Quarterly Letters: Primary Healthcare: The All-Too- Quiet-Revolution in Waiting.
I am very strongly in favour of a nurse practitioner program and have supported them very strongly in Cornwall. My concern is not displacement of physicians.
You also indicated that change seems faster and more effective across the ocean but the most important part that you omitted is the fact that in Canada we train and have far fewer physicians per population than exist in Europe. An integrated system still demands physician participation and a sudden transition from our patient-oriented system to a multidisciplinary team work requires stepwise establishment. That would dislocate existing physicians and therefore, at least temporarily, services would be curtailed rather than initially expanded. No physician is willing to participate in further curtailment of services even if the horizon is brighter in the future. Maybe governments should not have cut back on medical school enrolment in Ontario 15 years ago but implementation of a changing system is temporarily disruptive which would potentially lead to disaster during the implementation stage, even if the long-term effects are beneficial.
About the Author(s)
Thomas Baitz, MD, FRCP(C),
Internal Medicine - Nephrology - Cardiology, Cornwall, ON
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