I have observed the concerns expressed in the media recently regarding the loss of doctors in our community resulting in a decrease in access to health-care services.
I don’t think it would be appropriate or useful for me to enter into the debate about international medical graduates, but I do want to offer some constructive input regarding access to health care the public might find informative and encouraging.
The inability for any individual to obtain health-care services is troubling.
However, when we get fixed on the “access to a family physician” discussion, we do not get very far in finding solutions. When we shift the discussion to “access to a primary health-care provider” then there are a number of alternatives that could address the issue in the Yukon.
In other parts of Canada, a wider number of choices are available to the public when they seek health care and it is my hope we will soon see these here in the Yukon.
I would like to present a number of these options in this letter to encourage some constructive public dialogue, to suggest realistic alternatives to what we have presently in Whitehorse and to provide Yukoners with some optimism regarding possible options that are efficient, effective, economically sound and are focused on the patient/client, family and community.
Regulations authorizing the practice of nurse practitioners in the Yukon are likely to be passed by the end of this year.
In fact, at the time of writing this letter, a stakeholder consultation on these regulations is underway. Nurse practitioners exist in all of the other provinces and territories of Canada. These health-care providers have the competence to provide comprehensive health assessments, to diagnose health conditions and to treat and manage acute and chronic illness.
They order and interpret screening and diagnostic tests, perform a variety of surgical procedures and prescribe medications. By 2012, it should be possible to access a nurse practitioner as a primary health-care provider in the Yukon once the necessary policies have been developed by employers and appropriate government departments.
While the Department of Health and Social Services and the Yukon Registered Nurses Association have been working together to support the implementation of this new role in the Yukon health system, there has been little mention of this important health-care provider in the media as the debate related to access has unfolded.
Another option is one that has been previously promoted by a number of health professions in the Yukon and which is well established in other parts of Canada à centres or clinics where health professionals work in interprofessional collaborative teams.
In these instances, patients or clients can access the health professional that is appropriate for their immediate health concern.
For example: a physiotherapist to assess and treat their injured back; a dietician regarding nutritional advice and goals for someone with diabetes; or a pharmacist to provide expert advice on medication and potential side effects.
In this way, patients or clients have direct access to the appropriate health professional for their current health concern and those health professionals have the opportunity to consult and to easily refer patients to each other as necessary, thus reducing barriers and delays in service.
The new clinic that has been announced where a physician, social worker and addictions counsellor will be working together is a first step in this direction and we welcome it.
However, this is an idea that needs to be expanded to the broader population.
A third consideration is that of enabling the practice of regulated midwives.
The nurses’ association strongly supports the introduction of licensed midwives into the Yukon health-care system as a valuable option for women and families.
The Yukon has been considering regulation of midwives for many years and we would encourage the government to proceed with this policy initiative to facilitate the practise of this important member of the health-care team.
Discussions regarding the above options are taking place in a number of forums and the government is making some moves to implement them.
However, these solutions have so far been missing in media coverage.
It is important that all options for the provision of health care be part of the general debate on the future of health care.
The registered nurses’ association will continue to promote these positive solutions which, if implemented, could go a long way to meeting the needs of health care in the territory.
Peggy Heynen, RN, president
Yukon Registered Nurses Association
Whitehorse