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The question
I'm having a hard time finding a family doctor. Would seeing a nurse practitioner be an acceptable substitute?
The answer
This is a personal decision that needs to be based on being comfortable with a primary care provider.
With the challenge many Canadians face of finding a family doctor, a nurse practitioner (NP) can be a very acceptable option offering care that is safe, effective and comprehensive. NPs often work in collaboration with family doctors, so you can consider them part of a team that can support your health care needs.
NPs are registered nurses with advanced education and training that allows them to provide care relating to health promotion and disease and injury prevention. NPs practise in a variety of settings, including community health centres, urban and rural family practices, emergency rooms and long-term care facilities. Some have specific areas of expertise such as prenatal care and preventative care. They can perform health assessments, order and interpret tests, and diagnose and manage stable chronic conditions such as mood disorders, high blood pressure and diabetes.
While their prescribing privileges are limited, NPs may prescribe a wide variety of medications. Each province has legislation specifying which medications can be prescribed by NPs and which need the approval of a physician. For example, in most cases, narcotics would need a prescription from a physician.
When providing care for patients whose condition is more complex or unstable, NPs will transfer care to or work collaboratively with a physician. A classic example would be when a patient has unstable high blood pressure that is uncontrolled. Initially, a family doctor can be consulted to review and prescribe the appropriate medication. When the patient becomes stable, the NP can then return to being the patient's primary health care provider.
NPs are licensed in all provinces and territories across Canada. They were first introduced to our health care system in the 1960s in response to physician shortages in rural and remote settings. There was a renewed interest in NPs in the 1990s with the recognition of the important role they could play to decrease wait times, manage chronic diseases and help care for our aging population.
Several studies have confirmed NP patients have very good health outcomes when it comes to management of stable chronic diseases, and minor illnesses and injuries. Polls conducted on patients who are cared for by a NP have also shown high levels of satisfaction.
Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.
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