Alberta plan to empower nurse practitioners is an innovative approach to healthcare reform

By Emmanuelle Faubert
and Krystle Wittevrongel

Nearly one in eight Albertans don’t have access to a family doctor.

That makes for roughly 600,000 of our fellow citizens who don’t have a physician regularly following up on their health and tracking its evolution.

Alberta Premier Danielle Smith and Health Minister Adriana LaGrange have made two announcements – one on Alberta Health Services reform and one regarding nurse practitioner clinics – that aim to address this issue.

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Alberta’s plan to empower nurse practitioners is an innovative approach to healthcare reform

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And while this is far from the first time a government has promised a reform that would give every Albertan access to a primary care professional, there are good reasons to believe this time could be different.

Both announcements have made clear that going forward, nurse practitioners will be able to open their clinics and help provide family health coverage for Albertans in the same way as family physicians do.

Nurse practitioners are equipped to do much more than simply assist doctors. As part of their training, they learn how to assess, diagnose, and treat multiple conditions, order diagnostic tests, prescribe certain medications, and make referrals to specialists. In many ways, their area of competency intersects with numerous duties that were once the exclusive domain of family doctors.

But while nurse practitioners have proven expertise in performing such tasks, which are part of their scope of practice, the lack of a compensation mechanism has meant they couldn’t get paid for their work if they performed those acts in a clinic.

Given the current shortage of family doctors, recognizing these nurse practitioners’ specialized training and enabling them to provide the care they are trained to provide in their very own clinics can bring care to those who need it while allowing family doctors to focus on more complex cases.

That is precisely the issue Minister LaGrange addressed in announcing the province’s plan to help set up nurse practitioner clinics. To enable nurse practitioners to establish such facilities, the provincial government is introducing a new compensation mechanism so that they can get paid for performing these medical acts.

It should come as no surprise, then, that Susan Prendergast, head of the Nurse Practitioner Association of Alberta, applauded the government’s proposal for reform, saying, “The proposed changes have the potential to position Alberta as a leader in primary care.”

It’s important to note that the idea of setting up nurse practitioner clinics isn’t untested, either.

Ontario pioneered in the field, opening the country’s first nurse practitioner clinic in 2007. The project has been so successful that 25 such clinics operate in the province today.

In Quebec, the SABSA co-operative opened over a decade ago as a research project aiming to show local politicians the effectiveness of the nurse practitioner clinic model in more specialized care, focusing on the treatment of hepatitis C and HIV-positive patients from vulnerable communities with limited access to the traditional health system.

The success of the SABSA co-operative has been astounding, with over 4,000 patients now receiving care from the clinic’s health professionals. The latest data shows that the clinic’s staff is able to meet a full 95 percent of its patients’ needs. The other five percent is covered by an on-call doctor with whose help the clinic can create pathways of care by directing patients to the appropriate health professional.

Given this success, Quebec plans to open 23 more nurse practitioner clinics within the next five years, bringing the province’s total to 30.

There’s no reason such success couldn’t be replicated here in Alberta. And for the 600,000 of us who don’t have access to a family physician, the Smith government’s plan to do just that is a breath of fresh air.

Emmanuelle B. Faubert is an economist and Krystle Wittevrongel is a senior policy analyst and Alberta project lead at the Montreal Economic Institute.

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