Special nurses to lead 25 new health clinics

TheStar.com – Healthzone.ca – Special nurses to lead 25 new health clinics
February 21, 2009. Tanya Talaga, Queen’s Park Bureau

In the next few years, 25 nurse-practitioner-led clinics are set to open in areas of the province where the doctor shortage is most acute, but Ontario’s doctors say opening up these clinics is not the way to solve the crisis.

Nurse practitioners are specially trained, registered nurses who have the legislative authority to treat common illnesses and injuries and prescribe medications.

Premier Dalton McGuinty announced yesterday three new clinics are ready to go in the Windsor area, Sault Ste. Marie and Thunder Bay. These are the first of 25 clinics that will come into operation by 2012, McGuinty said during a news conference at the Registered Nurses’ Association of Ontario. The location of more will be announced this spring.

But the Ontario Medical Association, the group representing the province’s 31,000 doctors, does not feel opening up nurse-led clinics is the way to alleviate the shortage.

Dr. Ken Arnold, OMA president and a family physician in Thunder Bay, said he would prefer to see more family health teams created – groups of medical professionals such as doctors, nurses and dietitians working together – instead of nurse-practitioner-led clinics.

“It strikes me as a step in a different, backward direction in an unproven way of delivering care,” Arnold told the Star in an interview.

Opening up nurse-led clinics is part of the Liberal government’s strategy to address the doctor shortage and even alleviate waits in emergency rooms. It’s estimated anywhere from 500,000 to a million Ontarians are without a family doctor. Patients without doctors can often wind up in emergency rooms for minor ailments, needlessly clogging the system.

On Thursday, Health Minister David Caplan unveiled a new public website, ontariowaittimes.com, where residents can examine waits for 128 emergency rooms and shop for an efficient department. This link can also help lead a patient to alternative health-care options, such as a walk-in clinic. After collecting data on the total time spent in the emergency room, the health ministry discovered the maximum amount of time nine out of 10 patients with uncomplicated medical problems spend in an ER is 4.6 hours. Ontario has now set a target wait time of four hours.

For those patients with more serious problems, such as cancer patients who require more time for diagnosis, treatment and perhaps admission to a bed, for nine patients out of 10, the wait is 13.5 hours. A target time of eight hours has been set.

Many of the nurse-led clinics are aimed at underserviced communities where the need for medical help is the greatest, said Doris Grinspun, executive director of the nurses’ association.

“The three announced is where the need is huge,” Grinspun said. “We are well aware that more than 25 communities are in dire need of primary care.”

In Belleville, 200 kilometres east of Toronto, there are 20,000 “orphaned” patients in need of medical care, Grinspun said. “We have a group of nurse practitioners ready to go in Belleville. We are confident that one will be in the next round of announcements.”

In the 2008 budget, $38 million was set aside over the next three years to create the nurse-practitioner-led clinics.

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