What's the difference between a family doctor and nurse practitioner?
First off, consider the similarities.
Both professions produce highly-trained people who work independently to diagnose diseases, determine appropriate patient treatments, prescribe medications, and work with other health service providers to improve the health of the patients.
Both have attained graduate degrees that usually require a minimum of seven years of postsecondary schooling. Doctors must already have bachelor's degrees (four years of school) then go on to medical schools and follow up their studies through residency programs (at least four more years of school), usually in a hospital environment, before they are licensed to practice medicine or surgery.
In B.C., nurse practitioners must already be registered nurses (four years of study), then must complete a masters or doctorate degree at a nursing school (usually three years of study) with a minimum of 700 hours of clinical experience in a family practice community health setting.
"We get asked that all the time what the difference is and in a lot of ways we are like doctors," said Erin Wilson, a nurse practitioner and UNBC assistant professor.
"What's the biggest difference, sometimes it's pay," laughed Wilson, who works in the Victoria Medical Centre alongside family physician Gerrard Prigmore.
"It's really about the focus. Doctors get much better education on pathophysiology and on the cellular level. We get much better education on what it means to have this illness in the context of your life and your family circumstance and what does it mean to have this problem when you have to look after five children in a terrible housing situation.
"We certainly take into account the social determinants because we know things like your housing, your education and your job affect your health."
Nurse practitioners are often a patient's primary health care provider and focus on patients' conditions as well as the effects of illness on the lives of the patients and their families. They offer patients in-depth education on preventative medicine while promoting social justice and wellness programs, and provide health care counselling.
"We can independently and autonomously see patients, diagnose conditions, order and interpret tests, prescribe most medications, and complete management plans for follow-ups as any other primary care provider would," said Wilson. "If you had diabetes or renal failure or having chest pain, just as you would go to see your family physician, you could go see a nurse practitioner if one is available."
Two of the Prince George area's NPs are funded by First Nations bands (Carrier-Sekani and Lake Babine) one is jointly funded by Health Canada and Northern Health. Unlike doctors, NPs do not bill the province on a fee-for-service basis and instead hold salaried positions, seen as a cheaper alternative to hiring doctors. Most NPs see a high volume of patients, but not as many as a family physician would.
"They look at the whole person and the family and they deal particularly well with people needing chronic disease management," said Martha MacLeod, the chair of UNBC's nursing program. "The physician will work with some of the more complex issues. In a general practice, a nurse practitioner can do up to about 80 per cent of what a general practitioner does and they work hand in glove with GPs. They are not physician replacements."
