Most people across Canada will no longer need to pay nurse practitioners for primary care
Yvette Jarvis said that with no family doctor, she was forced to go to the emergency department to get her prescriptions refilled — a process that took 15 hours.
She soon went to a nurse practitioner (NP) and said she had paid about $2,500 over five years for the same service.
The St. John’s resident said the primary care she receives from a nurse practitioner is wonderful, but the service should be available to everyone without paying out of pocket.
“They gave me exactly the same care I would normally get from a family doctor, so I figure we shouldn’t pay $75 and it should be covered,” said Jarvis, 55.
Relief is coming for Jarvis on Wednesday, when she, along with most Canadians, will be able to see a publicly funded NP for services a physician would otherwise provide.
In January 2025, the federal government stated that provincial and territorial health plans must begin covering the services of NPs, pharmacists and midwives who provide primary care, setting a deadline of April 1, 2026, with enforcement to be initiated at a later date.
Instructions – mentioned in a “Explanation letter“The Canada Health Act – effectively modified which providers fall under the Canadian medical system to ensure that people are not being overbilled”Access to medically necessary care“
Patients in Ontario may have to wait a little longer, with the province’s health minister saying it won’t meet the April 1 deadline — but should do so by next year.
Delivered to approximately six million Canadians There is no family doctorNurse practitioners can help reduce the pressure on primary care physicians and the broader health care system.
nurse practitioners Applying clinical skills associated with nursing and medicine to assess, diagnose, and refer patients, mirroring many of the functions of a primary care physician, such as a family doctor or pediatrician. They work in family health teams and community health teams, hospitals and long-term care homes.
Jarvis said that despite her changing work schedule, the nurse practitioner was easy to reach.
“I want to continue my annual visits for my treatment or whatever the case may be,” she said.
NP says it feels as if ‘the shackles are being lifted.’
Jarvis said a relative who didn’t have a family doctor also benefited from the NP’s careful care, which gave her peace of mind.
Trent McDonald, who cared for both Jarvis and his family members, said the impending change means he will be able to take on 800 patients and be their primary health care provider not only when they get sick, but also for prevention and health promotion, such as keeping up to date on screenings.
“Since 2019, I’ve had some patients who weren’t able to pay me, and I knew it, so I never charged them,” McDonald said.
He said he can see the relief on his patients’ faces when he tells them the fees will soon be removed.
Commercially, McDonald’s compares this change to “the opening of the floodgates”. nurse practitionersAllows them to open their own clinics or join established clinics.
More Canadians have a family doctor than three years ago, but big gaps remain in access to timely or routine care, a new survey shows.
Ontario will not comply by 2027: ministry
While patients in most of the country will no longer pay out-of-pocket this spring, Ontario will be an exception.
Ontario Health Minister Sylvia Jones said the province Will not be able to follow suit Immediately, but also until April 1, 2027, when Ottawa can begin imposing fines on jurisdictions that are not in compliance.
There are more than two dozen publicly funded nurse practitioner-led clinics in the province, but those NPs are unable to establish independent practice. Their provincial association is pushing a model toward which many provinces and the Northwest Territories have moved, where NPs would be able to bill the government for their services.
“The Ministry of Health is actively reviewing and engaged in ongoing discussion “With provincial and territorial partners and the federal government regarding the implementation expectations of the federal government’s directive,” said Emma Popovic, a spokesperson for Ontario’s health minister.
“Nurse Practitioner-Led Clinics (NPLCs) that receive annual base funding from the Ministry of Health are already prohibited from billing patients or other entities for services covered under the agreement.”
The federal government has the discretionary power to withhold cash contributions to provinces and territories that fail to follow principles of the Canada Health Act, such as “reasonable access” to medically necessary care.
“Family physicians are not replaceable,” the college says.
Valerie Gridisa, CEO of the Canadian Nurses Association, said it’s “confusing” that Ontario lags behind other jurisdictions on NPs providing primary care.
Gridisa said the model could save taxpayers money. He gave a hypothetical example in which a family doctor billed the province $100 to see a patient, while an NP charged $75 to treat the same problem.
“As taxpayers we want our dollars spent in the right place at the right value, and we’re not spending it in the right place at the right value,” Gridisa said of Ontario.
The College of Family Physicians of Canada said in a statement that while it supports a single-payer, publicly funded health care system that provides universal access to essential medical services, “family physicians cannot be replaced.”
“They are uniquely trained and trusted to address key health concerns and replacing one role with another can create confusion and fragment care,” the statement said.
The college said that team-based care is about collaboration, which “works best when family doctors and other health care providers are able to use their full skills and training, and when everyone is clear about their role.”
A number of concerns were raised at a town hall on health care in Charlottetown Monday night. Big topic: Islanders who don’t have a family doctor. CBC’s Wayne Thibodeau was there.
But Gridisa, who previously worked as an NP in hospitals, said there is still much work to be done to meet the health care needs of Canadians.
“We really have to stop turfism and protectionism and the degradation of each other and build the right models of care based on eligibility for entry into practice,” he said.
Whether it comes from a physician, an NP or a pharmacist, “medically necessary care” is a gray area and its definition needs updating, said Erin Strumpf, a professor of health economics at McGill University, who conducted the study. financing primary health care in Canada.
“You want to protect patients and make sure they are getting high-quality care from qualified providers,” Strumpf said. “But you also need to balance the ability for people to get care from the provider of their choice.”
Other researchers have proposed more federal funding for primary care. strong case for fair access Under the Canada Health Act.
