelines in your province to ensure compliance and clarity
I. Prescriptive Authority by Province
Physician assistants in Canada have the authority to prescribe medications within the provinces they are authorized to work.
The extent of prescription authority varies among provinces, and this may include the involvement of:
Supervising physician(s)
Requirement of MD co-signatures for narcotics or controlled substances
Established PA medical directives (Ontario only)
Links to relevant documents and policy statements about PAs prescribing in Canada can be found here (This is based on what is publicly available)
Alberta
Alberta Health Services: PAs are fully regulated health professionals who work under supervision of a physician.
Alberta College of Pharmacy (ACP): PAs are able to prescribe with the exception of narcotics and controlled substances.
College of Physicians & Surgeons of Alberta (CPSA):
Manitoba:
In the regulated model, PAs can write prescriptions, order tests and investigations as stipulated by their contract.
College of Physicians and Surgeons of Manitoba (CPSM) Standard of Practice Prescribing Requirements for PAs
New Brunswick:
College of Physicians and Surgeons of New Brunswick (CPSNB): Regulation #6 PAs can prescribe medications to which the supervising physician has determined the PA is qualified to prescribe
Nova Scotia
Nova Scotia Health Authority: PAs as Authorized Prescribers
Nova Scotia Legislature: Bill 33 Physician Assistants Act
Ontario: Via delegation of controlled acts, PAs can autonomously write prescriptions within established medical directives. If medical directives are not established, then the prescription requires a co-signature from the supervising physician. PAs cannot write prescriptions for narcotics or controlled substances without a physician co-signature.
Ontario College of Pharmacists: Ontario’s Physician Assistants and Prescribing through Delegation
Ontario Hospital Association (OHA): The Ontario PA Initiative
For more information re: prescriptive authority of PAs in provinces/ territories not listed here, visit capa-acam.ca or contact admin@capa-acam.ca
II. Can Pharmacists Accept Prescriptions written by Physician Assistants?
Absolutely! Pharmacists in Canada can accept prescriptions written by physician assistants, provided that the prescription falls within the authorized scope of practice of the physician assistant and complies with the regulations and guidelines set by the respective province.
A prescription written by a PA should include:
PA Name, signature, designation (including CCPA Registration # so that the pharmacist may verify the PA’s credentials),
Supervising physician Name, CPSO/Billing #, and contact information
If applicable: Reference to the fact the prescription was generated by a delegated authority (e.g. whether via supervising physician name, and if Ontario: medical directive #).
An example of a PA prescription issued in Ontario. Image from Ontario College of Pharmacists’s Practice tools
Pharmacists play a crucial role in ensuring patient safety and the appropriate use of medications. When they receive a prescription from a physician assistant, they carefully review it to ensure its accuracy, appropriateness, and compliance with legal and professional requirements.
Pharmacists may also consult with the prescribing physician or physician assistant if they have any concerns or need clarification regarding the prescription.
III. Ensuring local pharmacies accept prescriptions from PAs
In Ontario, PAs and Employers can proactively reach out to nearby pharmacies, and can send:
A Letter introducing the PA and supervising physician, providing an overview of the PA scope of practice, an outline of prescriptive authority
Optional:
A copy of the medical directives
Relevant documentation from the provincial college for Pharmacists, Medical association or relevant legislation supporting PA
Ensure the prescription follows the recommended format as per medical directive (Ontario only).
Final notes
It’s important for employers and management to create environment that allows PAs to operate efficiently and at the top of their scope of practice, which includes the ability to write prescriptions.
Whether this means creating solid PA medical directives (Ontario only), writing pathways for PAs to sign via your EMR, and/or establishing relationships/meetings with pharmacies.
By embracing the skills and expertise of physician assistants, employers can optimize their healthcare teams, enhance patient outcomes, and improve the overall healthcare experience.
