New legislation in Nova Scotia has paved the way for greater use of nurse practitioners (NPs), but it makes no allowances for paying for them.
Under the Registered Nurses Act, certified nurse practitioners who work in collaborative settings with family physicians can now see patients, make diagnoses and write some prescriptions.
Although the Medical Society of Nova Scotia supports the collaborative model, President Bruce Wright wonders how the nurses will be paid. The province hasn't set aside money for their salaries, and it appears that physicians are expected to foot the bill. Health Minister Jamie Muir says preliminary results from 4 pilot projects in the province indicate that NPs free physicians to perform other duties. In some cases, he says, doctors were able to see 40% more patients, and thus the use of NPs should pay for itself.
Wright is skeptical, and says it is simply not feasible to add NP costs to an office's overhead; NP salaries would be in the $50 000 range.
Still, the province is counting on NPs to ease its physician shortage. “Nurse practitioners can help tremendously in rural areas by working with family physicians to address a range of health concerns of patients, providing continuing care and sharing the patient load,” says Muir. “This leaves doctors to use their special skills where they are most needed.” — Donalee Moulton, Halifax