Exploring the physician assistant-psychiatrist supervisory relationship and practice model at the Crisis Response Centre

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Skaritko, Dana
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Introduction: 1 in 3 Manitobans will be faced with a mental illness in their lifetime.1 Given the limited number of psychiatrists in Manitoba, coupled with the high burden of mental illness in the population, physician assistants (PA) represent a critical resource in ensuring access to specialty psychiatric services. The Crisis Response Centre (CRC) is an innovative and resourceful 24/7 central access point for mental health services.2 This study aims to determine how to best utilize PAs in practice at the CRC and ensure continued quality improvement in our healthcare system. Methods: This study examined the current supervisory practice model using an online survey distributed to both PAs and psychiatrists currently employed at the CRC. The survey focused on: 1. Gaining an understanding of the level of comfort in the current model from both psychiatrist and PA perspectives, 2. Identifying the roles and responsibilities that could be safely added if there was a change to practice, and 3. Examining PA- and psychiatrist-factors that influenced their level of comfort in the supervisory model. Results: Ninety-seven percent of psychiatrists agree that the presence of PAs has improved overall patient care at the CRC. There appears to be significant comfort under the current practice model from both PAs and psychiatrists and an evident willingness for PAs to have further autonomy, increased roles, and responsibilities. All PAs supported a model of only reviewing cases with which they are unsure of their management. Conclusion: Optimizing PA autonomy at CRC supports the community by utilizing the practice model to increase access to care and further this reach. It supports the growth of the PA model in psychiatry locally and nationally, as the CRC site is the principal employer of PAs in mental health in the country.