University of Manitoba, Winnipeg, MB R3M 0E2, Canada.
Can Fam Physician. 2011 Mar;57(3):e83-8.
To analyze the health policies related to physician assistants (PAs) and to understand the factors influencing this medical work force movement.
This work combines a review of the literature and qualitative information, and it serves as a historical bookmark. The approach was selected when attempts to obtain reports or literature using customary electronic bibliography (PubMed, CINAHL, Google Scholar, EBSCO, and MEDLINE) searches in English and French, from 1970 through 2010, identified only 14 documents (including gray literature) of relevance. Reports, provincial documents, and information from developers of the PA movement supplemented the literature base.
The historical development of the role of PAs in Canada spans 2 decades. There are now more than 250 PAs, most working in family medicine and emergency medicine. Enabling legislation for PAs has been formalized in Manitoba, and 3 provinces have recognized PAs in various policy statements or initiatives. Three universities and 1 military training centre have enrolled more than 120 students in PA programs. Retired PAs of the Canadian Forces, returning ex-patriot Canadians who had trained as PAs in PA programs in the United States, and American immigrants are working as PAs in Canada. Demonstration projects are under way to better understand the usefulness of PAs in various medical settings.
For a public health policy enactment of this size and effect, the literature on PAs in Canada is sparse and limited. In spite of this, PA employment is expanding, family medicine practices are using PAs, and there is enabling legislation planned. The result will likely be increased use of PAs. Documentation about PAs, review of their use, and outcomes research are needed to evaluate this new type of clinician in Canadian society.
分析与医师助理（PA）相关的卫生政策，并了解影响这一医疗劳动力流动的因素。
这项工作结合了文献综述和定性信息，是历史的记录。当试图使用常规电子文献检索（PubMed、CINAHL、Google Scholar、EBSCO 和 MEDLINE）以英文和法文检索 1970 年至 2010 年的报告或文献时，仅发现了 14 份相关文件（包括灰色文献），因此选择了这种方法。报告、省级文件以及 PA 运动的开发者提供的信息补充了文献基础。
加拿大 PA 角色的历史发展跨越了 20 年。现在有超过 250 名 PA，他们大多数在家庭医学和急诊医学领域工作。马尼托巴省已经制定了 PA 的授权立法，3 个省份在各种政策声明或倡议中承认了 PA。3 所大学和 1 个军事培训中心已经招收了 120 多名 PA 项目的学生。加拿大军队的退休 PA、曾在加拿大境外的美国 PA 项目接受培训后返回的前加拿大公民以及美国移民都在加拿大担任 PA。正在进行示范项目，以更好地了解 PA 在各种医疗环境中的实用性。
对于这样规模和影响的公共卫生政策制定，加拿大关于 PA 的文献稀少且有限。尽管如此，PA 的就业机会正在扩大，家庭医学实践正在使用 PA，并且计划制定授权立法。这可能会导致更多地使用 PA。需要对 PA 进行文件记录、审查其使用情况并进行结果研究，以评估加拿大社会中这种新型临床医生。
