Without a family doctor, Yvette Jarvis said she was forced to go to the emergency department to fill her prescriptions — a process that took an incredible 15 hours.
She soon switched to a nurse practitioner (NP) instead, and said she paid nearly $2,500 over five years for the same service.
The St. John resident said the primary care she receives from a nurse practitioner is excellent, but the service should be available to everyone without paying out of pocket.
“They gave me the same care that I would normally get from a family physician, so I feel like we shouldn’t have to pay $75 and it should be covered,” said Jarvis, 55.
Relief comes for Jarvis on Wednesday, when he, along with residents in many parts of Canada, will be able to look to a publicly funded NP for services that a doctor would otherwise provide.
In January 2025, the federal government said provincial and territorial health plans must begin covering the services of NPs, pharmacists and midwives who provide primary care, setting a date of April 1, 2026, with implementation thereafter.
Manual – explained in one “Interpretation letter“Canada’s Health Act – Effectively overhauled which providers fall under Canada’s Medicare system to ensure people are not overbilled”Access to medically necessary care“
Patients in Ontario will likely have to wait a little longer, with the province’s health minister saying it won’t meet the April 1 deadline — but it should by next year.
Given that nearly six million Canadians do not have a family doctor, nurse practitioners can help relieve pressure on primary care physicians and the broader health care system.
Nurse Practitioners Apply 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 physician or pediatrician. They work in family health teams and community health teams, hospitals and long-term care homes.
Despite her rotating work schedule, access to a nurse practitioner was easy, Jarvis said.
“I want to continue my treatments or whatever the case may be; my own annual visits,” she said.
It feels like ‘the bellies are falling,’ says NP
A relative who doesn’t have a family doctor also benefited from NP care, which provided them with peace of mind, Jarvis said.
Trent MacDonald, who provided care to both Jarvis and her family members, said the imminent change means he will be able to take 800 patients and be their primary health care provider not only when they are sick, but also for prevention and health promotion, such as keeping screenings up to date.
“Since 2019, I’ve had some patients who haven’t been able to pay me, and I know 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 drop.
Professionally, MacDonald likens the change to the “coming of age” for nurse practitioners, allowing them to open their own clinics or join established clinics.
A new survey shows more Canadians have a family doctor than three years ago, but large gaps remain in accessing timely or regular care.
Ontario will not comply until 2027: Ministry
While patients in many parts 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 do so immediately, but rather until April 1, 2027, when Ottawa can begin imposing fines on jurisdictions that do not comply.
The province has more than two dozen publicly funded clinics led by nurse practitioners, but these NPs cannot establish independent practices. Their provincial association is pushing for a model similar to what many provinces and the Northwest Territories are moving toward, where NPs would be able to bill the government for their services.
“The Ministry of Health is actively reviewing and working An ongoing conversation Emma Popovich, a spokeswoman for Ontario’s health minister, said the federal government is expected to implement the guidelines with provincial and territorial partners and the federal government.
“Nurse Practitioner-Led Clinics (NPLCs) that receive annual 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 grants to provinces and territories that fail to comply with Canada Health Act principles, such as “reasonable access” to medically necessary care.
Family doctors are irreplaceable, the college says
Valerie Gardesa, executive director of the Canadian Nurses Association, said it’s “paradoxical” that Ontario is lagging behind other jurisdictions in NPs’ primary care provision.
Gardisa said the model could save taxpayers money. She gave a hypothetical example of a family doctor paying $100 to the province to see a patient, charging $75 to treat the same issue with an NP.
“We as taxpayers want our dollars to be spent in the right places at the right value, and we’re not spending them in the right place at the right value,” Gardisa said of Ontario.
The Canadian College of Family Physicians said in a statement that while it supports a single-payer, publicly funded health care system that offers universal access to essential medical services, “family physicians are not irreplaceable.”
“They are specially trained and trusted for major health concerns and overlapping one role with another can create confusion and fragment care,” the statement added.
The college said team-based care is about collaboration, which “works best when family doctors and other health care providers can use their full skills and training, and when everyone is clear about their roles.”
In Charlottetown, Monday night, there was a lot of concern in the town of health care. Big issue: Islanders who don’t have a family doctor. CBC’s Wayne Thibodeau was there.
But Gardesa, who previously worked as an NP in hospitals, said there is plenty of work to go around to meet the health care needs of Canadians.
“We really need to stop tyrannizing and conservatism and reducing each other by building the right models of care based on our entry-practice capabilities,” she said.
Whether it comes from a doctor, NP or pharmacist, “medically necessary care” is a gray area and its definition needs to be updated, said Erin Strump, a professor of health economics at McGill University. Primary health care financing In Canada
“You want to balance protecting patients and making sure they’re getting high-quality care from qualified providers,” Strumpf said. “But you need to balance people’s ability to access care from the provider of their choice.”
Other researchers have suggested more federal funding for primary care is tied to a A strong case of reasonable access Within the Canadian Health Act.
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