I have read recent comments made in the media by our health minister about using nurse practitioners to perform many of the duties done by family doctors. I’m not sure whether he’s giving nurse practitioners a small compliment for being competent or insulting family doctors for being so inept that tasks have to be removed from their jurisdiction.
If Dr. John Haggie meant neither of these opinions, then let us call it poorly worded “political speak.” Either way, it is a remarkable statement from a former distinguished medical doctor — the political part of the brain has taken over.
The minister tells us we have “significant resources.” I have been checking on two of those resources which many people feel are significant: nurse practitioners and midwives.
Being a nurse practitioner is a noble profession, long overdue in this province. However, I can’t find out just how many are employed here.
Consultants from McMaster University presented their report to the provincial government in 2013 on midwifery, which was first legalized here in 2010, but not regulated. In 2013 there were 100 midwives interested in working in Newfoundland and Labrador.
In September 2016, the government announced that “a series of regulations that outline the necessary training and qualifications for midwives will come into effect on Sept. 30. This means that midwifery will soon be officially be recognized as a health-care profession by the provincial government.”
In May 2017, the government was saying, “(a) provincial midwifery consultant will be working with the government this fall to design a services delivery model and to develop policies.”
It is now 2018.
I think Dr. Haggie needs to re-evaluate. These important roles are still in some sort of government limbo. Instead, he turns on family physicians.
Family medicine occurs in the community. Those professionals live in the community. They are part of us. The role of family doctor is being watered down from a noble calling by rules and endless paperwork, turning them into paper-pushers and form-fillers.
The art of a family physician has been blindsided by government, allowing them less time to listen to patients, get to know families, deal with cuts, bruises and many illnesses which are now “go to Emergency.”
Since when was a doctor’s office not the place to have a finger stitched or a minor ailment dealt with? Now it’s a six-hour wait in a hospital. This is not medicine, it is a cattle market. This is a sick person terrified and bereft, who desperately requires the continuity and comfort of their family physician.
We need the return to the real the position of family doctor — someone you know will be with you every step of the way during sometimes difficult times and not dump you at the door of a hospital. We need more family physicians. Sick people need to feel safe. It may be just a flu shot, but a doctor who knows you can tell a lot from your demeanour. I think the government has already taken a big part of health-care delivery away from physicians, and in the trenches it is not a pretty sight.
In an ideal reachable model of a very old idea, a family practice would have doctors, at least one nurse practitioner and a midwife, each involved in his or her specialty — a cohesive group. It will never be possible in very small communities, but a nurse practitioner and a midwife should be there, hopefully living in the community. Most women would rather have the ministrations of a midwife they know rather than be handed off to a specialist in a large, noisy building. If a hospital is required, the local midwife should remain in attendance for the comfort of the mother.
We do not require more “Centres of Excellence.” We suffer from a “centre of incompetence” — Confederation Building.
We demand more local physicians, nurse practitioners and midwives working in small groups in the community. Places of safety, gentleness and humanity, with medical professionals who do what they were trained to do: be with their patients all the way from cradle to grave. You know, “80 per cent of a general practitioner’s day.”