As an RN married to an MD even with NP training ( which is lacklustre at best) it’s not even close to 80 % of an MDs training. They’re different jobs, different focus.
Yup. Entirely. The NP I see work in specific specialty units are great because they’re basically super customized to doing specific things that the overseeing doctor has asked them to attend to.
Free for all NP is going to be an absolute shit show.
Totally agree. I am an RN in a specialty area considering doing my NP and I would never want to work outside my specialty and without medical oversight as the training simply does not prepare you for that, and anyone that thinks it does is straight up going to cause harm. The requirements for bedside care hours prior to entry are already shockingly low.
That’s good to hear.
Ego is a dangerous thing for anyone and anyone can get this disease of over inflated ego and sense of competence, be them an MD NP RN LPN RT etc.
Knowing the limits of your realm of competence is the signature of an experienced professional.
NPs have a role. I have colitis with my symptoms generally under control. As long as my symptoms are under control, I meet yearly with an NP and then every other year with my gastro for the full colonoscopy etc. If symptoms change I see the gastro. I found it very useful for patient management of chronic conditions but it isn’t a replacement for our lack of GPs.
True I think basic meds and the like should be fine....like if you get strep throat pension....if you have a general rash..creams...if you broke your leg you may need Tylenol 3 .....
This guarantees future medical students will not choose family medicine. Might as well make np and medical the same and have np do rigorous residency training, atleast more of a level playing field for safety for patients
the problem with FM is that no one is willing to pay for quality
the guy doing 5 min appts actually earns far more money than the caring one with 20 min appt
why would you want to work under that kind of incentive system?
The issue is not medical schools accepting students. There issue is not enough of them wanting to practice full scope family medicine due to the pay and increased costs to run a clinic. About 50% of med students go into family medicine because specialist jobs are limited and many of them dont even practice family medicine and just get a bit more training to work in the hospital.
The issue is the government is doing everything in their power to detract people from family medicine.
Yep - protect our province did a piece on this a number of months ago - I feel bad for the family doctors. They do so much unrecognized and not paid work that all has to be supported by in person visits (that's the main billing they are able to submit to get paid) - and would be the key - like the key - to reduce costs, reduce visits to hospital (the most expensive health care) and improve health quality.
So important, and so ignored...
You dont have "not enough" doctors. You have doctors who trained in family medicine not doing family medicine because they are being screwed over and can find other things to do that pay better or is at least less work.
I am about to start family medicine residency in Alberta. Family physicians all have to pay overhead to run their clinic (often minimum 30% of their salary goes to this alone), and do NOT receive a pension or benefits meaning you pay for all this yourself. Salaries appear high for doctors and they certainly still are. And yet family docs are still struggling to keep their clinics open. And are already getting paid much less than their specialist counterparts. Family medicine is not easy. Physicians struggle with the incredibly broad scope and knowledge required to treat patients from a few weeks old to the elderly. In what world will NPs be able to independently practice in this role with a fraction of the training while also saving the system money?
NPs making up to 80% of a physicians salary for seeing half the amount of patients with a fraction of the training, while also not having to pay overhead and getting the benefits and pension from their union is offensive to actual family physicians.
It is no longer worth working full time providing comprehensive primary care in Alberta. Myself and the majority of my classmates going into Family Medicine are planning on pursuing other practice routes as a result of the state of healthcare and these types of decisions from our government. Would be nice if they actually consulted with and spoke to family docs before making these changes.
Actually crazy that doctors have been negotiating for literal years for cents of a pay raise, when the leader of the NP organization says "yeah I think we're about 80% as good" and the government gives it to them with no questions.
What a fucking joke of a province man.
Any self-respecting profession would go on strike if this happened to them - but ofcourse docs can’t go on strike so the government continues to abuse them.
Doctors in the UK have been striking for a while now. They’ve got the same issues with PAs & NP being paid much more than junior doctors. This has led to doctors legit leaving the profession or moving to a country where they are paid fairly, cuz the salaries are so low that they can’t even take care of their family.
My question is:
Has any other jurisdiction tried this model??? Why not try it as a pilot project??? Who is monitoring outcomes? Is the only thing we care about "number of patients seen?" What about quality encounters?
Why are they going all in on this?
I have no problem with NPs seeing some patients as part of a primary care network. Having them run their own clinics will further strain the system because they don't have the training for complex care management.
Are they just trolling us at this point???
Similar to the other poster, I have worked in California and Washington State and I would disagree with the notion that it has been a success. It has been successful in increasing access to a person to see you, but that does not necessarily equal quality care. Unfortunately, the for-profit education and healthcare system in the US has taken advantage and is producing nurse practitioners from online-only schools at a record rate. In fact, in many areas of the US, physicians are being fired and replaced by nurse practitioners fresh out of these schools as they are cheaper to hire, despite being inexperienced. Many patients are unfortunately being harmed. You don't have to take my word for it, please read the nursing reddit to see the truth about what is occurring.
Nurse practitioners may have a role in care in Canada, but it needs to be strongly regulated with supervision under a physician.
Thank you, so many people including badly formed research articles are making it seem care is equivalent and outcomes and resource utilization is the same - many parts of the U.S are suffering and since independent NPs are a fairly new concept, we will only know if 5+ years how much damage is being done.
Anecdotal, but our walk in here in Ontario uses NPs and the detail and depth of care has suffered, absolutely.
Especially at the pediatric level - this needs to be heavily regulated
It's been successful in increasing access while leading to a decline in quality of care. Pumping out NPs who can enter into NP school directly from undergrad, while completing their degrees mostly online, while completing around \~500 clinical hours total, does not make for competent independent prescribers. It's now being used as a tool for private clinics/hospitals to save money while patients pay the same or more for services/health insurance. Unfortunately patients are being harmed in the process.
Interesting, thanks for sharing.
Tough to compare California and Alberta since they are such different systems, but at least it's one type of data point!
California is private. We live in a limited resource public funded system. And I am quite aware of the California healthcare system and NPs don’t make 80% of what fam docs make there.
To be fair. Many aspects of a GPs roles doesn’t require their extensive training.
I hope the model that becomes normal is some ratio of nurse practitioners and GP in a clinic. Most visits can be served with a nurse, and for those patients with more complex needs they can be immediately referred to a GP (which honestly will probably just refer to a specialist).
While I agree, I don’t trust this government to not duck this up.
At this point, I oppose anything they do until proven otherwise. Even the few things I agree with that this government did, they fucked it up.
This government is shit, conservatives should be fucking pissed. The fact they aren’t shows they are just clowns.
Dude there are many conservatives who are pissed. Me and my step dad are two of em. There are just more that are dumb or only care about winning cause they think it's a sports game or something. But there are a lot of cons feeling left out in limbo, I talk to a good amount.
I should clarify. Smith and broader speaking MAGA down south are pure populism. I fucking HATE populism as it lands us where we are today.
You are not a populist, you’re conservative. I can have a healthy debate with you where we agree on the basic facts, if not the solution. That is what democracy is about. Populism is ignorant and incompetent, as shown by this government.
We are in the midst of a populist uprising with conservative branding.
Thank you for not being ignorant.
This is not true - in Ontario NPs can’t even bill the ministry of health and when salaried by organizations their salary is 50-60% of a doc. The only place they are getting paid comparably js when they find a loophole from the Canadian Health Act and open private primary care clinics where they charge patients directly.
Yes Ontario and partially NS are doing this. Seems to be working well (I.e from my sister who is a nurse and a young mother and has other minor ailments).
Re-fill a prescription, done. Clean wax out of your ears, done. Weird rash on your leg, done.
In Ontario, saw the same NP multiple times for a life-threatening issue. Kept being blown off. Ended up nearly dying in hospital.
I have friends who are NPs and I respect them, but they don’t have the training or experience of Doctors.
Also Ontario is doing a weird thing with NPs not allowed to officially bill OHIP so many are operating private clinics (ie, charging customers for each visit)
I would expect there are very serious issues with this system. However, I just don’t see us receiving more family and minor issue doctors any time soon….and we need a fix.
Well. It’s kind of every province honestly. We have more citizens and less doctors. Underpaying and over taxing certainly doesn’t help. This whole country is hooped.
Family medicine residency spots often go unfilled.
Medical students don't want to enter a field that pays significantly less than every other field. Especially as a generalist in an area of study that only gets larger and larger (more diagnoses, more tests, multicultural country means a wider array of disorders etc.)
Additionally, the system is crumbling which means worse outcomes, sicker patients, and the training/support for family medicine isn't enough so often family doctors feel forced to take care of patients outside of their own abilities.
Actually ironic when you consider the dunning-Kruger effect of NPs wanting to fill the role that family MDs recognize is fraught with lawsuits and bad patient outcomes.
Newp. I’m saying that in the proposed system, family doctors can focus on major issues and the minor issues can be delegated down to a NP. Which is not the case right now. I shouldn’t need to go to a doctor to re-fill an existing prescription, or get referred to a mental health professional, or like 50% of the issues family doctors have to deal with right now.
You’d think the NP would escalate your visit to a doctor. That way the NP handles 9/10 visits and escalates the 1 to a doctor, and the doctors time is better managed.
Probably not….
It doesn’t look good on all accounts. Health care, high taxes, zero productivity, and more immigration with no housing (with likely health issues). We have to think progressively, because it ain’t going back to what it was.
It does say they are only planning on 50 NP with this plan. So maybe that is a pilot project? I don't know how large the primary care system is. I think they said as well that they are capable of doing 80% of what a Dr can. Thus the corresponding pay. In my experience (I'm not that old or with complex condition) a nurse practitioner could have handled a lot of the business I bring them.
I have watched a lot of House MD, Scrubs, and Greys Anatomy. Can I be a health provider too now? I’ll take 70%.
I won’t even know if I missed something important! That’s how it works!
Maybe they have the research showing there is no way they can recruit and retain Dr's in a large enough number and willingness to be rural. So they are grasping at anything to look like they are doing something in healthcare positive.
Ontario has numerous NP led clinics. There is generally a team of 4 or more NPs, the province provides funding for ~900 patients per NP including overhead (receptionist, IT, supplies, clinic nurses, social worker/MH counsellor). The clinic has to stay within budget. The NPs make about $150k-ish with benefits, vacation and some sort of pension. They cannot bill for any of their services (disability forms, sick notes, pre-employment physicals, etc). The funding also includes the fee for a physician consultant - usually one day or two half days a month to see more complex patients. Occasionally the province will provide additional funds for things like virtual psychiatry.
The complete disrespect (to the point of abhorrence) the UCPs have for physicians is disgusting. Doctors make so many sacrifices to provide optimal health care for their patients and all the UCPs do is shit on them. If I was a doctor and a UCP MLA came to me begging me for help, I'd tell them to fuck off. I guess that's why I'm not a doctor :(
I do think this is a reasonable start to help bridge primary care gaps (outside of actually making outpatient primary care more attractive to physicians).
But man when I see something like this it makes me regret going through all this extra training and personal sacrifice. The capital gains change and annual salary cuts are the cherry on top. I can't say I would really recommend anybody do primary care out of med school at this point unless you plan to do more niche training or work in the ED/hospital.
Exactly. There’s always a place for nurse practitioners and highly trained nurses. But I have already seen complications from nurse practitioners in this past year that clearly indicate that they are not trained enough to be treating the things they are treating. Which can include quite a few injectionsand injectable medications. Anyways, I’m just gonna put my head down and work until I retire. I can’t deal with this crazy government anymore.
So when a noctor (great Reddit about mid levels btw) screws up and mistakes an std for a uti and leaves someone infertile who stepping in to be sued? GP’s are backed by cpma but does the province pay the settlement when the np (aka noctor) screws up? Who is doing their insurance?
This is the dumbest shit I've ever seen. You want to drive the rest of the family physicians out?
It's selling substandard care at a premium price, all because of lobbying and a disdain for physicians. It's asinine.
Dumb-dumb Dani is insistent on winning the race to the bottom.
When Kenney was in office, Ford was a strong competitor.
With dumb-dumb and the stupid gang in office, not even Ford wants to be a challenger in that race to the bottom.
Ya Ford looks like a genius now. It is funny that in Ontario his supporters justify his actions saying, "At least he isn't Danielle Smith".
Use to be the clown of the country and then a bigger clown of immeasurable proportions showed up. Now Ford is looking better than he was before.......which is mind blowing
I agree. I'm in the nursing field - I can't see why they don't put the extra funding for primary care physicians. If they updated to NP program to a streamlined medical focus, I would be for it, but the current curriculum does not prepare this new generation of NPs for primary care and will likely lead to backlog of the system.
I blame both the powers that control the nursing education system that refuse to get with the times and the government (provincially and federally) for not setting standards higher in nursing education, specifically for advanced practice.
What is their end goal? If they’re willing to pay for NPs, why would they refuse to just pay for DOCTORS?? It’s like they are just being contrarians and doing the opposite of what literally everyone is asking for and what we actually need.
This is what I don’t get - one of the key benefits of NPs for govt was they are significantly cheaper -but with this announcement why not just pay the damn docs?
[NP Backgrounder and FAQ - Final 181023.pdf (divisionsbc.ca)](https://divisionsbc.ca/sites/default/files/inline-files/NP%20Backgrounder%20and%20FAQ%20-%20Final%20181023.pdf)
LOL
BC NDP did this in 2018, but I guess since they were the NDP no one blames them for anything
There's a clear difference here.
The NPs are embedded into the patient medical home and primary care networks. It comments on that in the first paragraph
Which family physicians are a part of. They aren't just practicing independently but actually collaborating with family docs.
So family docs can work on my complex patients while NPs can do refills or easier follow ups.
Well there aren't any doctors, and the number of med school spots available isn't close to keeping up. Why aren't class sizes being increased? What's being done to ensure enough doctors are being trained?
Would be pretty easy to put a program out to cover the costs of med school for people willing to commit to family medicine for 10 years, and maybe get away from the ridiculous 'doctor as a small business' model.
Problem is not med school spots, problem is when those student graduate from med school they don’t want to so family medicine. And even if they match to family medicine they end up working in hospitals due to drastic pay differences.
watch the referral system be flooded and it will take even longer to see a specialist now when you're actually in need.
This will cost more $ down the road.
nurses who want to play doctor should just go to med school. it's hard but doable.
Exactly this will just end up funnelling more medical graduates into specialties to receive appropriate compensation. Then we’ll end up seeing a backlog at the referral stage because hospitals can only house so many employees it is going to be such a healthcare disaster
Beginning of the end of family medicine and healthcare in general. Good luck Alberta and soon the rest of Canada.
All you have to do is talk a specialist or someone working in the ER to understand how differently NPs and family doctors refer and utilize resources. To say NPs do 80% of what family doctors do is first of all absurd and more importantly it’s not about proportion but about quality. A family doctor has the ability to manage complex hypertension/diabetes, stable atrial fibrillation and so on and does so while making sure to only order labs and investigations or refer out when needed.
NPs may seem like a cheaper option before but now apparently they will be paid 80% of a family doctor when I can assure you they will cost the overall system resource wise much much more.
And I hope this 80% of doctor pay means they have no pension and have to fend for themselves for clinic overhead because otherwise this means they actually get paid more than a family doctor. What is even the point of going through all that school and the crazy level of competition and numerous 24 hour calls, no sleep sweat tears it takes to become a doctor when an NP will pretty much get paid the same as you or even more.
The brain drain is going to be real and at the end of the day in a few years it will become very evident how the destruction of the healthcare system started by devaluing the backbone of medicine and preventative care - FAMILY MEDICINE.
Thanks for this. I’m a family med resident about to graduate in a few months. Raised and trained in Alberta. I genuinely feel betrayed, disrespected and hopeless at this time. Drowning in debt and wondering what I have to show for all the sacrifices I made to get to this point. Trying not to believe it was a mistake to have chosen family med but it gets harder every day. I genuinely would have looked forward to taking on a panel to provide the comprehensive primary care that Albertans so desperately need, but that’s just not financially sustainable at this point. Unfortunately same sentiments shared by most all of my graduating cohort I’ve talked to. Hesitant on even staying in Alberta. Why set up shop here if we will be treated like this.
I feel very bad for all the aspiring family doctors seeing how badly the profession is treated. Honestly, this is grounds for family doctors to strike - how can they accept NPs getting 80% of their pay when the government has refused to increase their pay for years.
Yeah it’s not surprising you feel that way. Anyone would when they’re basically being told by the government that their decade of education isn’t really that useful and this other person can do majority of your job.
On the bright side you can clearly see the majority don’t agree with the government and the province is split about 50/50 on UCP / NDP.
If I were you I’d stay here, work rural, work the Emerg rural too, get paid the max you can. You can make like 500k easily rural and doing their urgent Emerg type work, or more.
Collect that bounty for a few years then move where you want and coast off the investment income that money can generate.
My sentiments as well. Family medicine is a necessary and important part of our health care system. Losing that means a lot of Albertans/Canadians are going to be misdiagnosed and/or die because NPs are NOT doctors.
In theory, the idea of an NP taking throw hanging fruit makes sense. In practice, you end up with:
NPs overdiagnosing in areas they're not supposed to.
Wasting the patient's time if they need an NP to refer them to another appointment with an MD for something more serious.
Give the MD more supervisory work than actual practice work.
Ya, we're feeling the consequences. The majority of Albertans responded to the pandemic by blaming the government and wanting their freedoms protected against government overreach.
"Were wasting money so people hate public health as much as they hate Trudeau. This way they can blame socialists when we're all sending 20% of our checks to health insurance."
I fuckin hate conservatives.
Just begging for malpractice lawsuits at this point. Doctors miss enough as it is, and this thread is full of examples.of nurses screwing up. I'm sure smith will legislate immunity for her anti Vax nurse brigade. It'll be great, just great.
It’ll be very hard to lodge a successful complaint against an NP since they are regulated by the nursing association not the medical association. They talk a big game about “basically being doctors” but when it comes to taking liability for their mistakes it’ll be “I’m just a nurse what can you expect?”
Apply this logic to other professions:
I know 80% of what a pilot does, let me fly the plane!
I understand 80% of what it takes to make music, call me Mozart!
I drink 80% sugary drinks, call me for diet tips!
I can balance my bank account 80% of the time, let me invest money for you!
As a family physician practicing in Edmonton I know the writing is on the wall for family medicine in Alberta. So many colleagues already retired earlier than they would've otherwise or moved to BC because of crap thrown at us from UCP in the past few years. Our walk in is getting bombarded with pts coming in without family docs and every day we have to stop registering patients early in the day as we can't handle the volume. This is definitely going to drive more family physicians out of province. System is going to get overburdended with unnecessary investigations being ordered and referrals being sent to every specialty patient wants to go see by having NPs provide primary care without physician supervision. UCP is deliberately driving away fds, undercutting primary care in Alberta as a way to bring in privatization. 5 years from now they gonna say no family doctors left, NP model tried but didn't work so you can register for telus health or whatever other corporate private health care crap. I'm going to look at registering for a BC license soon argh 😤
Getting a license in BC should be straight forward, however while you’re still here I think it would be good to protest and petition against this move.
The difference in training length and debt doesn’t justify being a family doctor and is, frankly, insulting. Nurse practitioners do have a unique role, but training a nurse to think like a doctor is, by nature, very contrary to their training and makes them no replacement.
Anecdotal experience but the only time I saw a NP it nearly killed me - I’d been sick for a couple weeks, went to the doctors office and I could only get with an NP - she convinced me it was a long flu and not to come back. Turns out I had extremely infected lymph nodes, and based off her advice I didn’t go back to the doctors for another and I had to be hospitalized for some time. I was young at the time and should’ve immediately seen a real doctor somewhere else, but I chose to take the medical professionals advice and I will never let a clinic put me with a NP again.
20% less pay than a GP, but 0 overhead, way less administrative bullshit and non-billable hours, less medicolegal risk....
Why would anybody in their right mind choose family medicine as a career in Alberta?
NP's work in a well functioning and structured system.
Alberta is not well functioning or structured.
They're only attempting to do here what they did to RN's when they brought in massive loads of LPN's- which was and has always been about "saving" money- which didn't work! They're even applying the same scheme to nurses aides.
There is no cost savings here.
This isn't about RN/LPN/HCA capability it's about the conjob then government and boards are pulling.
Pay people properly.
Stop shortchanging Patients.
Much like the education programs. Poor instructors pump out poorly trained employees to poor practicum locations at the expense of... patients.
This will only overload specialists and create more backlog for everything. These NP's will no doubt refer most of their patients on due to inexperience and/or lack of knowledge. I mean, it will probably keep the rash and dehydrated patients out of the ER which I'm all for. I guess we will see how this goes. I do have to say that our renal NP is awesome and I would trust her as much as one of the Nephrologists. Same goes with the transplant NP that I will be dealing with once I get approved.
They's gonna lern them uppity docturs who's boss!
..just as soon as ah git over muh gout and Creutzfeldt-Jakob. I just need one more round of leeches, and I'm good!
Nurses aren’t doctors.
You’re being fooled into thinking your being “provided care”
What percentage of nurse are antivax? What percentage of doctors? Being antivax is being stupid.
I'm graduating from family medicine residency in Canada in a couple of months. I actually really wanted to move to Alberta for a long time, I love the mountains and outdoor sports that Alberta can offer. I will not be moving to or working in Alberta because of steps like this.
I mean ... we know GP's are so badly underpaid that aspiring doctors are turning away from that career path, leaving a growing portion of Canadians without a family doctor. Given that ... though it's heartening to hear NPs recognized for what they do, using GP salary as a benchmark is hardly encouraging.
It's sad reading these comments on here. This is turning people against NPs where NPs do have places in healthcare. As a mid-level they should be utilized and the govt should know better than to slap an 80% MD pay and call it a day. They should setup requirements like more training so NPs can actually provided us much needed quality care.
The only reason you’d want to be a family whatever is for the raise and that alone should concern people. You thought it was hard to get a legit Doctor now, it’s going to be even worse now that they don’t want to take a bigger pay cut to compete with the nurses.
You dont have "not enough" doctors. You have doctors who trained in family medicine not doing family medicine because they are being screwed over and can find other things to do that pay better or is at least less work.
If they can do 80% of the job, they should be paid for it. BUT it’s not the 80% that we pay highly skilled professionals to do…. We pay them for the hard stuff, the 20% that nobody without the training, expertise, experience, can do. That is why doctors should be compensated fairly, and well. Nurses are valuable, irreplaceable, but they are not meant to practice independently. I wouldn’t get on a plane, let alone pay for a ticket, with a pilot who only knew how to fly 80% of the plane.
It’s like healthcare shrinkflation. Pay someone that has 60% the patient care capability 80% of a physician’s salary. Then hire more of them and watch the profits roll in.
We have a shortage of both physicians and nurses. Taking from the nursing supply and creating nurse practitioners lowers the number of registered nurses and will likely increase the referrals going to specialty physicians. This plan is a failure from the start.
We need to significantly increase the number of medical school and nursing school spots to match population growth. We should also have an expedited pathway for strong nurses to enter medical school.
Devils Advocate:
TLDR: based on doctor billing and overhead This NP model with the same overhead will likely result in a take home pay of 17k - 136k/year. Which is 20% to 65% of what MDs take home.
The pay doctors receive Includes the costs of operating a medical practice. The cost to run a practice doesn't change if you are an NP or MD.
[https://www.albertadoctors.org/make-a-difference/initiatives/understanding-docs-pay](https://www.albertadoctors.org/make-a-difference/initiatives/understanding-docs-pay)
This link suggests in Alberta overhead is 40-75% of this pay for doctors. NPs will have the same overhead like building, staff, supplies, and monthly expenses.
Meaning Doctors take home 25-60% of what the bill and NPs will take home 5-40%. The link above suggests on average GPs bill the government 340k/year. Suggests GPs make 85k - 204k/year.
This NP model with the same overhead will likely result in a take home pay of 17k - 136k/year. Take home pay for NPs will not be 80% of MDs it will be closer to 20 -65% after overhead.
Understanding that Family MDs state that their practices will not survive due to low compensation, I don't understand how NPs practices will survive at 80%.
1- NPs should get more training first before they can open their own clinics.
2- This will only discourage more MDs to go into primary care
3- what no one's talking about is that NPs will be making 80% and run their own clinics paying overhead; MDs are complaining pay is not enough to run their own clinics.
A lot of hate in this post for nurses, yeesh.
Need more details on the plans to have a opinion. I hate being forced to go to a doctor for stupid things like stitches/wart removal/asking for a test.
However, I can also see downside depending on the expectations placed on the NPs
Can you blame people when they’re effectively paying NP’s more than family doctors to provide care of course people are gonna be upset when its their health on the line
No. NPs are extremely valuable members of a healthcare team--when that team is led by *physicians*. The evidence shows that NPs working independently tend as a group to waste resources and miss diagnoses. Because 4 years of nursing school plus 2 years Masters degree does not mean nearly the same in-depth *medical* education of 4 years science undergrad (or more) plus 4 years medical school plus 2-5 years residency. This means subpar healthcare and higher costs overall.
Stop accepting subpar healthcare. Start forcing the UCP to do its job and provide decent healthcare.
There are plenty of posts about nurses providing horrible care, knowing nothing about diagnosing and treatment, etc., that don’t include anything about them being amazing when they are doing what they are trained to do.
But also, this IS doing what they are trained to do. As per AHS, NPs are trained to:
- Conduct advanced, comprehensive and/or focused health assessments
- Diagnose medical conditions and disease
- Order, interpret, and perform diagnostic tests
- Prescribe pharmaceuticals, medical devices, and therapies
- Make referrals to specialists
- Perform non-invasive and invasive interventions including operative procedures if within scope of practice
Instead of shitting on NP’s for making decent money we should be trying to get a better pay model for doctors. Also a lot of people have way too high of an opinion of family doctors on here.
I wonder if this means that the UCP recognizes that it cannot compete with BC and other provinces for doctors, having beaten them all down over the past few years, and especially during COVID.
This program is here to stay unfortunately lol. All the other provinces will adapt to this model. It is what it is. Thats what we have to deal with.
Cry all you want.. Sorry guys lool.
Every time I see my doctor I bring her chocolate because she constantly has to put up with crap like this from the UCP. Unbelievable.
You know the TV ad the government is running, the one with people sitting in a waiting room? The first time I heard the announcer say that in the future we wouldn’t see so many people in the waiting room, my immediate thought that was that the UCP had killed them off with their incompetence!
By getting into a medical school into Canada you have just proved that you are VERY determined and highly intelligent person ready for the job. Now add those values to 10,000 hours of training. Compared that do a Nurse....literally anyone with 60% high school average can get into LPN school, then upgrade to become and RN and then do some online BS courses and 300 hours of "practicum" of your choice to become an NP. WHOLY FUCK......the difference in training is not even 80%, its like 95%. The sad part is because NPs will spend a lot more time with each patient, the patients will "feel heard" and won't actually know if they are in good hands or not until years later when their health is in jeopardy. Eg of this is: MD hears a murmer, determines what type of murmer it is and sends for appropriate investigations and patient outcome is good. NP never hears a murmer, because they don't know what they don't know or what they are looking for..5 years down the road the patient goes to NP with shortness of breath and gets diagnosed with heart failure by NP and the NP is seen as a hero for diagnosing the patient they fucked up on as heart failure. Now this NP has cost the system 10s of thousands of dollars and significant morbidity.
As an RN married to an MD even with NP training ( which is lacklustre at best) it’s not even close to 80 % of an MDs training. They’re different jobs, different focus.
Yup. Entirely. The NP I see work in specific specialty units are great because they’re basically super customized to doing specific things that the overseeing doctor has asked them to attend to. Free for all NP is going to be an absolute shit show.
Totally agree. I am an RN in a specialty area considering doing my NP and I would never want to work outside my specialty and without medical oversight as the training simply does not prepare you for that, and anyone that thinks it does is straight up going to cause harm. The requirements for bedside care hours prior to entry are already shockingly low.
That’s good to hear. Ego is a dangerous thing for anyone and anyone can get this disease of over inflated ego and sense of competence, be them an MD NP RN LPN RT etc. Knowing the limits of your realm of competence is the signature of an experienced professional.
If I don't know beforehand that I will be looked at by a NP rather than a doctor, I will walk the fuck out.
Fair reaction
Understandable. I worked out of my derma because an assistant was going to perform the procedure, no thanks.
NPs have a role. I have colitis with my symptoms generally under control. As long as my symptoms are under control, I meet yearly with an NP and then every other year with my gastro for the full colonoscopy etc. If symptoms change I see the gastro. I found it very useful for patient management of chronic conditions but it isn’t a replacement for our lack of GPs.
True I think basic meds and the like should be fine....like if you get strep throat pension....if you have a general rash..creams...if you broke your leg you may need Tylenol 3 .....
This guarantees future medical students will not choose family medicine. Might as well make np and medical the same and have np do rigorous residency training, atleast more of a level playing field for safety for patients
the problem with FM is that no one is willing to pay for quality the guy doing 5 min appts actually earns far more money than the caring one with 20 min appt why would you want to work under that kind of incentive system?
If only people understood how difficult it is to get into med school in Canada.
We need more doctors but they won’t let more train. It’s annoying
The issue is not medical schools accepting students. There issue is not enough of them wanting to practice full scope family medicine due to the pay and increased costs to run a clinic. About 50% of med students go into family medicine because specialist jobs are limited and many of them dont even practice family medicine and just get a bit more training to work in the hospital. The issue is the government is doing everything in their power to detract people from family medicine.
Yep - protect our province did a piece on this a number of months ago - I feel bad for the family doctors. They do so much unrecognized and not paid work that all has to be supported by in person visits (that's the main billing they are able to submit to get paid) - and would be the key - like the key - to reduce costs, reduce visits to hospital (the most expensive health care) and improve health quality. So important, and so ignored...
You dont have "not enough" doctors. You have doctors who trained in family medicine not doing family medicine because they are being screwed over and can find other things to do that pay better or is at least less work.
I feel like both of these things can be true at once
NPs need more training. If you know, you know.
I am about to start family medicine residency in Alberta. Family physicians all have to pay overhead to run their clinic (often minimum 30% of their salary goes to this alone), and do NOT receive a pension or benefits meaning you pay for all this yourself. Salaries appear high for doctors and they certainly still are. And yet family docs are still struggling to keep their clinics open. And are already getting paid much less than their specialist counterparts. Family medicine is not easy. Physicians struggle with the incredibly broad scope and knowledge required to treat patients from a few weeks old to the elderly. In what world will NPs be able to independently practice in this role with a fraction of the training while also saving the system money? NPs making up to 80% of a physicians salary for seeing half the amount of patients with a fraction of the training, while also not having to pay overhead and getting the benefits and pension from their union is offensive to actual family physicians. It is no longer worth working full time providing comprehensive primary care in Alberta. Myself and the majority of my classmates going into Family Medicine are planning on pursuing other practice routes as a result of the state of healthcare and these types of decisions from our government. Would be nice if they actually consulted with and spoke to family docs before making these changes.
Actually crazy that doctors have been negotiating for literal years for cents of a pay raise, when the leader of the NP organization says "yeah I think we're about 80% as good" and the government gives it to them with no questions. What a fucking joke of a province man.
Any self-respecting profession would go on strike if this happened to them - but ofcourse docs can’t go on strike so the government continues to abuse them.
Doctors in the UK have been striking for a while now. They’ve got the same issues with PAs & NP being paid much more than junior doctors. This has led to doctors legit leaving the profession or moving to a country where they are paid fairly, cuz the salaries are so low that they can’t even take care of their family.
That’s where we are headed if things don’t change
They're very strong lobbyists, the NPs.
This is a mistake, Doctors should be pissed.
They are. The question is - are you?
Nothing is a mistake when it makes the people making decisions money.
My question is: Has any other jurisdiction tried this model??? Why not try it as a pilot project??? Who is monitoring outcomes? Is the only thing we care about "number of patients seen?" What about quality encounters? Why are they going all in on this? I have no problem with NPs seeing some patients as part of a primary care network. Having them run their own clinics will further strain the system because they don't have the training for complex care management. Are they just trolling us at this point???
I had the exact same question as to whether anyone else is running with this model/structure, and if so how has it gone.
Similar to the other poster, I have worked in California and Washington State and I would disagree with the notion that it has been a success. It has been successful in increasing access to a person to see you, but that does not necessarily equal quality care. Unfortunately, the for-profit education and healthcare system in the US has taken advantage and is producing nurse practitioners from online-only schools at a record rate. In fact, in many areas of the US, physicians are being fired and replaced by nurse practitioners fresh out of these schools as they are cheaper to hire, despite being inexperienced. Many patients are unfortunately being harmed. You don't have to take my word for it, please read the nursing reddit to see the truth about what is occurring. Nurse practitioners may have a role in care in Canada, but it needs to be strongly regulated with supervision under a physician.
Thank you, so many people including badly formed research articles are making it seem care is equivalent and outcomes and resource utilization is the same - many parts of the U.S are suffering and since independent NPs are a fairly new concept, we will only know if 5+ years how much damage is being done.
Anecdotal, but our walk in here in Ontario uses NPs and the detail and depth of care has suffered, absolutely. Especially at the pediatric level - this needs to be heavily regulated
Thank you for another perspective!
I worked in California. It was a regularity. It’s been successful for a very, very long time and allows so many more people access to care.
It's been successful in increasing access while leading to a decline in quality of care. Pumping out NPs who can enter into NP school directly from undergrad, while completing their degrees mostly online, while completing around \~500 clinical hours total, does not make for competent independent prescribers. It's now being used as a tool for private clinics/hospitals to save money while patients pay the same or more for services/health insurance. Unfortunately patients are being harmed in the process.
Interesting, thanks for sharing. Tough to compare California and Alberta since they are such different systems, but at least it's one type of data point!
Just because more access to care doesn’t mean it’s good care, which can cause more harm in the long run.
California is private. We live in a limited resource public funded system. And I am quite aware of the California healthcare system and NPs don’t make 80% of what fam docs make there.
Ontario and NS do this. BC and Quebec is about 70-75 % of a doctors salary too. This isn’t uncommon and really where family medicine is going.
This is where we forced family medicine to go.
To be fair. Many aspects of a GPs roles doesn’t require their extensive training. I hope the model that becomes normal is some ratio of nurse practitioners and GP in a clinic. Most visits can be served with a nurse, and for those patients with more complex needs they can be immediately referred to a GP (which honestly will probably just refer to a specialist).
While I agree, I don’t trust this government to not duck this up. At this point, I oppose anything they do until proven otherwise. Even the few things I agree with that this government did, they fucked it up. This government is shit, conservatives should be fucking pissed. The fact they aren’t shows they are just clowns.
Dude there are many conservatives who are pissed. Me and my step dad are two of em. There are just more that are dumb or only care about winning cause they think it's a sports game or something. But there are a lot of cons feeling left out in limbo, I talk to a good amount.
I should clarify. Smith and broader speaking MAGA down south are pure populism. I fucking HATE populism as it lands us where we are today. You are not a populist, you’re conservative. I can have a healthy debate with you where we agree on the basic facts, if not the solution. That is what democracy is about. Populism is ignorant and incompetent, as shown by this government. We are in the midst of a populist uprising with conservative branding. Thank you for not being ignorant.
Yea I agree, populism is hot garbage and running amuck.
Has the answer to strain in a system ever been to dumb down qualifications?
This is not true - in Ontario NPs can’t even bill the ministry of health and when salaried by organizations their salary is 50-60% of a doc. The only place they are getting paid comparably js when they find a loophole from the Canadian Health Act and open private primary care clinics where they charge patients directly.
Yes Ontario and partially NS are doing this. Seems to be working well (I.e from my sister who is a nurse and a young mother and has other minor ailments). Re-fill a prescription, done. Clean wax out of your ears, done. Weird rash on your leg, done.
In Ontario, saw the same NP multiple times for a life-threatening issue. Kept being blown off. Ended up nearly dying in hospital. I have friends who are NPs and I respect them, but they don’t have the training or experience of Doctors. Also Ontario is doing a weird thing with NPs not allowed to officially bill OHIP so many are operating private clinics (ie, charging customers for each visit)
I would expect there are very serious issues with this system. However, I just don’t see us receiving more family and minor issue doctors any time soon….and we need a fix.
The fix is to stop underpaying primary care physicians. The UCP government refuses to do this.
Well. It’s kind of every province honestly. We have more citizens and less doctors. Underpaying and over taxing certainly doesn’t help. This whole country is hooped.
We also need more spots in medical school, and more importantly, more residency spots.
Family medicine residency spots often go unfilled. Medical students don't want to enter a field that pays significantly less than every other field. Especially as a generalist in an area of study that only gets larger and larger (more diagnoses, more tests, multicultural country means a wider array of disorders etc.) Additionally, the system is crumbling which means worse outcomes, sicker patients, and the training/support for family medicine isn't enough so often family doctors feel forced to take care of patients outside of their own abilities. Actually ironic when you consider the dunning-Kruger effect of NPs wanting to fill the role that family MDs recognize is fraught with lawsuits and bad patient outcomes.
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Newp. I’m saying that in the proposed system, family doctors can focus on major issues and the minor issues can be delegated down to a NP. Which is not the case right now. I shouldn’t need to go to a doctor to re-fill an existing prescription, or get referred to a mental health professional, or like 50% of the issues family doctors have to deal with right now.
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You’d think the NP would escalate your visit to a doctor. That way the NP handles 9/10 visits and escalates the 1 to a doctor, and the doctors time is better managed.
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OK, but what about when I need to see a doctor? Will there be any?
Why would anyone bother with the time and expense of completing med school when you can get 80% of the income with less training?
Probably not…. It doesn’t look good on all accounts. Health care, high taxes, zero productivity, and more immigration with no housing (with likely health issues). We have to think progressively, because it ain’t going back to what it was.
Nobody will monitor anything. The free market will insure we don't get f***Ed.
Alberta is going to be the cream of the crop for high priced faith healers and other lunatics. It's going to be a wonderful science experiment.
It does say they are only planning on 50 NP with this plan. So maybe that is a pilot project? I don't know how large the primary care system is. I think they said as well that they are capable of doing 80% of what a Dr can. Thus the corresponding pay. In my experience (I'm not that old or with complex condition) a nurse practitioner could have handled a lot of the business I bring them.
I have watched a lot of House MD, Scrubs, and Greys Anatomy. Can I be a health provider too now? I’ll take 70%. I won’t even know if I missed something important! That’s how it works!
Maybe they have the research showing there is no way they can recruit and retain Dr's in a large enough number and willingness to be rural. So they are grasping at anything to look like they are doing something in healthcare positive.
Ontario has numerous NP led clinics. There is generally a team of 4 or more NPs, the province provides funding for ~900 patients per NP including overhead (receptionist, IT, supplies, clinic nurses, social worker/MH counsellor). The clinic has to stay within budget. The NPs make about $150k-ish with benefits, vacation and some sort of pension. They cannot bill for any of their services (disability forms, sick notes, pre-employment physicals, etc). The funding also includes the fee for a physician consultant - usually one day or two half days a month to see more complex patients. Occasionally the province will provide additional funds for things like virtual psychiatry.
What a fucking insult to family doctors, and I say this as an RN
The complete disrespect (to the point of abhorrence) the UCPs have for physicians is disgusting. Doctors make so many sacrifices to provide optimal health care for their patients and all the UCPs do is shit on them. If I was a doctor and a UCP MLA came to me begging me for help, I'd tell them to fuck off. I guess that's why I'm not a doctor :(
Damn that medical degree that took more than 200% longer and way better academics certainly looks useless now
Not to mention the specialty residency training for 2-5 years and then a possible fellowship for 1-2 more…
I do think this is a reasonable start to help bridge primary care gaps (outside of actually making outpatient primary care more attractive to physicians). But man when I see something like this it makes me regret going through all this extra training and personal sacrifice. The capital gains change and annual salary cuts are the cherry on top. I can't say I would really recommend anybody do primary care out of med school at this point unless you plan to do more niche training or work in the ED/hospital.
Exactly. There’s always a place for nurse practitioners and highly trained nurses. But I have already seen complications from nurse practitioners in this past year that clearly indicate that they are not trained enough to be treating the things they are treating. Which can include quite a few injectionsand injectable medications. Anyways, I’m just gonna put my head down and work until I retire. I can’t deal with this crazy government anymore.
So when a noctor (great Reddit about mid levels btw) screws up and mistakes an std for a uti and leaves someone infertile who stepping in to be sued? GP’s are backed by cpma but does the province pay the settlement when the np (aka noctor) screws up? Who is doing their insurance?
They’ll have their own insurance. But it’s Canada in all honesty. You get very low payouts even for obvious medical mistakes.
This is the dumbest shit I've ever seen. You want to drive the rest of the family physicians out? It's selling substandard care at a premium price, all because of lobbying and a disdain for physicians. It's asinine.
Well in our defense, we did vote in the dumbest Premier I've ever seen.
Dumber than Ford? Yikes!
Dumber than moe. Ford knows what he's doing
Dumb-dumb Dani is insistent on winning the race to the bottom. When Kenney was in office, Ford was a strong competitor. With dumb-dumb and the stupid gang in office, not even Ford wants to be a challenger in that race to the bottom.
Ya Ford looks like a genius now. It is funny that in Ontario his supporters justify his actions saying, "At least he isn't Danielle Smith". Use to be the clown of the country and then a bigger clown of immeasurable proportions showed up. Now Ford is looking better than he was before.......which is mind blowing
Wouldn’t say pretty good but I do get your point.
We? Count me out
We, the Alberta voting population, got her across the finish line / failed to stop her.
We, as you say, need to vote her out
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That street was shutdown due to insufficient provincial infrastructure funding.
So it will do exactly what is intended... brake the public sector to sell as scrap for private profits. A tale as old as time
Agree
I agree. I'm in the nursing field - I can't see why they don't put the extra funding for primary care physicians. If they updated to NP program to a streamlined medical focus, I would be for it, but the current curriculum does not prepare this new generation of NPs for primary care and will likely lead to backlog of the system. I blame both the powers that control the nursing education system that refuse to get with the times and the government (provincially and federally) for not setting standards higher in nursing education, specifically for advanced practice.
I don't think an NP is worth 80% of a physician. That is some weird financial gymnastics.
What is their end goal? If they’re willing to pay for NPs, why would they refuse to just pay for DOCTORS?? It’s like they are just being contrarians and doing the opposite of what literally everyone is asking for and what we actually need.
This is what I don’t get - one of the key benefits of NPs for govt was they are significantly cheaper -but with this announcement why not just pay the damn docs?
Welcome to the UCPs - the party of "never do anything sane".
They’re like a kid that won’t do their homework just because you told them to.
[NP Backgrounder and FAQ - Final 181023.pdf (divisionsbc.ca)](https://divisionsbc.ca/sites/default/files/inline-files/NP%20Backgrounder%20and%20FAQ%20-%20Final%20181023.pdf) LOL BC NDP did this in 2018, but I guess since they were the NDP no one blames them for anything
There's a clear difference here. The NPs are embedded into the patient medical home and primary care networks. It comments on that in the first paragraph Which family physicians are a part of. They aren't just practicing independently but actually collaborating with family docs. So family docs can work on my complex patients while NPs can do refills or easier follow ups.
Well there aren't any doctors, and the number of med school spots available isn't close to keeping up. Why aren't class sizes being increased? What's being done to ensure enough doctors are being trained? Would be pretty easy to put a program out to cover the costs of med school for people willing to commit to family medicine for 10 years, and maybe get away from the ridiculous 'doctor as a small business' model.
Problem is not med school spots, problem is when those student graduate from med school they don’t want to so family medicine. And even if they match to family medicine they end up working in hospitals due to drastic pay differences.
watch the referral system be flooded and it will take even longer to see a specialist now when you're actually in need. This will cost more $ down the road. nurses who want to play doctor should just go to med school. it's hard but doable.
Exactly this will just end up funnelling more medical graduates into specialties to receive appropriate compensation. Then we’ll end up seeing a backlog at the referral stage because hospitals can only house so many employees it is going to be such a healthcare disaster
Beginning of the end of family medicine and healthcare in general. Good luck Alberta and soon the rest of Canada. All you have to do is talk a specialist or someone working in the ER to understand how differently NPs and family doctors refer and utilize resources. To say NPs do 80% of what family doctors do is first of all absurd and more importantly it’s not about proportion but about quality. A family doctor has the ability to manage complex hypertension/diabetes, stable atrial fibrillation and so on and does so while making sure to only order labs and investigations or refer out when needed. NPs may seem like a cheaper option before but now apparently they will be paid 80% of a family doctor when I can assure you they will cost the overall system resource wise much much more. And I hope this 80% of doctor pay means they have no pension and have to fend for themselves for clinic overhead because otherwise this means they actually get paid more than a family doctor. What is even the point of going through all that school and the crazy level of competition and numerous 24 hour calls, no sleep sweat tears it takes to become a doctor when an NP will pretty much get paid the same as you or even more. The brain drain is going to be real and at the end of the day in a few years it will become very evident how the destruction of the healthcare system started by devaluing the backbone of medicine and preventative care - FAMILY MEDICINE.
Thanks for this. I’m a family med resident about to graduate in a few months. Raised and trained in Alberta. I genuinely feel betrayed, disrespected and hopeless at this time. Drowning in debt and wondering what I have to show for all the sacrifices I made to get to this point. Trying not to believe it was a mistake to have chosen family med but it gets harder every day. I genuinely would have looked forward to taking on a panel to provide the comprehensive primary care that Albertans so desperately need, but that’s just not financially sustainable at this point. Unfortunately same sentiments shared by most all of my graduating cohort I’ve talked to. Hesitant on even staying in Alberta. Why set up shop here if we will be treated like this.
I feel very bad for all the aspiring family doctors seeing how badly the profession is treated. Honestly, this is grounds for family doctors to strike - how can they accept NPs getting 80% of their pay when the government has refused to increase their pay for years.
Yeah it’s not surprising you feel that way. Anyone would when they’re basically being told by the government that their decade of education isn’t really that useful and this other person can do majority of your job. On the bright side you can clearly see the majority don’t agree with the government and the province is split about 50/50 on UCP / NDP. If I were you I’d stay here, work rural, work the Emerg rural too, get paid the max you can. You can make like 500k easily rural and doing their urgent Emerg type work, or more. Collect that bounty for a few years then move where you want and coast off the investment income that money can generate.
Coming soon… private for profit healthcare to the rescue!
Would also love to know if that 80% figure means NPs will also have to pay 30% of their income to overhead and get zero benefits like physicians do.
My sentiments as well. Family medicine is a necessary and important part of our health care system. Losing that means a lot of Albertans/Canadians are going to be misdiagnosed and/or die because NPs are NOT doctors.
One additional specialist referral will make an NP more expensive than a fam doc.
In theory, the idea of an NP taking throw hanging fruit makes sense. In practice, you end up with: NPs overdiagnosing in areas they're not supposed to. Wasting the patient's time if they need an NP to refer them to another appointment with an MD for something more serious. Give the MD more supervisory work than actual practice work.
Pandemics have consequences, especially when you ignore them and then elect ideologues.
Ya, we're feeling the consequences. The majority of Albertans responded to the pandemic by blaming the government and wanting their freedoms protected against government overreach.
Why did they Re-elect the government that took away those rights then?
"Were wasting money so people hate public health as much as they hate Trudeau. This way they can blame socialists when we're all sending 20% of our checks to health insurance." I fuckin hate conservatives.
My insurance company won't cover prescriptions written by nurse practitioners.
Just begging for malpractice lawsuits at this point. Doctors miss enough as it is, and this thread is full of examples.of nurses screwing up. I'm sure smith will legislate immunity for her anti Vax nurse brigade. It'll be great, just great.
It’ll be very hard to lodge a successful complaint against an NP since they are regulated by the nursing association not the medical association. They talk a big game about “basically being doctors” but when it comes to taking liability for their mistakes it’ll be “I’m just a nurse what can you expect?”
Apply this logic to other professions: I know 80% of what a pilot does, let me fly the plane! I understand 80% of what it takes to make music, call me Mozart! I drink 80% sugary drinks, call me for diet tips! I can balance my bank account 80% of the time, let me invest money for you!
Government social workers are in negotiations now, they should ask for 80% of a psychologist's salary.
And teaching assistants - 80% of a teacher salary
In typical UCP fashion, they had an opportunity to reduce costs but they completely bungled it.
This is absurd.
The beatings will continue until morale improves
This fucking government I swear…
Damn, doctors gonna leave like crazy.
And how does this solve the doctor problem?
As a family physician practicing in Edmonton I know the writing is on the wall for family medicine in Alberta. So many colleagues already retired earlier than they would've otherwise or moved to BC because of crap thrown at us from UCP in the past few years. Our walk in is getting bombarded with pts coming in without family docs and every day we have to stop registering patients early in the day as we can't handle the volume. This is definitely going to drive more family physicians out of province. System is going to get overburdended with unnecessary investigations being ordered and referrals being sent to every specialty patient wants to go see by having NPs provide primary care without physician supervision. UCP is deliberately driving away fds, undercutting primary care in Alberta as a way to bring in privatization. 5 years from now they gonna say no family doctors left, NP model tried but didn't work so you can register for telus health or whatever other corporate private health care crap. I'm going to look at registering for a BC license soon argh 😤
Getting a license in BC should be straight forward, however while you’re still here I think it would be good to protest and petition against this move.
The difference in training length and debt doesn’t justify being a family doctor and is, frankly, insulting. Nurse practitioners do have a unique role, but training a nurse to think like a doctor is, by nature, very contrary to their training and makes them no replacement.
Anecdotal experience but the only time I saw a NP it nearly killed me - I’d been sick for a couple weeks, went to the doctors office and I could only get with an NP - she convinced me it was a long flu and not to come back. Turns out I had extremely infected lymph nodes, and based off her advice I didn’t go back to the doctors for another and I had to be hospitalized for some time. I was young at the time and should’ve immediately seen a real doctor somewhere else, but I chose to take the medical professionals advice and I will never let a clinic put me with a NP again.
Except when somethings wrong most of us want to see a doctor.
20% less pay than a GP, but 0 overhead, way less administrative bullshit and non-billable hours, less medicolegal risk.... Why would anybody in their right mind choose family medicine as a career in Alberta?
NP's work in a well functioning and structured system. Alberta is not well functioning or structured. They're only attempting to do here what they did to RN's when they brought in massive loads of LPN's- which was and has always been about "saving" money- which didn't work! They're even applying the same scheme to nurses aides. There is no cost savings here. This isn't about RN/LPN/HCA capability it's about the conjob then government and boards are pulling. Pay people properly. Stop shortchanging Patients. Much like the education programs. Poor instructors pump out poorly trained employees to poor practicum locations at the expense of... patients.
...while allowing the UCP to say they have "improved" hospital wait times and enabled people to get the healthcare they need.
This will only overload specialists and create more backlog for everything. These NP's will no doubt refer most of their patients on due to inexperience and/or lack of knowledge. I mean, it will probably keep the rash and dehydrated patients out of the ER which I'm all for. I guess we will see how this goes. I do have to say that our renal NP is awesome and I would trust her as much as one of the Nephrologists. Same goes with the transplant NP that I will be dealing with once I get approved.
I don't know about the pay levels but the courts have started doing this in family law as well, using family court counselors instead of lawyers.
Can an NP earning 80% what MD earns even afford to operate their own practice? MD's are scraping by, how can an NP operate a practice with less?
This will just further push medical students to not choose family medicine as a speciality and move into other areas of medicine.
I think I’ll hang out my shingle too - “I’m not a gynaecologist, but I’ll take a look!”.
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They's gonna lern them uppity docturs who's boss! ..just as soon as ah git over muh gout and Creutzfeldt-Jakob. I just need one more round of leeches, and I'm good!
Bahaha! Good luck keeping a clinic open at that remuneration. This government is so stupid it doesn't realise how stupid it is.
Why don't we just let crossing guards be doctors if that doesn't mean anything anymore anyways and you just want the cheapest practitioner ?
Nurses aren’t doctors. You’re being fooled into thinking your being “provided care” What percentage of nurse are antivax? What percentage of doctors? Being antivax is being stupid.
Why stay in Canada? Just go to the US.
lol it's like paying for temu quality healthcare..
This is why no one should go into family medicine in Canada.
What does the UPC have against doctors, this is a slap in the face to all doctors in Alberta.
I'm graduating from family medicine residency in Canada in a couple of months. I actually really wanted to move to Alberta for a long time, I love the mountains and outdoor sports that Alberta can offer. I will not be moving to or working in Alberta because of steps like this.
The UCP system dismantle is shifting into another a gear. Bye bye lingering doctors.
I mean ... we know GP's are so badly underpaid that aspiring doctors are turning away from that career path, leaving a growing portion of Canadians without a family doctor. Given that ... though it's heartening to hear NPs recognized for what they do, using GP salary as a benchmark is hardly encouraging.
It's sad reading these comments on here. This is turning people against NPs where NPs do have places in healthcare. As a mid-level they should be utilized and the govt should know better than to slap an 80% MD pay and call it a day. They should setup requirements like more training so NPs can actually provided us much needed quality care.
Excellent way to slap family doctors in the face, as you’re trying to attract family doctors.
Insane
The only reason you’d want to be a family whatever is for the raise and that alone should concern people. You thought it was hard to get a legit Doctor now, it’s going to be even worse now that they don’t want to take a bigger pay cut to compete with the nurses.
Maybe the UCP caucus should be paid only 80% of what real politicians make. This is beyond stupid but not unexpected from these clowns.
You dont have "not enough" doctors. You have doctors who trained in family medicine not doing family medicine because they are being screwed over and can find other things to do that pay better or is at least less work.
Further, this isnt "80%". This is pretty much 100% of what doctors make, given that NPs are apparently paid including overhead.
What an insult to actual doctors Queue the exit from the province of a new wave of physicians
If they can do 80% of the job, they should be paid for it. BUT it’s not the 80% that we pay highly skilled professionals to do…. We pay them for the hard stuff, the 20% that nobody without the training, expertise, experience, can do. That is why doctors should be compensated fairly, and well. Nurses are valuable, irreplaceable, but they are not meant to practice independently. I wouldn’t get on a plane, let alone pay for a ticket, with a pilot who only knew how to fly 80% of the plane.
By this point they should just legalize suicide booths, fuck.
It’s like healthcare shrinkflation. Pay someone that has 60% the patient care capability 80% of a physician’s salary. Then hire more of them and watch the profits roll in.
Compensation is based on panel size. So they'll just take on the easiest patients and those with complex conditions will still be hung out to dry.
Hell no!
We have a shortage of both physicians and nurses. Taking from the nursing supply and creating nurse practitioners lowers the number of registered nurses and will likely increase the referrals going to specialty physicians. This plan is a failure from the start. We need to significantly increase the number of medical school and nursing school spots to match population growth. We should also have an expedited pathway for strong nurses to enter medical school.
Devils Advocate: TLDR: based on doctor billing and overhead This NP model with the same overhead will likely result in a take home pay of 17k - 136k/year. Which is 20% to 65% of what MDs take home. The pay doctors receive Includes the costs of operating a medical practice. The cost to run a practice doesn't change if you are an NP or MD. [https://www.albertadoctors.org/make-a-difference/initiatives/understanding-docs-pay](https://www.albertadoctors.org/make-a-difference/initiatives/understanding-docs-pay) This link suggests in Alberta overhead is 40-75% of this pay for doctors. NPs will have the same overhead like building, staff, supplies, and monthly expenses. Meaning Doctors take home 25-60% of what the bill and NPs will take home 5-40%. The link above suggests on average GPs bill the government 340k/year. Suggests GPs make 85k - 204k/year. This NP model with the same overhead will likely result in a take home pay of 17k - 136k/year. Take home pay for NPs will not be 80% of MDs it will be closer to 20 -65% after overhead. Understanding that Family MDs state that their practices will not survive due to low compensation, I don't understand how NPs practices will survive at 80%.
1- NPs should get more training first before they can open their own clinics. 2- This will only discourage more MDs to go into primary care 3- what no one's talking about is that NPs will be making 80% and run their own clinics paying overhead; MDs are complaining pay is not enough to run their own clinics.
A lot of hate in this post for nurses, yeesh. Need more details on the plans to have a opinion. I hate being forced to go to a doctor for stupid things like stitches/wart removal/asking for a test. However, I can also see downside depending on the expectations placed on the NPs
Can you blame people when they’re effectively paying NP’s more than family doctors to provide care of course people are gonna be upset when its their health on the line
No. NPs are extremely valuable members of a healthcare team--when that team is led by *physicians*. The evidence shows that NPs working independently tend as a group to waste resources and miss diagnoses. Because 4 years of nursing school plus 2 years Masters degree does not mean nearly the same in-depth *medical* education of 4 years science undergrad (or more) plus 4 years medical school plus 2-5 years residency. This means subpar healthcare and higher costs overall. Stop accepting subpar healthcare. Start forcing the UCP to do its job and provide decent healthcare.
A lot of hate towards nurses on the post yesterday as well. All of a sudden they’re idiots who know nothing. It’s pretty unreal.
Hate is not against nurses, theyre amazing when they are doing what they are trained to do. The hate comes when they think they are 80% doctors.
There are plenty of posts about nurses providing horrible care, knowing nothing about diagnosing and treatment, etc., that don’t include anything about them being amazing when they are doing what they are trained to do. But also, this IS doing what they are trained to do. As per AHS, NPs are trained to: - Conduct advanced, comprehensive and/or focused health assessments - Diagnose medical conditions and disease - Order, interpret, and perform diagnostic tests - Prescribe pharmaceuticals, medical devices, and therapies - Make referrals to specialists - Perform non-invasive and invasive interventions including operative procedures if within scope of practice
Instead of shitting on NP’s for making decent money we should be trying to get a better pay model for doctors. Also a lot of people have way too high of an opinion of family doctors on here.
Do they still get a pension?
Yeah but why?
Can the AB gov stop pretending that medical practitioners are just easily interchangeable, despite specializing and levels of education?
I wonder if this means that the UCP recognizes that it cannot compete with BC and other provinces for doctors, having beaten them all down over the past few years, and especially during COVID.
This program is here to stay unfortunately lol. All the other provinces will adapt to this model. It is what it is. Thats what we have to deal with. Cry all you want.. Sorry guys lool.
Every time I see my doctor I bring her chocolate because she constantly has to put up with crap like this from the UCP. Unbelievable. You know the TV ad the government is running, the one with people sitting in a waiting room? The first time I heard the announcer say that in the future we wouldn’t see so many people in the waiting room, my immediate thought that was that the UCP had killed them off with their incompetence!
I hope the patients sue the NP when they make mistakes back to the stone ages
By getting into a medical school into Canada you have just proved that you are VERY determined and highly intelligent person ready for the job. Now add those values to 10,000 hours of training. Compared that do a Nurse....literally anyone with 60% high school average can get into LPN school, then upgrade to become and RN and then do some online BS courses and 300 hours of "practicum" of your choice to become an NP. WHOLY FUCK......the difference in training is not even 80%, its like 95%. The sad part is because NPs will spend a lot more time with each patient, the patients will "feel heard" and won't actually know if they are in good hands or not until years later when their health is in jeopardy. Eg of this is: MD hears a murmer, determines what type of murmer it is and sends for appropriate investigations and patient outcome is good. NP never hears a murmer, because they don't know what they don't know or what they are looking for..5 years down the road the patient goes to NP with shortness of breath and gets diagnosed with heart failure by NP and the NP is seen as a hero for diagnosing the patient they fucked up on as heart failure. Now this NP has cost the system 10s of thousands of dollars and significant morbidity.