Photo: Renaud Philippe Archives Le Devoir A specialist nurse examines a child at the GMF in Saint-Étienne de Lauzon.
Isabelle Porter in Quebec
April 11, 2024
- Quebec
Nurse practitioners specializing in primary care (IPSPL) will be able to care for people registered at the family doctor access window (GAMF) from April 15, the minister announced on Thursday of Health, Christian Dubé. Until now, only general practitioners could do this.
“It greatly enhances the nursing profession,” the minister declared Thursday morning, looking forward to “improving access for all Quebecers.”
If all goes well, this change could melt the list of orphan patients in Quebec which still numbers 630,000 people. Indeed, a thousand nurses will eventually be able to each take care of between 250 and 800 patients, or between 250 and 800,000 people.
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However, the measure, which will come into force next week, will immediately affect only a few dozen IPS, the equivalent of two to four for each of the eleven specialized clinics already open.
Able to handle 95% of problems
To patients who might fear being less well served by an NP than by a family doctor, the minister retorts that NPs are capable of treating 95% of patients’ problems and that they can refer to doctors when this is not necessary. is not the case.
“We can’t just put pressure on doctors,” he said. Mr. Dubé also mentions that in certain family medicine groups (GMF), 95% of patients are already followed by an IPS even if they are paired with a doctor.
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For the moment, however, only nurses who work in the new IPS clinics will be able to take care of patients.
Those who work in GMF or in organizations like the SABSA clinic in Quebec do not yet have the power to do so. This will have to be the subject of financial negotiation with the Federation of General Practitioners of Quebec (FMOQ). Currently, FMOQ members who practice in GMF receive a bonus when they supervise a nurse.
Exodus to the private sector ?
On Thursday, Québec solidaire saw this announcement as “good news”. The party, however, fears that some of the IPS equipped with these new powers will leave the public network to practice in the private sector. In recent years, dozens of them have made this choice, mostly claiming that their working conditions were not sufficiently attractive.
“They will open their own private clinics, then they will charge money to patients,” argued Rosemont MP Vincent Marissal, who claims to receive complaints on this subject at his office constituency in Montreal.
Questioned on this subject, Minister Christian Dubé recognized the existence of “labor issues” in IPS clinics. However, he argues that “the debate on private matters” has “nothing to do” with his announcement.
The culmination of a process lasting several years
Good prince, Minister Dubé recognized that this progress was also the fruit of the work of his predecessors Danielle McCann and Gaétan Barrette whom he thanked.
Former Liberal minister Gaétan Barrette invested massively in 2017 to increase the number of qualified IPS in Quebec. From the approximately 100 recorded at the time, they should cross the 1,400 mark this year. As for Ms. McCann, it was she who passed Bill 43 in 2020 giving them more responsibilities.
“This confirms what the law allows,” reacted the vice-president of the Interprofessional Health Federation (FIQ), Jérôme Rousseau. The union now hopes that we do not stop there. “It should not be [done] for purely statistical purposes. […] I see Minister Dubé coming who is going to boast [of the fact] that there are fewer patients on the waiting lists. »
Ultimately, registered NPs will all have to be part of an interdisciplinary team, he says. Otherwise the patients to whom they are matched do not find themselves orphaned again during an absence or sick leave of an IPS.
A point of view shared by the outgoing president of the Association of Specialized Nurse Practitioners of Quebec (AIPSQ), Christine Laliberté. “It takes team ownership,” she says. We must not replace the idea of a family doctor for everyone, she continues, with that of an “IPS for all”.