SNPs and diagnoses
On February 22, the Collège des médecins du Québec (CMQ) adopted a resolution to allow specialized nurse practitioners (SNPs) to diagnose certain common health problems related to their specialities, for example, urinary tract infections, ear infections, and sexually transmitted infections. They will also be able to diagnose six chronic diseases: diabetes, hypertension, hypercholesterolemia, asthma, chronic obstructive pulmonary disease, and hypothyroidism.
Since 2007, SNPs have been able to start treatment for these conditions but were not allowed to formally diagnose them; their diagnosis had to be confirmed by a physician within 30 days, which is now no longer necessary.
However, we’ll have to wait another few months before SNPs will be able to make diagnoses. The CMQ and the Ordre des infirmières et infirmiers du Québec (OIIQ) are set to produce a joint draft regulation that will be adopted at the CMQ’s next Board meeting on April 26. The regulation will then be submitted to the Office des professions, after which it must be approved by the Government of Québec.
Note that the National Assembly unanimously passed a motion introduced by the Parti Québécois asking the government “to put a swift end to the compensation of physicians for the general supervision of the front-line medical activities of SNPs.”
A family medicine group receives $30,000 per year for the “supervision” of an SNP by the physicians and $30,000 for the SNP’s use of the office space, equipment and staff.
Minister of Health and Social Services Danielle McCann has promised to follow through on this motion, but the Fédération des médecins omnipraticiens du Québec (FMOQ) is opposed to it. In fact, the two have differing opinions on what the “supervision” of an SNP actually means. The Minister of Health and the CMQ believe that the supervision of an SNP consists in the “general supervision” of the SNP’s medical acts, whereas the FMOQ views it more as “collaboration between professionals,” or case discussions. And according to the FMOQ, physicians need to be compensated for their collaborative work with SNPs, an opinion that is shared by the Association des infirmières praticiennes spécialisées du Québec (AIPSQ).