Chris LeBouthillier is a Physician Assistant from Toronto. He completed his undergraduate degree in Health Promotion from Laurentian University and his Bachelor of Health Sciences (PA) at McMaster University. He is currently employed at a busy family practice in Downtown Toronto which serves a diverse population including the LGBTQ community, the underhoused and those struggling with mental illness. He has spent time working in surgery and obstetrical care in rural Zimbabwe and has a passion for travel medicine. Chris is a Course Director for the PA Education Program at the University of Toronto and has been a clinical preceptor for over 25 PA students completing their core and elective rotations. He is committed to increasing the awareness of Physician Assistants through education of the public and by having undergraduate students and other health professionals interested in the field of medicine shadow him. In his spare time he enjoys playing ball hockey, traveling and hanging out with his wife and 19 month old daughter.
A Typical Day in Family Medicine
Working in family practice every day is different. My typical day involves arriving at the clinic in the morning, reviewing blood work and imaging results, specialist reports and other paperwork to determine whether any patients need to be followed up on and then starting to see patients.
We have lunch break built into our day, but it also serves as catch-up time for extra busy days. On any given day I may see 20-30 patients, depending on the length of the shift.
On a given day I may see people for routine visits, to address acute needs or for follow up. I also do well baby visits, sexual health education and treatment, and minor procedures like joint injections, IUD insertions, biopsies and minor surgical procedures.
I do most of my documentation at the time of seeing the patient, however, I usually have some extra documentation, referrals and insurance paperwork to complete or additional results to review which I complete at the end of the day or at home.
I have been working at the same clinic since it’s inception, so in addition to my clinical roles I have taken on an unofficial clinic manager role including being involved in hiring, payroll, IT and other miscellaneous tasks.
I work typically 4-5 days per week, or 19-20 days per month.
My Work Setting
Urban community family health organization in downtown Toronto with an extremely diverse patient population including chronic pain, the LGBTQ community, the underhoused and those struggling with mental illness.
Procedures I Perform
- Lipoma Excision
- Joint Injections
- IUD Insertion
- Nail Resections
- Excisional Biopsies
- Punch Biopsies
- Foreign Body Removals
Benefits of Working in Family Medicine
Benefits include building Patient Relationships, schedule flexibility and the diversity of conditions seen. The parts I love most about working in family medicine is that every day is different. I also enjoy building meaningful relationships with my patients.
Benefits of Adding a Physician Assistant to a Family Practice
Its been beneficial multiple ways. We have nearly a 100% ability to see patients on the same day or the next day when a visit is required. The physician burnout level is significantly less because of the shared workload. Our patients appreciate having a team looking after them and they feel that they have multiple people who are able to address their complaints. With the enhanced care we are able to provider as a team, we are also able to provide regular communication options with our patients through email.
Physician Assistant Supervision in Family Medicine
I function relatively autonomously, but we do review cases throughout the day, mostly informally. My supervision is usually direct, with the physician on site, however there are some occasions where he is offsite. There is typically other physicians on site to provide assistance and my primary supervising physician is available by phone for quick communication if needed.
On The Job Training as a Physician Assistant
When I first started by job I had worked with my supervising physician as a student. Due to this pre-existing relationship I was seeing patients on my own rather quickly, however, the level of supervision/case review was close for the first 6-12 months.
Funding a Physician Assistant in Family Medicine
Family Practices can utilize multiple ways of funding for a PA. Assuming they are in a FHT (which I am not) they can utilize the direct funding available. Otherwise, in a capitation model, physicians can increase their roster size (and therefore their base rate salary) while also working further toward increasing targets for bonuses, increasing availability and reducing outside use.
Tips for Physician Assistant students Aspiring to Practice in Family Medicine
Meet Physicians to do your first year shadowing (LP/LCE) with someone who may be interested in a PA in the community you want to work in. This will open up the opportunity to complete second year rotation with that physician. Take time to discuss the possible ways to fund a PA.
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