It helped provide 24 hour on-call care. I split the call between my supervising physician, 50% of the time I was on call and 50% of the time he was on call. Of course anytime I was on call, he had to be on back-up call. The reality is that PAs are very capable of managing the vast majority of issues that come through especially if you plan well. I think maybe once there was a time that I had been on call where I had to call him, but that was it.
We were able to provide a 24 hour service to our palliative patients. Really if you’re going to provide good quality palliative care, you need to have 24 hour access.
And we were also able to visit patients more regularly. They had very quick access, and if they called that day for an issue they received care that same day, and we resolved whatever issue they were having that same day – and that was not happening prior to me being there.
I think that was the biggest thing, the amount of access that they received is the biggest difference that patients have.
The other thing, a lot of family physicians are not doing a palliative care service. The fact that I was there, I created the palliative care service while I was there. That was 100% created by me, supported by my supervising physician. It did not exist before me.
Not enough palliative care teams in the GTA, there is a study that came out approximately 6 months ago citing the number of patients that should receive palliative care, wanted palliative care but did not receive it before they died – and it was a fairly high number (perhaps 40% of patients).
PAs seem like an untapped resource for GPs expanding their care to palliative care. Do you see this as an area of growth for PAs?
Obviously yes. Its not an area that receives a lot of focus in many areas of our conventions and discussions in school etc. but is an area that really needs it.
The same with NPs. NPs are more commonly found in palliative care than PAs – but they’ve just been around longer. There’s not really a reason they have to be more in that market than we do, I think in fact, in might even be the other way around because physicians in palliative care often want to have a relationship with the patients even though they don’t have the time to be there with every single patient in the same manner. Because PAs are more physician extenders, rather than NPs being a bit more independent, we tend to have a more closer relationship.
I’ll say that with a caveat, I really think NPs and PAs can function equally successfully in this role, and that both of our professions should be more involved in palliative care in providing that service.
If there is ever a time in life, that you deserve the best care, it is during your end of days.
Everybody deserves to die peacefully, quietly and not in pain. Right now in Canada, that is not happening. I will say that Canada is one of the forerunners, we are leader in palliative care in the world on a global setting, but we’re not there. We still have a long ways to go
If a Physician or LHIN were interested in incorporating onto a Palliative Care Service or things they should look into?
LHINs are already hiring PAs, it is recognizing that palliative care needs PAs and devoting money towards it. You go about hiring just as you would any other practice. The key would be to fit in any other practice, the key would be to find the person who is the right fit for that role.
The medical piece of palliative care is not complicated. There are common things that you see again and again, and anybody can learn that. The hard piece, which I alluded to earlier, is the emotional piece that comes along with palliative care.
You just have to find the right fit in terms of the PA hiring for that. But otherwise, I think you would hire them in any other fashion that you would.
The first step is recognizing that it’s a need. Private physicians practices, LHINs, I don’t think recognize that this is a need or a service that PAs can fulfill. That falls to us to be networking and advocating.