Introducing Physician Assistants to Ontario
Bibliographic record
Abstract
In 2006, the Ontario Ministry of Health and Long-Term Care (MOHLTC) introduced Physician Assistants (PAs) through the announcement of demonstration projects, education and training programs, and subsequent funding. PAs are directly supervised by physicians and act as physician extenders by performing acts as delegated to them by their supervising physicians. PAs were proposed as a potential solution to help improve access to health care and reduce wait times throughout the province. Prior to the 2006 Ministry announcement, there was little public discussion regarding the acceptance of the PA role or its sustainability. Opposition from nursing and other groups emerged in response to the 2006 announcement and flared again when stakeholder comments were solicited in 2012 as part of the PA application for status as regulated health professionals. As a health reform, the introduction of PAs has neither succeeded nor failed. In 2013, the majority of PA funding continues to be provided by the MOHLTC, and it is unknown whether the PA role will be sustainable when the MOHTLC withdraws salary funding and health system employers must decide whether or not to continue employing PAs at their own expense. Le ministère de la santé et des soins de longue durée de l’Ontario (MSSLD) a introduit les Adjoints au Médecin (AM) en 2006 en annonçant des projets expérimentaux, des programmes de formation et d’éducation, ainsi que des financements à venir. Les AMs sont placés sous la direction directe des médecins et agissent comme des prolongements des médecins en effectuant des actes qui leur sont délégués par leur médecin superviseur. Les AMs ont été vus comme une solution possible aux problèmes d’accès aux soins et de délais d’attente dans la province. L’acceptabilité et la pérennité du rôle des AMs n’avaient pas vraiment été discutées publiquement avant cette annonce du ministère en 2006. Les infirmières, ainsi que d’autres groupes, ont marqué leur opposition en réponse à l’annonce de 2006, et de nouveau en 2012 lorsque des commentaires des parties prenantes ont été sollicitées dans le cadre d’un dépôt de demande de régulation en profession médicale par les AMs. L’introduction des AMs ne peut être qualifiée de succès ou d’échec. La majeure partie du financement des AMs est toujours assurée par le MSSLD en 2013 et il est impossible de savoir si le rôle des AMs sera pérennisé lorsque le MSSLD arrêtera de financer leur salaires, laissant les employeurs au sein du système de santé décider par eux mêmes s’ils veulent ou non continuer à employer des AMs sur leur propre budget.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.004 | 0.000 |
| Scholarly communication | 0.000 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.004 |
| Insufficient payload (model declined to judge) | 0.001 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".