Registered nurse practitioners who run private clinics in Saskatchewan are asking for legislation that allows them to bill the government directly for services they provide to patients.
Joelynne Radbourne a registered nurse practitioner who runs a private clinic in Emerald Park, says she is one of the three nurse practitioners running private clinics in the province. She has 400 patients and takes walk-ins.
“In private practice, as you can see, it’s a warm it’s a welcoming environment. You get 30 to 60 minutes with me. I’m able to fully address all your concerns when you come in. It’s just a different approach,” Radbourne said.
Janelle Sebastian, who has been seeing Joelynne at her private clinic for the past six months, chose this option because of the reduced wait time.
“I choose to use this private clinic because the wait times are shorter, my appointments are not rushed. Joelynne spends an incredible amount of time with me to know my health history,” Sebastian said.
The head of the Saskatchewan association of nurse practitioners, Johanne Rust, says registered nurses have always been able to go into private practice and nurse practitioners are registered nurses first.
“All registered nurse practitioners became licensed in this province in 2004. So potentially any time after 2004, nurse practitioners were able to set up private practice. So that’s going on 20 years now,” Rust said.
Nurse practitioners provide many of the same services as doctors and therefore should be paid by the province.
“Essentially, there’s no difference between a doctor and a nurse practitioner anymore, and so it all depends on your underlying education,” Radbourne said.
“However, we do still partner with our colleagues. So, whether you’re following with a physician, a physician’s assistant or a nurse practitioner, we’re all supposed to use what’s called interdisciplinary care approach. A team-based care model.”
The problem here, the nurse practitioners say, is billing. Patients pay out of pocket for services rendered by the nurse practitioner.
“So, for my patients, it’s fee for service,” Radbourne said. “Patients come in, they see me, they pay a fee and they’re reimbursed by most of their third-party insurances.”
Those who don’t have health insurance have to pay out of pocket.
“This deters the number of patients I can see and the demographic of the patients that I can see, because not everybody can afford private health care,” Radbourne said.
“For some people it’s difficult because it’s out of pocket, I feel our government should take a look at this, the health system is very fatigued,” Sebastian said.
Radbourne is asking the government to let them bill the public system directly.
“I would love say, please open legislation and allow other disciplines to bill you guys directly… That access is so important to patients across all demographics. Whether you are low income, high income, educated, uneducated, you should be able to access to the same care as anybody else,” Radbourne said.
The nurse practitioners are asking the government to work with people in their profession who already have a growing scope of practice.
“Next year, we will be able to independently admit and discharge patients, which will make care for admitting people into long-term care facilities or other locations much easier and streamlined. We can do emergency room care. We can do long-term care. We can do prenatal care,” Rust said.
Rust says more nurse practitioners graduate every year, and if the province is not able to make good use of them, the graduates will go elsewhere.
“We are at risk of losing those nurse practitioners to other jurisdictions such as Alberta, where there is more opportunity to set up private practice. So, we are advocating and asking the government to look at ways to use all of our nurse practitioners rather than miss out on this opportunity for excellent care for the people in this province.”
Rust and her colleagues say if registered nurse practitioners who run private clinics are able to bill the government directly, more nurse practitioners will be encouraged to set up private practices that will reduce the pressure on the health care system.
In a written statement the Saskatchewan Ministry of Health says it is actively engaging with partner organizations, to identify opportunities to expand access to primary care, including utilizing nurse practitioners as an important part of the primary care team.
It says a pilot project is operating in Warman, it offers nurse practitioners led care as a way to expand the delivery of primary care offered to Saskatchewan residents.
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