The shortage of family doctors in Quebec is a well-documented reality - it was estimated in 2024 that over a million Quebecers did not have a family doctor, and delays in obtaining an appointment with a general practitioner can reach several weeks, even months, for many residents of the province. Faced with this challenge of access to primary care, Quebec has progressively expanded the scope of practice of specialized nurse practitioners (SPNs) since the creation of this professional title in 2007 - a trend that has accelerated with recent legislative reforms, notably Bill 67 passed in 2021, which considerably extended the autonomy of practice of SPNs in Quebec.
The Specialized Nurse Practitioner (SNP) is a nurse who has completed specialized post-graduate (master's) university training - typically 3 to 4 years of advanced training after a bachelor's degree in nursing - giving her advanced clinical skills to diagnose diseases, prescribe medications and tests, and treat patients autonomously within her field of expertise. Clinique Omicron integrates PHNs into its care model in several of its Quebec branches, working in interprofessional collaboration with physicians to provide expanded access to primary care.
What can a GPI do? Scope of practice and clinical skills
The Primary Care Nurse Practitioner (PCNP) - the most widespread specialty in Quebec - is empowered to perform a wide range of clinical activities that were traditionally the exclusive domain of physicians. She can assess a person's state of health through a complete medical history and physical examination, diagnose many acute and chronic medical conditions, prescribe medications - including prescription drugs, controlled substances in certain contexts, and medications used in chronic diseases - order and interpret diagnostic tests (blood tests, imaging studies, ECGs), carry out certain clinical procedures, and provide longitudinal follow-up for patients with chronic diseases.
In practice, common consultations handled by an IPSPL at Clinique Omicron include: follow-up and adjustment of treatment for chronic diseases such as type 2 diabetes, hypertension, dyslipidemia and hypothyroidism; management of common infections (urinary tract infections, respiratory infections, skin infections), with antibiotics prescribed if indicated; contraception - prescription, renewal and follow-up of hormonal contraceptives, insertion and removal of IUDs in collaboration with the physician; cancer screening (Pap test, referral for mammography and colonoscopy); prescription and administration of vaccines; preventive check-ups and periodic medical examinations; management of common mental health problems (anxiety, mild to moderate depression), including prescription of antidepressants and follow-up.
The IPS-physician collaborative model: safety and quality of care
IPS practice in Quebec is part of a model of interprofessional collaboration with physicians - a fundamental aspect of Quebec's regulatory framework, and a prerequisite for the quality and safety of care. Far from being an inferior substitute approach, IPS-physician team practice represents a care organization that optimizes the complementary skills of both professions. The IPS manages autonomously the situations that fall within its field of competence - routine primary care, stable chronic diseases, prevention - and consults or refers to the physician for more complex situations, conditions outside its field of practice, or cases requiring specialized medical expertise.
The scientific evidence on the quality of care delivered by PHIs is reassuringly consistent across decades of research in North America: studies comparing PHI care with medical care for comparable primary care conditions show equivalent clinical outcomes in terms of chronic disease control, patient satisfaction, appropriate use of emergency services and overall safety. SPIs often allow more time per consultation - favoring therapeutic education, prevention and counseling - which patients particularly appreciate. At Clinique Omicron, PHNs work closely with the medical team, with access to medical consultation as clinically required, ensuring continuity and safety of care.
Frequently asked questions about IPS and access to care
Can an IPS be my family doctor? Does RAMQ cover consultations with an IPS?
Yes - since Quebec's legislative reforms and the expansion of the role of PHNs, a nurse practitioner specialized in primary care can assume the role of primary health care professional («functional family physician») for many patients without a regular family doctor. The PHN can provide longitudinal follow-up, annual check-ups, medication renewal, chronic disease management and specialist care coordination - all core functions of primary care. Concerning RAMQ coverage: procedures performed by IPSs in public network establishments and in certain settings are covered by RAMQ, but the remuneration and coverage structure may vary depending on the practice setting (private medical clinic, GMF, CLSC, independent practice). Clinique Omicron can inform you of the specific coverage terms applicable at the time of your consultation.
What are the limits of a GPI's scope of practice? When is it absolutely necessary to see a doctor?
Although the scope of practice of IPSPLs in Quebec is very broad and covers the vast majority of primary care needs, some situations require medical consultation or management by a specialist physician. The main situations that go beyond the IPSPL's autonomous scope of practice include : the management of medical emergencies or unstable or complex clinical situations requiring immediate medical assessment; the prescription of certain specific drugs reserved for physicians or specialists (certain immunosuppressants, chemotherapies, specialty drugs); the performance of surgical or invasive procedures outside the IPSPL's scope of practice; rare or complex medical conditions requiring specialized expertise (complex rheumatological, hematological, oncological, complex neurological diseases); the initiation of treatment in situations outside the IPSPL's scope of practice, such as certain severe psychiatric illnesses. In these situations, Clinique Omicron's IPS will refer you to the appropriate doctor, whether the clinic's own physician or a specialist, ensuring continuity and fluidity in your care pathway.
How do I get an appointment with an IPS at Clinique Omicron? Do I need a medical referral?
No - a medical referral is generally not required to see an SPI at Clinique Omicron for routine primary care. Patients can make an appointment directly, just as they would for a regular medical consultation, for a wide variety of reasons: medication refills, chronic disease follow-up, acute health problems, preventive check-ups, contraception, and many others. Accessibility is precisely one of the advantages of the IPS model - offering appointments with reduced waiting times for quality care equivalent to that of a family doctor for primary care needs. Clinique Omicron has several points of service on the South Shore and throughout Quebec, with appointments booked online or by telephone. For emergency or semi-emergency situations, walk-in consultation slots may be available at some clinics - check with the clinic of your choice for current availability.
Omicron Clinic
Need to consult a doctor?
Treatment within 24-48 hours. In-clinic or telemedicine, anywhere in Quebec.
Insurance receipts. 7j/7. No family doctor required.
