PAs in BC

PAs are all the buzz in BC these days. Fraser Valley Health Authority and The Interior Health Authority are both 'looking.' It seems that the Pathologists are reducing or nearly-eliminating their level of service in the two regions and the hospitals are scrambling to find some experienced individuals capable of dissecting more complex surgical specimens. Histotechs are currently handling the less-complex specimens.

The Interior HA has a really novel idea (has been done in a few centres; mostly in the USA) about using telepathology to perform frozen sections. It's a natural (if it works well) for multi-site hospitals which may not have Pathologists on staff. The scenario is one where a PA (possibly accompanied by a Histotechnologist) will go to the frozen section room (in the OR usually) instead of the Pathologist, who may be many miles away. Via a secure web cam, the PA will describe and dissect the specimen under the watchful eye of the Pathologist. Either the PA or the Histotech will perform the frozen section and the slide will be reviewed remotely by the Pathologist; manipulated on the stage at her/his direction. The PA will write (and sign on behalf of the Pathologist) the microscopic description and the diagnosis. Pretty neat, eh?! For the hospitals, this presents an opportunity for a significant saving in that the PA, rather than the Pathologist, will be travelling (and waiting if necessary); will be present at the F/S and will be paid substantially less per unit time. For the majority of cases wherein there is a single slide, the healthcare system stands to save substantially. There will be no discernable reduction in turnaround time or quality control.

I haven't discussed how autopsies will be handled yet but will soon learn what their plans are.

Fraser Valley HA is in a slightly less frantic situation wherein the Pathologists are reducing their level of service. As a result, they are looking at starting from the grassroots level and plan, in full consultation with the BC health ministry, to set-up a PA training program. It is my understanding that they hope (unlike Winnipeg which has a Masters-level program) to set-up a BSc-level program, probably with a 1-year post-grad practicum. I think they hope to do this at UBC.

Needless to say, the PAs will justifiably achieve a higher standing than MLTs; I believe their intent is to pay the PAs at least two levels higher on the same (unionized) pay scale. All of this is in its infancy and subject to considerable change as time progresses. The time line, however will seem to go at the speed of light compared to anything that has happened elsewhere in the country over the last 30+ years.

I sincerely hope that the organizers in BC keep the CAP apprised of their progress, especially in regards their training program. The CMA Accreditation Office can provide important direction in the formulation of a curriculum based upon the core expectations (essentially the job description) of PAs. As a result, BC may have the first nationally-accredited PA training program.

I may have more to say on the subject of telepathology in a week's time. A demonstration is being held in Kelowna in a few days' time and I'll be there with the Director of The Interior HA. I'll be able to consider trying to 'sell' my own Director at The Ottawa Hospital on the idea of telepathology as we too are a multi-site hospital with numerous client hospitals at a distance from Ottawa.

It has been good to make contact with several PAs across the country recently. I feel a slow re-kindling of enthusiasm for the certification issue. I am very very appreciative of the CAP's efforts thus far. Please remember to ask every PA who you know whether or not they have received and replied to the letter from Dr. Cook (Pres. of the CAP).