Op-Ed: Nurse Practitioners Provide Solution to Alberta’s Primary Care Crisis

This op-ed was written by Dr. Susan Prendergast, President of the Nurse Practitioner Association of Alberta

Alberta voters currently find themselves in the middle of a polarizing election. And while there seems to be little the two main parties can agree on, there does seem to be one commonly accepted fact: our province has a serious problem with access to primary care.

Roughly one-in-four Albertans lacks access to a primary care provider. This means over 1 million Albertans are left to access their care from walk in clinics, urgent care, or hospitals - leading to higher cost and lower quality primary care delivery. When the foundation of our healthcare system is strained due to lack of access, the other layers of our health care system suffer, resulting in increased wait lists and higher burnout levels among vital health care providers. 

Visiting walk-in clinics or ERs means a different health practitioner will treat the patient at each visit and will not know the medical history or other pertinent information about lifestyle, mental health, and others that play an important role in finding the right solution for an individual. Long wait times at walk-in clinics and ERs also make it more likely Albertans will ignore health problems for as long as possible, ultimately leading to more severe problems. This is a loss both for personal health and our health system responsible for paying for treatment.

So, what exactly is the root cause to the lack of access to primary care? We have heard from the Alberta Medical Association (AMA) that the political climate in Alberta has resulted in fewer medical graduates choosing family medicine as their first or even second career choice, leaving dozens of unfilled, fully funded residency spots in Alberta this year. So, the continued reliance on increasing physicians to improve primary care in Alberta, through increased recruitment, training or retention strategies will not address our primary care access needs.

Luckily, there is a simple solution to fixing the primary care crisis in Alberta, and it is right under our nose: direct funding to Nurse Practitioners (NPs).

What exactly are NPs? NPs are master’s or doctorally prepared health professionals (former registered nurses) who provide essential healthcare services such as primary care, outpatient clinic-based care, or hospital care. They assess, diagnose, treat and manage medical presentations similarly to a physician. Simply put, NPs provide primary care that is of the same quality as a family physician. 

There are currently over 800 NPs registered in Alberta. Unfortunately, there is not a direct funding framework in Alberta that allows NPs to work independently in the community to provide primary care. Empowering NPs to be able to open and lead clinics would mirror what is taking place across Canada where other provincial governments are already funding NP-run clinics. This improves access to care while keeping NP care financially accessible to the public. Other provinces are already doing this because it makes sense!

With other provinces taking this obvious step to plug the gap in access to primary care, the empowerment of NPs has now become an even more urgent issue in Alberta. Many NPs in Alberta will begin to look east, west or south if they know that other health systems will enable them to operate to their full capacity while funding them with equitable reimbursement. 

 Solving the crisis in access to primary care is simple and can be done quickly. There is no need to introduce new legislation or to amend existing legislation. All the Government of Alberta has to do is implement a direct funding model for NPs, such as what is available to physicians and NPs in other provinces.

There is no debate about the capabilities of NPs in the medical system. The only thing missing is the political willpower to empower NPs before it’s too late. If the government waits any longer, Albertans  will undoubtedly lose a ton of talent to other provinces that appreciate the value that NPs bring. It’s time for all parties to clearly articulate where they stand.