Doctorless clinics of Quebec: Why not let patients decide?

quebecmedicineThe “super clinics” project of Quebec, announced just a few weeks ago by Health Minister Gaétan Barrette, is bumping up against various obstacles and attracting serious criticism, whereas an efficient and cost-effective solution for improving access to health care already exists.

Indeed, “super nurse” clinics, which have seen the light of day over the course of the past year, are now allowing thousands of Quebecers to enjoy quick access to front-line care.

Yet the government insists on maintaining a rigid, physician-centric model rather than allowing innovative solutions like doctorless clinics to emerge.

As part of its health care research program, the Montreal Economic Institute I has produced a short documentary looking at the efficiency of this new model of clinics led by specialized nurse practitioners (SNPs). Pascale Déry, Senior Advisor in Communications and Development at the Institute, met with SNPs on the ground and with patients using these clinics.

“A nurse practitioner can look into a child’s ear and see that it’s red and swollen and antibiotics are required,” said one of the patients interviewed. “I don’t need to wait 20 hours to see a doctor for that. It’s ridiculous.”

Health Minister Gaétan Barrette, Isabelle Têtu of the SABSA clinic, and Régine Laurent, President of the Fédération interprofessionnelle de la santé du Québec, who are all at the heart of the debate, agreed to take part in the documentary.

“In every other sphere of activity, and particularly in economics, the government keeps saying that markets need to be liberalized. So why, when it comes to health care, are we not able to have this variety that meets people’s needs?” asked Régine Laurent when she was interviewed.

SNPs cost the health care system around 1/3 of what general practitioners cost, and can make diagnoses and prescribe certain drugs, activities formerly restricted to doctors. There are 294 specialized nurse practitioners inQuebec, versus 2,134 in Ontario. Whereas the neighbouring province also has 25 public “super nurse” clinics,Quebec’s public health system has none.

“Thankfully, the private sector has stepped in to remedy the situation. There are more and more nurse practitioner clinics responding to patients’ needs, without having the Department dictate their every move,” says Pascale Déry. – CNW

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