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Thorsby and Warburg benefit from a Nurse Practitioner’s approach to Primary Care
It’s been an exhausting two years for Michelle Williams, an NP now working in the communities of Thorsby and Warburg. Since Michelle was hired to serve as the nurse practitioner in an NP-led clinic serving both communities in 2020 she has worked tirelessly to establish the technical components of a primary care clinic as well as address system-wide barriers to primary care NP practice.
Thorsby and Warburg are towns separated by about 20 km, both of which found themselves without access to a primary care provider. In fact, 93% of residents did not have access to a General Practitioner. As is the case in many non-urban communities throughout Alberta, recruitment of new providers was proving difficult, and residents were traveling significant distances to access healthcare services. For community leaders, the access issues became significant enough that they reached out to the local PCN to partner with them in recruiting a new type of primary care provider, a Nurse Practitioner.
Nurse Practitioners are advanced clinicians who have a graduate degree in nursing and training in medical diagnosis and treatment. They have been licensed in Canada for 50 years. An NP can provide the same level of care as a family physician in the community and serve in highly acute/specialized settings throughout our health system. Though originally used to serve remote outposts where care was not readily available, in 2022 an NP may set your broken arm, drain a collection of fluid in your chest, manage your diabetes, or provide you with routine preventive care. NPs work without supervision and are completely responsible for the care that they provide. They have been effectively incorporated as GPs in other provinces in Canada (BC and ON) and are widely accepted there and across the United States. The barrier to full integration in Alberta is the lack of an NP payment method within the Alberta Health Care Insurance Program.
Given the fact that there is no provincial funding framework in place for NPs serving as independent general practitioners, leaders in the Thorsby/Warburg communities needed to get creative. Partnerships were necessary to supply clinic space and supplies, as well as support staff and other ongoing overhead costs, to ensure that residents received the same level of care they would have received by attending a GP in a larger centre. Leduc County, the Leduc-Beaumont-Devon Primary Care Network, and the Ministry of Health contributed funds and space to allow the development of the two clinic spaces and ongoing staff. There has also been significant support from the communities of Warburg and Thorsby, with residents reporting that they have received “thorough and caring” services from the NP and her medical assistant, and that they “definitely DO NOT want to lose access to the facility”.
Residents being cared for by Michelle would like to see expansion of care by NPs. Other neighbouring communities are also without primary care access and could benefit from a similar model. The continued barriers are funding and awareness - many communities do not realize what Nurse Practitioners are, and don’t know that they might be available. Funding limitations mean that an NP cannot simply start a clinic as there is currently no mechanism to pay them for their services. Communities can help by contacting their MLAs and asking the right questions: How can we access primary care from Nurse Practitioners in our community? When will funding frameworks be available to support NP practice in primary care? What can the community do to advocate for NPs overall, and for their towns specifically? It is only through advocacy that barriers will be removed, and access improved.
Questions about Nurse Practitioners and what your municipalities can do to increase access to care can be directed to president@albertanps.com.