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Sadly, rural health care tends to be an afterthought. When people visualize a hospital, they often think of a downtown emergency room, where people come in and get triaged to any number of services within a few blocks. Health providers in rural environments must be nimble in their care. Often serving multiple roles. A prime example is a rural physician assistant (PA), who is the ultimate generalist.

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Mark Simons and Linda Parrish were some of the first PAs hired in Alberta under the PA Demonstration Project in 2013. For Mark, it was the amazing geography and hunting that lured him to Milk River, and then the care he could provide for patients that caused him to stay.

Little did he know Milk River does and always had problems keeping practitioners since losing the Border Counties General Hospital in the 1980s. He has worked with several doctors over the years, all teaching him unique aspects of rural health care delivery.

He often speaks to how the learning curve for a PA coming out of the military and into rural family medicine is steep, to say the least. When he first started, he helped a doctor who came out of retirement to serve the community. The extra support that a PA provided helped make sure Milk River didn’t lose that doctor. Now that he has more years under his belt, Mark does emergency on-call alone, with his attending physician in a nearby town.

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Linda also started in the 2013 pilot project, but in Bassano. It has been hard to recruit physicians to this remote location and the promise of PA support helped alleviate that burden. At the end of the two-year pilot project, the physician assistants were deemed so critical that their positions were made permanent.

Every day looks different to Linda. Day to day, Linda works throughout the hospital and clinic — with hospitalists, in acute care, geriatric care, ER, procedures clinic, and outpatient clinic with women’s health. Rural hospitals are unpredictable, one day they could be swamped and another they could be slow. Feast or famine, making it hard to determine staffing levels. Patients often ask Linda to please stay in the community, having been burnt before when care providers left. Having a PA in Bassano allows them to have the emergency room and clinic open at the same time, which helps to alleviate backlogs and wait times to be seen.

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Given these success stories on PAs in rural Alberta, would you believe that the province trains zero physician assistants a year? There is no education program in Alberta for PAs to attend. As a result, we must hope that those trained out east choose to come west for their career. A risky gamble to take.

We need to train PAs in Alberta. A program in Alberta could be a game-changer in addressing the health human resources challenge in the province. New graduates going into rural health get to test all their skills and get exposed to a wide range of health interventions. PAs in rural care are ready for anything. It is time to have more PAs in Alberta.

Mark Simons is a physician assistant working out of Milk River and Linda Parrish is a physician assistant working out of Bassano.

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