Dr. Sarah Bates, acting president of the family medicine section with the Alberta Medical Association, said she believes nurse practitioners have a role to play. But she thinks every Albertan should have access to a family physician. (Alberta Medical Association)
“It’s a false equivalency to think that a nurse practitioner is a family physician,” said Dr. Sarah Bates, the acting president of the family medicine section with the Alberta Medical Association.
According to Bates the messaging leaves family physicians feeling devalued, overlooked and disrespected.
“It’s injurious to family medicine to see investments into nurse practitioner clinics while family medicine is gasping.”
The relationship between family doctors and the provincial government has been fraught for years, sparked in large part by former health minister Tyler Shandro’s decision to rip up their master agreement early in 2020.
The pandemic, changes to fees, and an exodus of health workers have also left family doctors feeling burned out and many say they’re struggling to keep their doors open.
“The ministry must act immediately to stabilize what we already have. We have to stop the hemorrhaging in family medicine,” she said.
NPs push back
Susan Prendergast, president of the Nurse Practitioner Association of Alberta (NPAA), said she’s taken aback by the response from doctors.
“I think we’re fighting over — or arguing over — a word. No one likes to be ‘replaced,'” she said during an interview on Alberta at Noon.
“We’re not trying to undermine or make someone feel less valued. The point is is that there’s hundreds of thousands of people that don’t have a care provider and we can do the same work.”
According to Prendergast, B.C., Ontario, Nova Scotia and New Brunswick all have independent NP clinics in place and they work well.
“The reality is this is being done across the country … It’s about time. It’s past due.”
Training requirements
Nurse practitioners, she said, must obtain at least six years of education (a four-year undergraduate degree, followed by at least two years working full-time, and then a minimum two-year masters degree).
According to the Alberta College of Family Physicians, family doctors are required to have between eight and 11 years of training, including an undergraduate degree, medical school and residency.
Myles Leslie, director of research at the University of Calgary’s school of public policy, said allowing NP-led clinics could help improve access for Albertans.
“I think it’s kind of on-target. It’s consistent with moves that have been made elsewhere … Expanding capacities in places like pharmacies and nurse practitioner clinics seems like a viable option to me,” he said.
“It is neither going to be the panacea that solves everything nor the downfall of the system.”
Leslie says he’d like more details, including whether NP clinics will be encouraged to open in areas such as rural Alberta, where the family doctor shortage is most acute.
“They have a scope of practice and they will know, as part of their training, where those limits are. And their college will keep them to those limits.”