Nurse practitioners have a key role to play
Government must address any unfair billing practices, writes
I am writing regarding the Ottawa resident who was charged for a Pap test. As a primary care nurse practitioner (NP) with almost two decades of experience, my commitment has always been to fair and equitable access to health care. I share your subject's outrage at the situation described.
It is deeply troubling that individuals are burdened with charges for essential health care services, especially when those services are supposed to be covered by OHIP. The incident you reported on likely reflects exploitive billing practices on the part of the employer. It is concerning that the nurse practitioner involved may be unfairly shouldering the blame.
Identifying problems is indeed the first step toward innovation and finding effective solutions. Recent negative press surrounding nurse practitioners has only added confusion. It is crucial to recognize that NPS resorting to private practices and charging residents for care is about “need and not greed.”
Statistics provided by the Ontario Medical Association suggest Ottawa needs 171 family doctors immediately. According to the College of Nurses of Ontario, the province boasts the largest number of NPS in Canada, with Ottawa having the second-largest number. So the situation is that we have a discrepancy between the supply of NPS and the demand for doctors.
What is a nurse practitioner? NPS are registered nurses with advanced university education and experience who provide a full range of health care services. NPS independently diagnose illness and health-care conditions, can prescribe all medications, and can order diagnostic imaging and laboratory tests for their clients as well as refer them to specialists.
NPS can also admit and treat patients in hospitals and long-term care homes. Unlike doctors, nurse practitioners cannot bill OHIP directly for patient visits and therefore must be funded on a salary-based model of care.
Nurse practitioners are already on the front lines of health-care delivery, providing high-quality care and managing complex health conditions. They are keeping residents out of expensive ERS and decreasing hospital length of stay.
Nurse practitioner-led clinics are a team-based model that integrates health promotion, disease prevention, chronic disease management and care co-ordination for clients of all ages and their families. Ontario was the first province to recognize this effective model: there are 25 Np-led clinics in the province, serving approximately 100,000 Ontarians. Everyone who works in an Np-led clinic is salaried by the Ministry of Health, similar to the model in community health centres, where physicians are also salaried.
It is my hope that the government will continue to prioritize such investments and course-correct to enable NPS to practise independently and take necessary measures to address any issues of exploitation or unfair billing practices within the healthcare system. Thank you for bringing attention to this important issue through your reporting.