Mike W. Bryant
Northern News Services

Yellowknife (Nov 07/01) - Primary health care was on the agenda for delegates from the health and social services field at a conference held in Yellowknife last Friday.

About 90 physicians, nurses and community health care workers, were looking at ways to better serve the interests of Northern communities.

"There's approximately 3,200 potential patients in the Deh Cho region," said Dr. Shane Barclay, who gave a presentation on remote community health centres. Dr. Barclay is the only physician working in Fort Simpson, a community of about 1,300 people.

"There is no way I can see everybody, especially when I have to do 10 days a month community travel."

A key initiative raised at the conference was to encourage the territorial government to hire more nurse practitioners, who could perform many of the same duties that doctors do. Last September, Aurora College in Yellowknife began a new certificate program for nurse practitioners.

There are currently nine students enroled -- three in a six-week introductory program, and six others in the more in-depth 16 month course.

Applicants for the program must have worked as a registered nurse for two years in an NWT community, and received the community's sponsorship. The cost of the program is $1,500 a semester, and is funded by the territorial government.

Dr. Barclay thinks the government can do even more.

"I don't see why it couldn't be developed," said Dr. Barclay. "It just takes political and financial will."

"It just a matter of putting an educational stamp on it here," Dr. Barclay added, noting that many nurses in remote communities perform front line care and patient diagnosis. ""It's already existed for some time."

Nurse practitioner Madge Applin was in Yellowknife to relate her experiences working in remote communities in Newfoundland. The province developed a practitioner program in 1997, and Applin said it has been very successful so far.

It has been so successful in fact, that Aurora College used the province as a model for its certificate program.

Nurse practitioners there can order blood tests, X-rays, and prescribe certain drugs.

"Nurses have been key to providing health services in remote communities for a long time, but they shouldn't only be in remote areas but urban and suburban areas as well," Applin argued.

She said a nurse practitioners program is relatively inexpensive when compared to the money that would be needed to train doctors.

To train 16 nurses in Newfoundland for practitioner's certificates costs about $300,000 a year. Applin said one of the problems facing the province was the reluctance from some doctors to take nurse practitioners into their practice, where physicians work to a fee for service compared to nurses who receive a salary.

More nurse practitioners means less fees a doctor can recoup from the government at the end of the day.

Dr. Barclay, however, said that is not a problem in the NWT, where most doctors are on salary as well.

"It's a manpower issue," said Dr. Barclay.

"It's my experience in the last three years is that we use what we have."