Nova Scotia

Nurse practitioners could replace doctors at some walk-in clinics

The province plans to reduce the fees paid to doctors at walk-in clinics as part of a process to have more nurse practitioners staff the sites.

Fee changes for doctors to open new opportunities for 'underutilized' nurse practitioners

Changes to the fees paid to doctors at walk-in clinics could mean more work opportunities for nurse practitioners in the province. (Martin Barraud/Getty Images)

Nurse practitioners could eventually replace doctors at some walk-in clinics in the province.

In a recent note to doctors about the contract they're currently voting on, officials with Doctors Nova Scotia mention that the province wants to reduce how much doctors are paid for services provided at walk-in clinics. Changes would be phased in, with no more than a 10 per cent reduction each year.

Walk-in clinics won't close

Last week, Health Minister Leo Glavine said the change is part of a plan to move nurse practitioners or family practice nurses into some of the clinics.

"It's part of a long process," he said. "We do not plan to close or reduce the walk-in clinics."

The minister said he's met with representatives of the Nurse Practitioners' Association of Nova Scotia and the group welcomes the chance to have access to new work opportunities.

No jobs for recent grads

While the provincial health authority plans to move to a collaborative primary care model—which would include nurse practitioners, family practice nurses and other professionals—that could take up to 10 years to complete.

Right now nurse practitioners are an underused resource, said Nova Scotia Nurses' Union president Janet Hazelton.

"As a matter of fact, we had 15 graduates last May and none of the 15 are currently employed as nurse practitioners," Hazelton said on Wednesday.

At sites where nurse practitioners are a regular part of service, such as the collaborative emergency centres, patients are happy with the experience, said Hazelton. And because they are able to write prescriptions, order tests and offer diagnosis services, patients don't need to see a doctor in many cases, said Hazelton.

Janet Hazelton, the president of the Nova Scotia Nurses' Union, with Health Minister Leo Glavine. (Steve Berry/CBC)

The health authority's goal is to eventually reduce people's reliance on walk-in clinics as collaborative practices become more common. Glavine said some clinics might be ready to change their set-up quickly, while others might need more time.

"We have those private contracts that some of the clinic owners have established with doctors," he said. "So it's not a clear path forward, but over time there will be a transitioning going on."

Plenty of work to go around

Hazelton said it's not uncommon for people—nurses included—to get territorial as the scope of practice increases for some professions. But there is plenty of work to go around within the system, she said, and everyone needs to work toward finding how best to make it operate.

"We need to come together and talk about where would the nurse practitioner best fit: in what community [and] looking after what population?"


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