Ontario seeks expanded role for many health-care providers

Posted on May 12, 2009 in Debates, Governance Debates, Health Debates

TheGlobeadMail.com – Life/Health – Ontario seeks expanded role for many health-care providers
May 12, 2009.   KEITH LESLIE, The Canadian Press

TORONTO — Ontario wants to broaden the scope of practice for many health-care professionals as part of a strategy to address the chronic shortage of doctors, proposing new rules that would allow nurse practitioners to set broken bones and give dental hygienists the power to write prescriptions and sell medicine.

Under legislation introduced yesterday, dentists would be able to fill prescriptions, pharmacists would be allowed to write refills for prescriptions and physiotherapists would be given the power to order X-rays and treat injuries.

The proposed changes will make Ontario’s health-care system more efficient and more accessible, Premier Dalton McGuinty said.

“It will free up doctors to do those kinds of things which only doctors can do,” he said. “There’s a number of things doctors are doing on their own right now that we think other health-care professionals can do as well.”

An estimated 850,000 people in Ontario don’t have a family doctor.

Mr. McGuinty said adding new responsibilities to a host of different health-care professionals doesn’t mean the government will be offering them additional pay.

“We’re talking about increasing the other kinds of rewards for health-care professionals, which is to recognize that they can do more for us [and] we want them to do more for us,” Mr. McGuinty said.

“There’s a tremendous … psychic reward that comes from knowing you can in fact do more than you have in the past.”

Alan Hudson, the man in charge of Ontario’s strategy to reduce health-care waiting times, said the legislation signals a shift to consumerism in a service industry that he said was originally designed more to suit the needs of the providers – doctors – rather than patients.

“Consumers, people who pay for this – it’s your tax dollars and mine – they’re going to call the shots,” Dr. Hudson said. “Physicians aren’t going to decide that.

“About 50 per cent of what a family doctor does could be done by other people, so they can concentrate on doing doctor stuff, and other non-MD health-care providers can do that work.”

The Ontario College of Pharmacists said it is “very pleased” with the proposed legislation.

The Registered Nurses’ Association of Ontario called the bill “a good first step,” but said the changes don’t go far enough because the government bowed to pressure from a powerful doctors lobby.

“To me, this is catering to the Ontario Medical Association,” said RNAO executive director Doris Grinspun.

If the province is serious about increasing access to health services and decreasing wait times, it is imperative that nurse practitioners be able to admit and discharge in in-patient settings.”

The New Democrats agreed that nurse practitioners should be allowed to write any prescription, not just those on a pre-approved list, and said it is crucial that nurse practitioners also be given powers to admit and discharge patients from hospitals.

“More and more in rural Ontario, physicians refuse to have admitting privileges, so you have hospitals that are struggling with no physician on staff, and the nurse practitioners are not allowed to admit or discharge,” complained NDP health critic France Gélinas.

“New medications come out fast and furious – something like 50 a month – so [nurse practitioners] are forever having to prescribe from an outdated list.”

The Progressive Conservatives welcomed the idea of expanding the scope of practice for health-care professionals.

“I personally had an experience where I didn’t get a proper treatment from a doctor in Ontario, and it was diagnosed appropriately by a doctor’s assistant in Lake Placid, New York,” interim Opposition leader Bob Runciman said.

“I think we can look at broadening those responsibilities in Ontario quite safely as long as the training is in place.”

The goal of the legislation is to reduce the number of stops a patient must make in navigating Ontario’s health-care system, Health Minister David Caplan said.


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