The Quebec government is in intense negotiations with family doctors to allow nurse practitioners more autonomy.
Quebec Health Minister Danielle McCann says she expects the number of nurse practitioners in the province to jump from 500 to 2,000 in the next five years.
That could allow more Quebecers to have faster access to medical treatment.
McCann insists nurse practitioners — also nicknamed “super nurses” — need to be more autonomous and can handle minor issues without having to refer patients to a doctor.
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“We know that they’re trained to do that, to give the diagnosis and follow-up with the patient,” she said, adding 500,000 people are still waiting to be registered to a family doctor or family medicine team (GMF).
“It’s done already in all the other provinces in Canada. We’re the only province where that situation [nurse practitioners being obliged to refer patients to doctors] still exists.”
McCann argues it’s time to make a change that will also support family doctors by giving them a team to work with.
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As part of the negotiations with the Quebec College of Physicians and the Fédération des médecins omnipraticiens du Québec (FMOQ), the province said it is willing to change the way doctors are paid — per patient instead of per act.
“We are not looking to diminish the salaries of family doctors — not at all,” McCann insists.
“On the contrary, when they take on more patients, they will get the same salary, but we just want to give more services to people who are waiting.”
McCann says she believes this could encourage family physicians to take on more patients and delegate services to other members of their team.
“Physicians are recognizing that they need to have a team with them,” she said.
“The physicians are not able to provide all the services, they need the help of their team members.”
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She notes consultations could possibly also be done over the phone or online.
“For us, at this moment, we always have to remember that diagnoses is a medical question,” said Louis Godin, FMOQ president.
“For us, the most important question is how all the other health professionals will work with us, in our medical organization.”
“It’s very important to work in collaboration to help the family physician in their practice.”
Godin adds there are currently 350 nurse practitioners working with family physicians.
He argues there is a limit to what nurse practitioners can do as they don’t have the same training as doctors.
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Sol Zanetti, Québec Solidaire third opposition group critic for health, said it seems there are “cultural obstacles” that still need to be overcome.
“It’s obvious that if a certain task is associated with a certain amount of money, you have an interest of wanting to keep all the acts for yourself, as a group, as a profession,” he said.
“We have to break this dynamic in order to make sure the system is more efficient. We have to change the way doctors are paid.”
Sylvain Gaudreault, the Parti Québécois’s second opposition group critic for health, adds there needs to be clarity about how the plan will be funded.
“For us, it’s a very important issue and we want to take all measures to achieve this,” he said.
The health minister she hopes this plan will be implemented within the next year.