What about health workers who fill gaps and cost less?

There is a lot to like in Budget 2026’s health-care chapter. Building and expanding emergency departments, investing in home care and increasing health workforce training positions are just a few examples. The Kinew government deserves credit for listening to the concerns of Manitobans and putting real money into a struggling health-care system.

But buried in the highlights are two lines worth examining: $223 million for more doctors and an additional $6.3 million to recruit more doctors to rural Manitoba.

There is no question, Manitoba needs more doctors. However, a question the budget doesn’t answer, and frankly, one nobody in the legislature seems to be asking is: why are we spending $229.3 million exclusively on physicians when that same investment could fund more than 1,700 physician assistants — and get patients seen faster, in more communities, starting now?

This is not a rhetorical question. The “math isn’t mathing.”

We need to have an honest look at where things currently stand. Hundreds of thousands of Manitobans do not have access to a primary health-care provider. Patients are waiting over 10 hours to be assessed, if at all, in emergency departments. Rural communities are watching clinics close, resulting in individuals driving an exorbitant number of miles to receive care.

Even the government’s own budget document acknowledges that the province is “still in a transition period” as it rebuilds health-care services.

This is not a jab at the government’s intentions. But good intentions do not cut emergency department wait times. Smart decisions do.

The reality of physician recruitment in Canada is this: it takes, on average, a decade to train a physician. Even with competitive incentives, rural recruitment is a persistent challenge. Manitoba has been dealing with this problem for years and the shortages continue to grow. Throwing more money at the same approach and expecting different results is just wishful thinking.

So, what’s an alternative solution to fix this problem? Physician assistants (PAs). PAs are highly trained, regulated health-care professionals. They complete graduate-level medical education and work in collaboration with physicians. PAs are authorized to take patient histories, complete physical examinations, order and interpret diagnostic tests, diagnose conditions, prescribe medications and perform procedures.

They are not medical residents, not nurse practitioners and not a workaround. They are a proven, internationally recognized component of a high-functioning health-care system.

In the United States, over 190,000 PAs have been embedded in primary care, emergency medicine and specialty practices for decades. In the Canadian Armed Forces, they have long been a cornerstone of medical care in the field. In Manitoba, they remain vastly underutilized, especially in primary care, and this budget does very little to change that.

A PA salary in Manitoba runs roughly $130,000 annually, a fraction of what it would cost to recruit, retain and pay a physician.

Recently, the OurCare national study suggested that 89 per cent of Manitobans are connected to a family doctor or primary care provider. This is something to celebrate. However, being connected does not mean it’s easy to get an appointment. Seventy-one per cent of Manitobans with a family doctor were unable to get a same-day or next-day appointment and 74 per cent couldn’t access care after hours. Research consistently shows that implementing PAs into medical practices reduces patient wait times. Patients get seen quickly. Issues get caught earlier. Patients are satisfied.

Adding 1,700 physician assistants to provide primary care to Manitobans would be transformational.

Another real and worsening problem is physician burnout. This is often linked to overwhelming patient volumes and administrative burden. Budget 2026 rightly addresses the need to eliminate sick notes. But establishing PA-MD teams would do far more. It would mean that the work gets distributed evenly. This leads to less physician burnout and higher physician job satisfaction.

This is not theoretical. It works. The evidence exists. The profession exists. The training program exists. What is missing is the political will to fund it.

To be crystal clear: nobody is saying Manitoba should stop recruiting physicians. The province needs more doctors — in family medicine, in the North and in underserved communities. Investment there is warranted. But a health system that bets everything on a single provider type when cost-effective, trained alternatives exist is not being strategic.

Right now, Manitoba has an opportunity to build a primary care model that works. This means a team-based approach in which physicians, PAs, nurse practitioners, nurses, psychologists and allied health professionals work together to provide the highest-quality care for patients. Countries and health systems that have implemented this strategy are not looking back.

Manitobans waiting months to see a family doctor are not interested in why it is complicated. They want things to get better. They want someone to help them. Physician assistants can do that, right now, at a cost this government’s own budget could accommodate. This is a “Made in Manitoba Solution.”

Steven Piotrowski is a family medicine physician assistant and the academic and wellness lead for the Master of Physician Assistant Studies program at the University of Manitoba.