Introducing Physician Assistants into the Ontario Healthcare Workforce: Health Reform Analysis

The Utilization of Nurse Practitioners and Physician Assistants: A Research Synthesis


The Michael Smith Foundation for Health Research (MSFHR) funded this Research Synthesis for Health Research on behalf of the Nursing Research Advisory Council (NRAC). Its purpose was to:

1) provide decision makers in the British Columbia (BC) health sector with a comprehensive  international review and synthesis of the research literature pertaining to nurse practitioners (NP) and physician assistants (PA), including information regarding their current and potential organization, financing, funding, regulation, and service delivery in BC

2) offer pragmatic advice in regard to the future implementation and utilization of these two professions within this province. A set of nine questions posed by NRAC provided a framework for the project.


Introducing Physician Assistants into the Ontario Healthcare Workforce : Health reforme Analysis


Meredith Vanstone

Meredith Vanstone, PhD is Assistant Professor in the Department of Clinical Epidemiology & Biostatistics and a member of the Centre for Health Economics and Policy Analysis at McMaster University. She is an interdisciplinary qualitative health researcher who uses a socio-cultural approach to examine questions of relevance to health policy and health professional practice and education. Meredith is particularly interested in the inclusion of social and ethical considerations into health technology policy. Kristen Burrows, MSc, CCPA is a practicing Canadian Certified Physician Assistant in Internal Medicine at St. Josephs Hospital in Hamilton, Ontario. She is a graduate of the inaugural class of McMaster University’s Physician Assistant Education Program, and has since returned to the program as an Assistant Clinical Professor. Prior to becoming a PA, Kristen worked as a Public Health Epidemiologist both locally and internationally. She has a BSc in Biomedical Sciences and a MSc in Epidemiology from the University of Guelph. Kristen will soon be commencing a PhD in Health Research Methodology at McMaster University with a research interest in the role of Physician Assistants in the Ontario healthcare system. Her current clinical interests include end-of-life discussions and palliative care issues, especially in patients with dementia.


Sarah Boesveld

Sarah E Boesveld, MSc, RN is a PhD candidate in the Health Policy program at McMaster University. Her research interests include the role of non-state actors in shaping health policies, the politics of HHR policymaking, patient and public engagement. Sarah’s dissertation research, which is nearing completion, focuses on developing an improved understanding of the motivations and actions of health profession organizations as interest groups in health policymaking processes. Sarah is a current recipient a Harry Lyman Hooker Senior Fellowship (McMaster University), and a past recipient of OGS. She also received funding to complete the Ontario Training Centre Diploma in Health Services and Policy Research.

Summary of Research 

This is a policy analysis of a recent health reform, the 2006 introduction of Physician Assistants (PAs) Ontario. Well established in the United States, PAs are new to civilian health care in Ontario. They were introduced by the Ontario Ministry of Health and Long Term Care in 2006 as part of a significant reform to health care in Ontario which also included the formation of several new ministerial bodies (e.g.) Health Force Ontario, Health Quality Ontario). PAs are directly supervised by physicians and act as physician extenders, performing tasks (including controlled acts) delegated by the supervising physician. Using Kingdon's three streams framework, we examine the way that PAs appeared on the policy agenda, how they were framed as a potential solution to existing issues such as wait times and health care costs, and the interest groups who worked to promote and to oppose this new health profession.

Summary of Poster

poster 1


Send us your latest HHR related research, reports and publications to showcase through our pan-Canadian HHR Knowledge Exchange Platform.