Quebec authorizes NPs to care for patients without a family physician

Nurses specializing in primary care (IPSPL) will be able to care for people registered in the Family Doctor Access Window (GAMF) from April 15, Health Minister Christian Dubey announced on Thursday. Until now, only general practitioners could do this.

“This greatly improves the nursing profession,” the minister announced Thursday morning, looking forward to “improving access for all Quebecers.”

If all goes well, the change will melt Quebec's orphan patient list of 630,000 more. In fact, a thousand nurses could eventually each care for 250 to 800 patients, or 250 to 800,000 people.

However, the move, which will take effect next week, will immediately affect only a few dozen IPSs, the equivalent of two to four for each of the eleven specialty clinics already open.

95% of problems can be solved

For patients who fear that an NP is less well served than a family physician, the minister responded that NPs are capable of treating 95% of patients' problems and that they can see physicians when this is not needed. .

“We cannot put pressure on doctors,” he said. In some family medicine groups (GMF), 95% of patients follow IPS even though they are affiliated with a doctor, Mr. Dube notes.

However, for now, only nurses working at the new IPS clinics can attend to patients.

Those working at GMF or at institutions such as the SABSA clinic in Quebec do not yet have the authority to do so. This should be subject to financial negotiation with the Federation of General Practitioners of Quebec (FMOQ). Currently, FMOQ members who practice at GMF receive a bonus when they supervise a nurse.

Out to the private sector?

On Thursday, Québec solidaire saw the announcement as “good news.” However, the party fears that some IPS with these new powers will leave the public network and train in the private sector. In recent years, dozens of them have made this choice, often saying that their working conditions are not attractive enough.

“They will open their own private clinics and then they will charge the patients,” argued Rosemont MP Vincent Maricel, who says he receives complaints on the matter in his constituency office in Montreal.

Questioned on the matter, Minister Christian Dubey acknowledged there were “manpower issues” at IPS clinics. However, he pleads that “discussion on personal matters” has “nothing” to do with his announcement.

The culmination of a process spanning many years

The good prince, Minister Dube, recognizes that this progress is the result of the work of his predecessors, Daniel McCann and Caden Barrett.

Former Liberal minister Gaétan Barrette invested heavily in 2017 to increase the number of qualified IPS in Quebec. From approximately 100 identified at the time, this year they should exceed 1,400. Ms. For McCann, passing Bill 43 in 2020 gave them more responsibilities.

“It confirms what the law allows,” replied Jérôme Rousseau, vice-president of the Interprofessional Health Federation (FIQ). The union now hopes we won't stop there. “It doesn't have to be [fait] Purely for statistical purposes. […] I see Minister Dube coming who is going to brag [du fait] There are fewer patients on the waiting list. »

Ultimately, he says, all registered NPs should be part of an interdisciplinary team. Otherwise, the patients they are implanted with will not find themselves orphaned again when they are out of IBS or on sick leave.

That's a sentiment shared by Christine Laliberté, outgoing president of the Association of Specialized Nurse Practitioners of Quebec (AIPSQ). “It takes team ownership,” he says. We shouldn't change the idea of ​​a family doctor for everyone, “IPS for everyone,” he continues.

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