Paramedics Key to Solving Canada’s Healthcare Labor Crisis

Years of chronic overwork, poor salaries, and stress-related burnout due to COVID-19 have led to a human resources crisis in the Canadian healthcare system.

“About 78,700 physician job openings are expected over the 2022—31 period as ongoing challenges persist, including shortages in rural and remote areas, inefficient interprovincial labor mobility processes, the need to address demand and readiness for virtual care, and challenging pathways to licensure for international medical graduates,” said a June 8, 2023 news release from the Government of Canada. Meanwhile, information from the Canadian Nurses Association suggests that there will be a shortage of 117,600 nurses in Canada by the year 2030. 

Faced with such a crisis, Dr. Michael Austin — Medical Director for the Regional Paramedic Program for Eastern Ontario supporting 1500 paramedics — has come up with a novel solution: Train and permit paramedics in this country to assume frontline positions in Canadian medicine.

The Right Time to Shift

Writing in the emottawablog.com along with Dr. Josée Malette in a posting entitled, ‘Transforming Canada’s Healthcare Landscape with Paramedics’, the pair state that, “paramedics have transcended their traditional role as mere responders; they have evolved into frontline care providers with the capacity to administer medications, execute advanced medical procedures, and deliver life-saving interventions even before hospital admission.” At a time when the Canadian healthcare system needs more skilled practitioners, the time has come for “empowering paramedics and healthcare providers to deliver robust care at the community level. Expanding paramedic scope of practice enables a more holistic approach to patient needs and reduces strain on hospitals.”

In an exclusive interview with EMS World, Dr. Austin explained why this is the right time for this radical shift in Canadian medicine.

“Paramedics in Canada have evolved beyond their traditional role as mere responders to emerge as frontline care providers,” he explains. “By reducing strain on hospitals, this shift could offer a more cost-effective and efficient approach to healthcare. Paramedics, armed with enhanced skills, could deliver timely interventions at the community level, potentially averting the escalation of medical issues and decreasing the need for costly hospital admissions within our socialized health system. While some investment in infrastructure may be necessary initially, this long-term strategy aims not only to save costs but, more importantly, to ensure a patient-centered approach within the Canadian healthcare system.”

Steps Needed

To make this happen, Canada’s paramedics will need additional training, increased resources, and robust support systems.

“Currently, a gap exists in knowledge and skills that must be bridged to enable a secure transition to autonomous and independent practice,” says Dr. Austin. “It is noteworthy that paramedics typically undergo a foundational 2-3 years of college education, laying the groundwork for their professional expertise. Importantly, there is a growing movement in Canada advocating for the development of university Paramedicine Degree programs. These initiatives not only aim to provide advanced training but also aspire to cultivate paramedicine leaders capable of navigating and succeeding in this new, more advanced domain.” 

He also called on paramedics to play leading roles in medical research and to foster “a culture of inquisitive inquiry” within the paramedic profession.

“This commitment to scholarly exploration contributes not only to individual professional development but also serves to enhance the overall effectiveness of paramedicine in meeting the diverse needs of the population,” Dr. Austin says.

Key Obstacles to Change

Of course, such advances would require changes to Canada’s existing medical environment.

“The obstacles to paramedics playing a larger role are notably rooted in challenges to fully implement a Professionally Autonomous paramedic model,” explains Dr Austin. “This challenge arises primarily due to limited opportunities for higher education paramedic degree programs and regulatory constraints. Additionally, the seamless transition of patient healthcare records poses a significant barrier in many provinces and territories. The shift from paper to electronic records lacked standardization, and systems are now catching up.” 

Still, there is interest among Canada’s medical professionals in advancing Canadian paramedics into frontline roles.

“In navigating this transformative shift, the growing domain of Prehospital and Transport Medicine Physicians is prepared to support paramedicine,” said Dr. Austin. Still, “transforming paramedics into frontline care providers involves not only regulatory changes and increased autonomy but also a crucial emphasis on high-level education and a cultural shift within the paramedic profession.”