Collaboration with the super-nurses: the family doctors must be paid, said their federation

Collaboration avec les super-infirmières: les médecins de famille doivent être payés, dit leur fédération

If doctors are no longer paid to do the “general supervision” of the medical activities of the nurse practitioner specialty (IPS), then, like the elect, it is all the work of collaboration with these professionals that is compromised, warns the Fédération des médecins omnipraticiens du Québec (FMOQ).

On Tuesday, a motion asking the government “to put an end in the shortest possible time to the remuneration of doctors linked to the general supervision of the medical activities of nurse practitioners specialized in primary care” has been adopted unanimously in the national Assembly.

The cabinet of the minister of Health, Danielle McCann, has promised to address, considering that this remuneration was no longer justified in the context of the new responsibilities that will be entrusted to the IPS. They will be able to diagnose common health problems and the six chronic diseases for which they initiaient already treatments. The College of physicians has also announced that the patient will no longer have to see the doctor within 30 days of the initiation of treatment by the IPS to confirm the diagnosis.

A group of family medicine (GMF) receives $ 30,000 per year to pay for this, that the College of physicians called the “general supervision” of the medical activities of the IPS, but that the FMOQ prefer to identify as the work of “interprofessional collaboration” (discussion of cases). Another $ 30,000 is paid to the GMF for the use of an office, equipment and staff by the IPS. In 2017, family physicians have shared $ 7 million to the general supervision or interprofessional collaboration with IPS, denounced the CAQ in the last year.

According to the FMOQ, if one follows the logic of the elected officials, family physicians will now be required to refrain from discussing patient cases with the IPS. It stresses that all health professionals (nurses, nurse practitioners, specialist, social workers, etc) are paid when they collaborate with the family doctor, and that it is normal that it will do the same for his work. If the IPS are remunerated at hourly rates, this is not the case of family physicians, who are paid to act, unless they practice in CLSCS.

A barrier to collaboration

“Remove the remuneration of the doctors to discuss the case with the IPS, it is a disincentive and a barrier to work cross-industry. This is counter-productive, and it goes against the will of delegated acts”, explains the spokesperson of the FMOQ, Jean-Pierre Dion.

Dion points out that”there is not a doctor who makes money with it (the discussion of the case with the IPS)”. At most can it reach $ 2000 per year, calculated there. “If he saw him-even the patients, it would be paid more.”

According to him, the elect who are inadequately the issues around the professional collaboration between the physicians and the IPS. “We are open to discuss the form, of the mechanism of compensation, but it is necessary to find a solution” to ensure that the physician continues to be paid for his collaborative work with the IPS. All the more that physicians have a professional responsibility towards the patients who are enrolled in their GMF, he says.

The Association of nurse practitioners specialized in Quebec (AIPSQ) sharing the point of view of the FMOQ. “It is sure that there must be some compensation for the doctors when they must discuss the case with them,” said the president of the AIPSQ, Christine Laliberté.

According to it, if the IPS need to consult with family physicians, it is not so much because they need that because “the current guidelines that mark the Regulation on the practice of the IPS are so made that one has more often to do it.” “But it is sure that, in time, we will always need to refer to the doctor as a family doctor must refer to a specialist physician,” says Ms. Laliberté.

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