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Are Nurse Practitioners the Answer to Family Doctor Shortage?

The need for family doctors continues to grow with over 6 million Canadians without a family doctor. In the absence of an immediate plan to solve this problem that Canadians continue to be frustrated with, nurse practitioners are stepping up.

How Can Nurse Practitioners Help With This Problem?

All nurses focus on patient observation and patient care. The key difference between nurses and nurse practitioners is that nurse practitioners are permitted to prescribe treatments, order tests and diagnose patients, key responsibilities of a physician.

Over the last 1-2 years, we’ve seen pharmacists take on a bigger role in patient care with the ability to prescribe for minor ailments. While this continues to be new, we’ve seen searches for minor ailments grow 30% over the last 6 months.

The ability to easily get a prescription for a minor ailment is great but what if there was a need for someone to examine and diagnose a health issue? Walk-in clinic doctors are the obvious place to start but according to our recent annual wait time index, wait times continue to skyrocket across the country so the thought of facing those long wait times isn’t ideal.

Bridging the Gap in Healthcare Accessibility

In a recent story on CBC, a patient learned about a clinic in Toronto, where a nurse practitioner could examine, diagnose and treat him. While the cost is not covered under OHIP, some may find it worth it for the peace of mind of a resolved health concern. Costs can range anywhere from $70-90 per visit at these private clinics. The high demand for this service should send a signal to Health Canada and provincial governments that more affordable options are needed so clinics with nurse practitioners don’t end up charging high fees.

The number of nurse practitioners in Canada grew by 11% from 2021 to 2022, the largest percentage increase compared to other nursing types, while the number of new family doctors is showing a downward trend with 7.7% growth (between 2017 to 2021) from 12.9% (from 2012-2016). If this trend continues to be a big problem, the family doctor shortage will continue to grow, as more doctors begin to retire. As of 2017, nurse practitioners can perform the same primary care tasks as family doctors, including diagnosing and treating common conditions, referring to specialists and prescribing medication. For all intensive purposes a patient receives the same level of care from an NP as a family doctor, so why don’t we have more nurse practitioners lead clinics? Or do we? And there is just simply a lack of awareness.

In a CBC article CEO Alon Birshtein of Care & Family Health in Toronto says “But really the fact is that, you know, most Canadians aren’t aware that we’ve had a so-called two-tier system for many years already. This isn’t really something new, I think it’s just more at the forefront, more people are kind of talking about it.” says Alon Birshtein is CEO of Care & Family Health in Toronto.

Navigating the Complexities of Care

Provincial legislation related to OHIP does not specifically mention nurse practitioners, but Natalie Mehra, the executive director of the advocacy group, the Ontario Health Coalition, argues that charging patients for nurse practitioner services violates the Canada Health Act, which guarantees universal access to medically necessary insured services.

How do you feel about paying for access to nurse practitioner which in some cases might allow you to skip the long lines and quickly get the care you need?

Alternatively, should nurse practitioners receive the same billing codes as family physicians? This change could substantially increase access to care across the country, naturally reducing wait times and potentially enhancing the quality of care.

While Ontario health minister Silvia Jones says “Clinics cannot charge for OHIP funded services,” many do. The number of new nurse practitioner led clinics opening up continues to rise and there are no firm rules in place to stop nurse practitioners from charging.

Evolving Models for Enhanced Healthcare Access

The Saskatchewan government has taken a different approach to leveraging nurse practitioners to increase access to care. In a recent announcement, Premier Scott Moe and Health Minister Everett Hindley joined MLA Terry Jenson to announce a pilot to enhance the role of Nurse Practitioners through a new model for independently operated, publicly funded Nurse Practitioner clinics.

“Access to primary health care is a high priority for our government,” Moe said. “By creating more opportunities for Nurse Practitioners throughout the health care system, we can improve access to primary health care services for Saskatchewan patients and their families,” says Evertt Hindley, Health Minister.

Medimap’s Take

The growing acceptance and demand for NP-led services reflect a healthcare system at a crossroads, seeking innovative solutions to persistent challenges such as accessibility, affordability, and quality of care. The discussion around nurse practitioners—whether it be about expanding their roles, integrating them more fully into our public healthcare system, or exploring new models for their services—underscores a broader dialogue about the future of healthcare in Canada.

The dialogue opened by Health Minister Everett Hindley in Saskatchewan suggests a proactive approach, recognizing the value NPs bring to the healthcare table. It points towards a future where nurse practitioners are not just a stopgap measure but a fundamental part of a diversified and resilient healthcare system. This shift requires not only legislative support but also a cultural shift in how we view and value different healthcare providers.

The question of whether to expand billing codes to include nurse practitioners or to continue exploring private models of care challenges us to consider what we value most in our healthcare system. Ultimately, the path we choose must aim to reduce wait times, increase access to quality care, and ensure that every Canadian can receive the medical attention they deserve when they need it. The integration of nurse practitioners into the fabric of our healthcare system not only offers a viable solution to current shortages but also invites us to envision a more inclusive, efficient, and compassionate future for Canadian healthcare.

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