With more than 6.5 million Canadians currently without a family doctor, and that number climbing to 10 million by 2026, many people are scrambling to find solutions to their ongoing healthcare needs.  

Regular access to a primary care practitioner is vital in preventing illness, managing chronic disease, helping with pre- and post-natal health, and addressing acute injury or illness.  

One study shows that when patients have long term access (>15 yrs.) to a family doctor, there is a 30% reduction in walk-in clinic and hospital admission, and a 25% reduction in mortality compared with a patient who has had only 1 year of access to a family doctor. 

One of the many interim solutions being thrown at this physician shortage crisis is the promotion of the Nurse Practitioner (NP). 

What Care Do Nurse Practitioners Provide? 

Nurse practitioners first appeared in Canada in the 1960s mainly to provide care in remote areas. By the 1970s, interest in the NP role increased and more education programs were introduced.  

Today, Nurse Practitioners can take on much of the role of a family doctor, helping patients with preventive care, care for chronic diseases and access to specialists in the case of illness. 

Just like family doctors, they provide primary patient care, ideally bringing a holistic overview to their relationship with their patients. Nurse practitioners place a significant focus on teaching patients about their health conditions and treatment recommendations. 

They help with their patients’ needs relating to their physical and mental health. Specifically, NP’s can: 

  • Autonomously diagnose and treat illnesses. 
  • Order and interpret tests. 
  • Prescribe medications. 
  • Perform many medical procedures. 

These highly trained medical professionals are quickly becoming an essential part of the fabric of our medical system and are touted to help alleviate the family doctor shortage. 

But is it as simple as that? 

The Difference Between MD’s and NP’s 

Much of the difference between MD’s and RN’s comes down to education and clinical experience.  

NP’s are not as educated as MD’s, but are not too far off. An NP must first become a registered nurse (RN) before earning a master’s in nursing and passing the nurse practitioner’s certification exam. They must also have full-time clinical experience as a registered nurse. 

In contrast, family doctors must obtain their undergraduate degree, graduate from an accredited medical school, pass practical and written exams and complete residency training.  

Doctors examine patients, order lab tests, and evaluate the physical and mental health of patients. They prescribe and administer medications and treatments, perform, and assist in surgeries and in delivering babies, and provide emergency care, acute care, vaccines, and pre-natal and post-natal care. They often work in their own practices, or within a healthcare organization. 

NPs often work within teams of other health professionals such as physicians, mental health professionals, pharmacists, and social workers. In a growing number of cases, just as with doctors, they lead their own practices.  

In complex cases, when things go beyond their knowledge or skill, nurse practitioners must consult and collaborate with physicians and other healthcare professionals. Their scope is still somewhat limited compared to a medical doctor. 

NP’s Setting up Private Practices; Out of Pocket Care 

In theory, the role of a nurse practitioner is to complement the work of a patient’s healthcare team, including the family doctor. However, with the current shortage of family doctors, they can now pick up the slack in the circle of care, and a growing number of patients are now turning to NP’s as an alternative. 

Controversy is brewing in some provinces such as Ontario where nurse practitioners are not allowed to bill OHIP for their services like physicians do. Instead, they earn a salary when working within a family health team. 

As a result, private, independent nurse practitioners charge the patient fees for their services, even if the service is technically covered by provincial medicare.  

A more recent trend is for NP-led private clinics to offer a variety of primary care services in return for an annual fee. Pricing is variable depending on the clinic, costing anywhere from $300 and up. If you are not an annual member, you will be charged for the services and tests you require at each visit. 

Private health insurance may cover the out-of-pocket costs, so be sure to ask if you can be reimbursed if you have private coverage. 

For Ontario residents: To find a Nurse Practitioner-Led Clinic near you, visit https://npao.org/nplcs/.

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