Expanding access: exploring the role of physician assistants in providing medication and telemedicine abortion services - a narrative literature review
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Date
2020
Authors
Hahlweg, Satya
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Abstract
Introduction: In Canada, induced abortion services are safe, legal, and publicly funded; however, access to abortion services varies across Canada and continues to be a challenge for many women. Physician Assistants (PAs) are uniquely positioned to help address the issue of access to abortion services, specifically, in the delivery of medication abortion. PAs could be utilized in the delivery of medication abortions in both urban and rural areas, as well as via telemedicine services to help increase patient access and enhance physician delivery of reproductive health services. PAs have a long history of providing abortion care in the United States, however, have yet to be utilized in this particular area of health care in Canada. Methods: Relevant articles for this narrative literature review were identified using PubMed and Google Scholar databases using search terms “abortion services”, “physician assistants”, “medication abortion OR medical abortion OR abortion”, “mid-level provider OR advanced practice clinician”, and “telemedicine and abortion”. Inclusion criteria for articles included in this review included studies published in English, primary research, and a focus on PAs as opposed to
other non-physician providers. Results: Nine unique studies were selected to review for this project. Conclusion: Current literature demonstrates strong evidence to support that physician assistants are safe and effective providers of first-trimester abortion care. Given PAs training and scope of practice, they are uniquely positioned to help address the issue of access to abortion and provide quality abortion care. Telemedicine delivery of abortion care offers patient’s greater choice in abortion services whilst maintaining confidentiality and quality care. Research demonstrates that telemedicine provision of abortion care is equally as safe and effective as compared to in-person provision and contributes to geographic equity, which remains a major barrier to abortion access.
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Keywords
telemedicine, abortion