When Donna O'Sullivan, her husband, Ken, and their daughter, Natasha, moved to Beaverton, Ont., they were told the local family doctor was not taking new patients. But it was imperative that they find a primary-care provider: Natasha, 36, is severely autistic, blind, has no speech and suffers from seizures.

The doctor's receptionist suggested a local nurse practitioner, a registered nurse who with additional certification can diagnose and treat common medical issues.

The O'Sullivans were more than pleased with the results. The nurse practitioner was never rushed and offered helpful tips. To deal with Natasha's extreme fear of needles, for example, she recommended a patch that temporarily anaesthetizes the area to be injected.

When the family moved back to Toronto last fall, they were once again without a family doctor — until Donna noticed an advertisement in a community newspaper for the Emery-Keelesdale Nurse Practitioner-led Clinic, which had just opened its doors near Keele and Eglinton Avenue West.

“When I saw the flyer, I said, ‘I'm going to try that route again,’ ”

Donna says. “I was so overwhelmed with the level of care we had received.”

Emery-Keelesdale is one of 25 nurse practitioner-led clinics (NPLC) across the province expected to be fully operational by the end of 2012. The clinics have are being opened in communities that Local Health Integration Networks have identified as particularly in need.

According to Beth Cowper-Fung, president-elect of the Nurse Practitioners' Association of Ontario, 23,000 patients in 23 communities who previously did not have access to primary, now, through NPLCs, do.

Since November, Emery-Keelesdale's satellite location has accumulated 80 patients, including Donna, Ken, Natasha, and Ken's 91-year-old mother. In the next eight to 12 months, a larger location will open with an additional three nurse practitioners, each serving a projected 800 patients. The main challenge, says lead nurse practitioner Tarik Towfeq, is communicating what a nurse practitioner does.

“Many people are not familiar with the concept of a nurse practitioner or a nurse practitioner-led clinic,” Towfeq says. “But once they hear about us and who we are and what we deliver and the model of care, really, the majority have a positive impression of it and are very enthusiastic.”

Nurse practitioners are university-educated and can diagnose and order tests for a patient. They can prescribe all but federally regulated medications and, when they need to, work with a collaborating physician. NPLCs also offer a holistic range of services depending on the community's needs, such as a social worker, dietician and a pharmacy.

“People don't realize that a year ago, Bill 179 came in, which really opened up a lot of things for nurse practitioners,” says Maurice Michelin, the administrative lead at Emery-Keelesdale. “It means we prescribe medications and we can actually dispense medications. It means we can order X-rays, ultrasounds, all lab tests. We can refer to specialists. These are all things that took some education with the community to get them to know that.”

There are still kinks in the changes Bill 179 promised that need ironing out. For example, through OHIP, specialists are paid less when a nurse practitioner makes a referral than when a physician does. For this reason, nurse practitioners at NPLCs have their collaborating physicians make referrals for now.

But the clinics are saving physicians a remarkable amount of time, says Doris Grinspun, the chief executive officer of the Registered Nurses' Association of Ontario. Thunder Bay's Lakehead Clinic, she says, has 3,600 patients, but a physician only needs to come in for approximately two hours every two weeks. And with a holistic approach to health care that emphasizes preventative care and education, she says, there will be fewer people in the emergency room.

It's a model that Grinspun hopes to see in full form by the end of

2012 in the 25 planned clinics, and then expanded even further.

Sudbury's NPLC was the first to open its doors in North America, and Grinspun fields calls from around the world from people wanting to know how they're working.

“Give it five to 10 years,” Grinspun says. “Nurse practitioner-led clinics, in years to come, they'll be all over the country.”