Family Doctor vs Nurse Practitioner: Understanding the Difference

Nurse practitioners (NPs) and doctors (also known as physicians or family doctors) play vital roles in patient care, and their duties often overlap. However, there are certain areas such as their scope of practice, prescribing power, and even aspects like cost and accessibility of care. 

Practice and Services Between Family Doctor vs Nurse Practitioner

Nurse practitioners, sometimes called a CNP nurse (certified nurse practitioner) are licensed to perform a wide range of medical services autonomously. They can assess patients, diagnose health conditions, order and interpret lab tests, and provide treatment. For example, an NP can examine you for an illness, determine the diagnosis, order blood-work or X-rays, and initiate a treatment plan. In Alberta, NPs can also make referrals to specialists if a condition requires care from a medical specialist. 

Doctors in primary care (family physicians) perform all the tasks stated above and have ultimate responsibility for patients. The experience for a patient visiting a family doctor or a nurse practitioner for a routine issue is very similar. 

Both are qualified to manage common illnesses or chronic conditions safely and effectively. Research in Ontario has shown that nurse practitioners can handle around 83 per cent of the care provided in a typical family practice, with only the more complex cases needing a doctor’s intervention. 

Differences Between Family Doctors and Nurse Practitioners

That said, there are some differences between doctors and nurse practitioners. Physicians have a broader scope in the sense that they can manage more complex or specialized medical issues. For example, if a person has a rare disease, needs specialized surgery, or advanced hospital based treatment, a doctor (often a specialist physician) would take the lead. 

Nurse practitioners focus on primary care and they will refer patients to a doctor for any cases beyond their scope of practice. NPs do not perform major surgeries and typically do not handle highly complex diagnoses alone. For routine check-ups, minor illness, and stable chronic conditions, a nurse practitioner can provide comprehensive care. 

For more complex diagnoses or surgical treatments a doctor would be taking care of you. However, NPs and doctors often work together ensuring that the patient gets the appropriate level of care.

Prescriptions and Medical Authority Between Family Doctors and Nurse Practitioners

In Canada, doctors have full prescribing authority and always have. They can prescribe any medication deemed necessary, including controlled substances (like opioids or certain stimulants), subject to medical guidelines. Nurse practitioners also have significant prescribing power. 

In the past NPs had more limitations but now they are authorized to prescribe most medications including many controlled drugs and substances under federal and provincial regulations. This means that NPs  can write you a prescription for antibiotics, chronic illness medications (like diabetes and hypertension), and even pain medications or other controlled drugs when appropriate. 

According to federal law in Canada, “practitioners” (including NPs, physicians, dentists, and a few other professionals) may prescribe controlled substances, though they must follow specific regulations and any provincial rules. For example, a nurse practitioner can prescribe a narcotic painkiller if it’s within the provincial scope and they have the required licensing and education for prescribing that class of drug. A doctor on the other hand can prescribe that drug. 

For most prescriptions in primary care an NP can provide it just as a doctor would. If a patient is seeing a nurse practitioner and requires medication that is outside their authority, the NP will refer the patient to a doctor to get what they need, however this does not typically happen today.

Both doctors and nurse practitioners can order other treatments and write medical notes. NPs are authorized to write a sick note or medical letter, order therapies like physiotherapy, and arrange for diagnostic imaging (ultrasounds and MIRs) when needed, much like physicians. Both can also direct your overall care plan. 

Cost and accessibility of care 

Visiting a family doctor in Canada is covered by public health insurance plans, however, depending on the province some NPs are covered while others require out-of-pocket spending. For example, in Ontario nurse practitioners are not covered under OHIP (Ontario Health Insurance Plan). 

Many provinces employ NPs in publicly funded clinics to expand the number of primary care providers available. In regions with physician shortages, an NP might be more readily available and have shorter wait times, making them more a convenient option for timely care.

Difference Between a Registered Nurse and a Nurse Practitioner

In Ontario, registered nurses must complete either a four-year university nursing program or a collaborative college-university nursing program which both lead to a Bachelor of Science in Nursing degree (BScN) or Bachelor of Nursing degree (BN). Because of this, they have a deeper understanding of areas such as clinical practice, critical thinking and research utilization.

Nurse practitioners are RNs with advanced university education and provide personalized, quality health care to patients. They work in four specialties: primary health care, adult and pediatric care and anaesthesia.

Doctor or Nurse Practitioner: Which one should I see?

For many day-to-day health concerns, either a doctor or nurse practitioner can take care of you. Both are highly trained professionals and research shows that NPs offer similar services to physicians. Here are some guidelines on choosing between them:

• Seeing a nurse practitioner: primary care needs like annual check-ups, minor illness (coughs, cold, minor injuries), and chronic disease management (diabetes or hypertension). NPs offer preventive care and patient education and they also have shorter wait times for appointments. If an issue is beyond an NPs scope, they will refer you appropriately.  
• Seeing a doctor: complex or specialized conditions that might require advance diagnostics, multiple specialist interventions, or procedures. For example, if you suspect that a condition might need surgery, or you have complicated symptoms that require extensive investigation then a physician would be the right choice. Also if you require certain controlled medication or treatments that some NPs (depending on the province) may not prescribe, then a doctor is the best option. 

The difference between a nurse practitioner and doctor in Canada lies in the nuances of scope and approach, but both are competent primary care providers. NPs provide a patient-centered, holistic touch and improve access to care, while doctors bring extensive training for all levels of medical complexity. 

For example, if your child has a persistent cough and fever, an NP can assess, diagnose, and treat it. But if there’s suspicion of pneumonia that doesn’t respond to initial treatment, they may refer to a doctor for imaging or further tests.

For most common health issues, an NP can serve as your first point of contact and for more complex concerns a doctor’s expertise may be necessary. Ultimately, what matters is that you get the right care for your situation and understanding these roles can help you choose what kind of appointment you should make. 

Family Doctor vs Nurse Practitioner (NP): Frequently Asked Questions

Resources

• https://www.cno.org/standards-learning/nurse-practitioners/nurse-practitioners#:~:text=Nurse%20Practitioners%20(NPs)%2C%20also,guidelines%20all%20nurses%20must%20follow.
• https://globalnews.ca/news/10108594/alberta-nurse-practitioners-compensation-model/#:~:text=Nurse%20Practitioners%20,and%20advanced%20knowledge%20and%20skills
• https://compasshealthservices.ca/blog/public-healthcare-vs-private-healthcare-nurse-practitioners/#:~:text=nursing%20and%20medical%20science%20is,take%20more%20time%20with%20their
• https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/hcs-sss/alt_formats/hpb-dgps/pdf/nurs-infirm/2006-np-ip-eng.pdf#:~:text=gen%02eral%20practice%20in%20England%2C%2086,minor%20illnesses%20or%20injuries%20are
• https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/hcs-sss/alt_formats/hpb-dgps/pdf/nurs-infirm/2006-np-ip-eng.pdf#:~:text=gen%02eral%20practice%20in%20England%2C%2086,minor%20illnesses%20or%20injuries%20are
• https://www.canada.ca/en/health-canada/services/substance-use/toolkit-substance-use-covid-19/frequently-asked-questions.html
• https://www.canada.ca/en/health-canada/services/substance-use/toolkit-substance-use-covid-19/frequently-asked-questions.html
• https://bodymeasure.ca/understanding-the-difference-between-a-doctor-and-a-nurse-practitioner/#:~:text=When%20To%20See%20A%20Doctor
• https://www.ctvnews.ca/ottawa/article/ontario-faces-calls-to-fund-nurse-practitioners-as-clinics-charge-patients-a-fee/
• https://www.ctvnews.ca/ottawa/article/ontario-faces-calls-to-fund-nurse-practitioners-as-clinics-charge-patients-a-fee/
• https://rnao.ca/about/types-nursing