​For many years as a NP, I was advocating for NP's to be able to bill direct to the province (Manitoba Health) for our services which would allow us to have an independent clinic without all the red tape and bureaucracy that gets in the way of our job satisfaction and the quality of care for our patients!!  Well, through experience, talking to family doctors, and looking critically at the politics and the true definition of patient-centered care, I discovered I was advocating for the WRONG thing!!!

Billing fee-for-service sounded like something that would work...why not?  We could have our own practices and just bill direct for our services....but we are forgetting that this would create a situation where we would have to have our own or at least contribute to reception staff, software, clinic supplies and all of the overhead that is there in your own practice.   All of a sudden, there is a perspective change!   You then realize that you would have to see many patients per hour just to pay the bills and you would still have much unpaid hours of work to do in between.   Hmmm, a fee for service practice funded by the health system suddenly doesn't feel so good.   This system would still contain the pressures to see high numbers of patients every hour and would seriously limit the quality and true ability to provide patient-centered care as you would want to in order to have job satisfaction!  Oh, and if you are working in a clinic that would be billing your work fee-for-service, there would also be productivity expectations to pay their bills as well!!    

Another consideration is...the moment we are funded by the Province (thus becoming part of Canada Health Act), we will have limitations, restrictions for what will be paid for, and it will then be illegal to offer medical services outside what 'they' authorize.  So what about those patients who want half hour or an hour appointment to sort out some major issues or multiple concerns?   Will we have to put up a sign that says "ONLY ONE ISSUE PER APPOINTMENT" like we often see in physicians offices?   The reason those signs are there is a billing system issue.   The health system pays for ONE issue per appointment and the amount they pay only really covers about 10 minutes of professional time.   Hmmmm....more things to think about!   

Time to re-consider whether you would want to work fee-for-service through our provincial health system?  ...I know I wouldn't want it!  NO THANKS!   Currently in Canada, Nurse Practitioners are considered an uninsured service.   AHA!!!  :)  This is both good for us and for patients because they (the patients) can pay for the service that THEY want.  They can get the client-centered care they want this way and not have some regulator putting a stop to the quality medical care they prefer to pay for!!

Learn more about how to become an autonomous, independent and FREE NP who has learned to LOVE their work again....it is SO worth it!  
www.npautonomy.com

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Diane Gudmundson 
Nurse Practitioner, Entrepreneur in Manitoba, Canada
Irrationally Passionate about NP role, outstanding care for patients, supporting and promoting NP’s and with Fitness and Nutrition / disease prevention and de-prescribing!
Email:  admin@NPautonomy.com
FB: facebook.com/nponwheels
Private Practice:  www.nponwheels.com
NP Blog:   www.uniqueprovider.com
Join the movement here!   www.NPautonomy.com
Call/Text:  204-870-0652

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To become part of the NP independence and autonomy movement, get your name and email on the list ASAP so that you don’t miss out on the upcoming opportunities!     www.NPautonomy.com

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Subscribe to this awesome you-tube channel!   
https://www.youtube.com/channel/UCTYVbA9x_sd0YPzbNaZnZKw

​Seriously, the stories get better all the time. I was triggered to remember this story of my primary care practise being covered by a public health nurse while I was off for surgery. A public health nurse is a highly skilled and respected professional, but is not a Nurse Practitioner nor has the scope of practise to cover a Nurse Practitioner practise. Its unfortunate that, despite agreeing with me wholeheartedly that a PHN covering an NP was not appropriate, both our regulating body and our union did not support me nor enforce it when my employer at that time decided to proceed anyways with covering my practice with a PHN.

While I was off for surgery, the PHN that was assigned to cover for me was, to say the least, in a bit of an uncomfortable position. She contacted me by phone (while i was in bed recovering from surgery) to consult about the meaning of test results and how to interpret them and what action to take from there. By no fault of her own, she was placed in a difficult position by her boss, which was not a good scenario for her either.

As Nurse Practitioners, we need to band together to STOP the nonsense. There are too many stories from hundreds of NP's (not just me!) all across North America where the NP is not treated properly, not recognized for his/her scope and definitely not remunerated appropriately for the level of responsibilities that are expected!

If we look back in time, we can see definite patterns of where the source of issues can be traced back to, legal decisions that were made that led to misunderstanding of the role and where we are at NOW is definitely a SYMPTOM of where we have been and what we have allowed until now! Its time for CHANGE and if you are an NP who is ready to join a movement of NP's who are ready for change, then be sure to get your name and email into the system below and have your voice heard!

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Yet another story that demonstrates how the Nurse Practitioner role is not known and is misunderstood in our health care system!

Its scary to me that I have been working my butt off as an NP now for 15 years and people still do not understand the role or how it fits into our health care system.... how can this be?

The issue is being boxed into a "mini-doctor" role in the back of a clinic. Patients and other providers and even employers will see an NP as just another "doctor" style provider if we are in those roles. THAT is the problem from all of these years! I was boxed in and misunderstood for far too long!

Anyways, its TIME for change, TIME for all of the BS to stop and time to move forward as unique providers in our health care system. We are not doctors, we are unique providers that have something far different to offer and its time the world realized this. Once the world realizes this, EVERYTHING will change!

As an NP, be sure to join the movement forward. its time to move our profession forward at a FAST rate and not spend another 15 years unknown and working like something we are NOT in a little box!

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Diane Gudmundson Nurse Practitioner, Entrepreneur in Manitoba, Canada Irrationally Passionate about NP role, outstanding care for patients, supporting and promoting NP’s and with Fitness and Nutrition / disease prevention and de-prescribing!
Email: admin@NPautonomy.com
FB: facebook.com/nponwheels
Private Practice: www.nponwheels.com
NP Blog: www.uniqueprovider.com
Join the movement here! www.NPautonomy.com
Call/Text: 204-870-0652
============================================
To become part of the NP independence and autonomy movement, get your name and email on the list ASAP so that you don’t miss out on the upcoming opportunities! www.NPautonomy.com
​============================================
Subscribe to this awesome you-tube channel! https://www.youtube.com/channel/UCTYV...