A report card released on National Physician Assistant Day by the Canadian Association of Physician Assistants (CAPA) shows that, as far as the profession has come in improving patient care and reducing costs to the health care system, overall progress is being hampered by a lack of recognition for PAs in several provinces. While Ontario, Manitoba and Alberta haven't fully integrated PAs into the health care system, 95% of Ontario physicians said that their overall efficiency had been helped by the use of a PA. \u201cOur PAs are currently being underutilized in Canada. If we look to other jurisdictions in the world, like the Netherlands, the U.S. and India, we know that we\u2019re just not keeping up," said CAPA National President Chris Rhule. "If you\u2019re a PA in these jurisdictions you are in high demand, because governments recognize the benefits on patient care and on their pocket books." On the same day that CAPA issued its report card, Manitoba's Health Minister Sharon Blady announced that "this year\u2019s graduating class of physician assistants have all accepted jobs in Manitoba," with 12 students graduating from the Masters of Physician Assistant Studies Program. \u201cManitoba was the first province to put legislation in place to allow physician assistants to practice and we continue to reap the rewards of that decision,\u201d said Minister Blady. \u201cTheir skills and expertise will benefit patients across the province, improving access to care for thousands of Manitobans each year.\u201d Established in 2008, Manitoba's program is the first of its kind in Canada, with more than 80 physician assistants working in various health care settings, including emergency departments, surgery, medical rehabilitation, family medicine and mental health services. \u201cWe are very proud of our success in Ontario and Manitoba, and we\u2019re very excited about the outlook in Alberta," said Rhule. "That\u2019s why we\u2019re calling on the remaining provinces to follow the evidence, and start taking steps to introduce these critical players into their healthcare systems. If provinces are not willing to integrate PAs perhaps the federal government may need to include PAs in future health accords so that incentives exist to make these important changes." Despite studies showing that physical assistants are a cost-effective way to yield results in primary care, emergency medicine and orthopaedic settings, CAPA's report card showed a significant need for improvement in British Columbia, Quebec, Prince Edward Island, Nova Scotia, Newfoundland and Labrador, Northwest Territories and Saskatchewan. PAs in long-term care settings have been shown to decrease the hospital admission rates by 38% for seniors, they can increase surgical throughput of primary joint replacements by 42% a year and reduce wait times for surgeries by 14 weeks, they can reduce emergency department wait times by 1.9 times and reduce by half rates of patients having left without being seen, and can be used for 75% of all visits without referral to physician level care.