Nurse Practitioners
A major event occurred last summer in Sudbury. For the first time in Ontario a clinic to provide medical care was organized and is led by “Registered Nurses in the Extended Class” or commonly now known as Nurse Practitioners (NPs). Doctors are consulted as required, and in the clinic in Sudbury are present 14-15 hours weekly
Two factors, no doubt, influenced the Ministry of Health to take this bold action. The Canadian Medical Association stated that more than 4 million people in Canada were without access to a Family Doctor (FP) and, without doubt, many lived in Ontario. Primary Care was thus not available and left people, no choice, but to go to the emergency department in their local hospital. A very expensive way to provide care and sometimes not appropriate.As well in 2031 all the “Baby Boomers” will reach 65 and the pressure on our health care will be beyond our capacity to respond
In the Ontario budget for 2008, Premier McGuinty promised 3 more nurse- led clinics in Ontario plus 38 million dollars set aside for 25 extra clinics throughout the province . NPs by law must work in collaboration with FPs. Prior to this clinic`s opening many NPs worked in doctor- led clinics usually in areas with a doctor shortage. They, however, found work in other areas as well. This new Sudbury clinic does not require full-time doctors on staff but they can be called in to consult if the health problem goes beyond the expertise of the NP.
NPs must have a Nursing Degree from a University and at least 2 years of clinical experience. At that point they can apply for a University nurse-practitioner certificate which entailed 2 more years at university at the Masters Level.
What exactly by law can the NP do? According to information from NPs in the field they do about 80% of the work done by FPs. The Regulated Health Professions Act and the Nursing Act set and guide the practice of nursing. In general the NPs are able to consult with physicians, communicate and diagnose, prescribe drugs from a regulated list, order laboratory tests as well as x-rays and ultra-sounds
There is no question that the medical profession is looking askance at this new development. Due to the fact that so many people do not have access to a FP they are not able to complain too strongly. However when the Baby Boomers reach senior age costs will be the major factor and when the NPs are finally placed in cities there will be competition between physician and nurse- led clinics. Nurses will be paid a salary and if everything remains the same doctors will work “fee for service” which would be much more expensive for the government
With the preponderance of old people and their need for MRIs, Cat-Scans, new hips, new knees it is a priority on the government to provide quality health using the least expensive professionals.
