Alberta nurse practitioners want to be able to own and run clinics

Nurse practitioners are calling on the Alberta government to allow them to run their own practices to help address the pressure on primary care.

As frustrated Albertans without family doctors languish in drop-in clinic waiting rooms for routine medical care, the Nurse Practitioner Association of Alberta says part of the solution sits in limbo, ready to go and waiting for bureaucratic changes.

"We are limited to working in a restricted manner for a wage that undermines our significant education, experience and scope," association president Susan Prendergast said at a Wednesday morning news conference in front of the legislature.

The association estimates a quarter of Albertans don't have a family doctor. Heading to emergency rooms for routine care is expensive, and unnecessary, Prendergast said.

The province suggests the problem is less dire, saying 85 per cent of Albertans are registered with a local primary care network.

Nurse practitioners are registered nurses with graduate degrees who can diagnose health conditions, prescribe medication, perform procedures, order tests and interpret the results.

They can work independently, just like a family doctor, but unlike doctors, they cannot bill the government for seeing patients.

There are about 800 NPs working in Alberta, and they have lobbied successive governments to expand their scope of practice and allow them to run their own clinics — particularly in rural and remote areas that are struggling to recruit doctors.

In its 2019 platform, the United Conservative Party pledged to "provide Albertans with increased choice of medical practitioners by increasing the number and scope of nurse practitioners in Alberta and allowing nurse practitioners the ability to bill directly to Alberta Health."

The UCP government has since added about 50 NP positions to primary health networks, tripling the number of those positions around the province. However, NPs still can't bill Alberta Health.

Association vice-president Karen Parker says some NPs have teamed up with doctor's clinics, where the doctor can bill the provincial government to cover the overhead costs when NPs see patients.

The province wants to see NPs play a larger role in primary care, said Steve Buick, the health minister's press secretary, in an email.

"We're working on plans to create more opportunities for NPs in primary care with their input," Buick said, adding that government is also looking at a funding model proposed by the association.

Buick did not directly answer a question about whether the government plans to honour its election commitment and allow NPs to directly bill Alberta Health.

Bouncing from doctor to doctor

Shayne Smith is among those who'd like to see more NPs taking patients in clinics.

The Calgary parole officer bounced between three doctors offices, one closing after the other. For problems such as workplace injuries and prescription refills, he would drive to urgent care centres in Airdrie or Cochrane, hoping the wait times would be shorter than in the city.

That was, until he got in to see a nurse practitioner.

"Rather than listen to me for 10 seconds and kick me out the door, I felt heard, I felt listened to, and I felt cared for," Smith said Wednesday.

With family doctors taking home sometimes double what an NP earns, Prendergast said the government should pay them on par with physicians.

The 450 NPs who work for Alberta Health Services and Covenant Health and mainly work in hospitals are currently in their first-ever round of collective bargaining with those employers.

Alberta Union of Nurse Practitioners president Anne Summach says the "hard part to swallow" for some NPs is working alongside registered nurses while earning less, but while shouldering more liability and responsibility.

She said NPs also have a crucial role to play in primary care, and that Alberta could be a model for using the professionals in preventive health care.

"The need is becoming urgent," Summach said. "More and more people cannot access appropriate care."