Issue of double standards ignored in suit - nurse

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A Metis nursing practitioner who sued a provincial body for interfering with her right to practice has lost her legal battle.

But Joyce Atcheson believes that it is only a matter of time before the public of Alberta forces the College of Physicians and Surgeons to change what she calls its double standards on medical care for Aboriginal ans non-Aboriginals.

"If this is doctoring, then it should be doctoring all the time and every where," said Atcheson, who was accused of acting "too independently" by the college.

"If I am good enough to work with Native people in Fort Chippewan, then I'm good enough to work with anyone in the city."

But the legal issue at stake was not whether Atcheson was practicing medicine in the clinic or not, said Dr. Larry Olhauser, college registrar.

"This was an issue contract law. We believe the case showed we were not unfair," said Olhauser.

The clinic was ordered to stop billing the province for physician's services which in fact had been rendered by Atcheson. There was no intention of forcing the clinic to termination her contract, he said.

Justice Ellen Picard ruled Feb. 23 in Edmonton the college "was not acting illegally or unlawfully in the actions taken and did not restrict (Atcheson) in the practise of nursing.

Atcheson has been a nursing practitioner in northern communities for 25 years. As such she supplied primary health care including examinations, testing, diagnosis and recommendation of treatment. In one community a doctor flew in for half a day ever two weeks, leaving her virtually in charge of providing around-the-clock health care for the 380 residents.

In 1988 Atcheson started working under contract for the Thickwood Medical Clinic in Fort McMurray. Her case loads were reviewed regularly and she received 60 per cent of the Alberta Health Care billings if they exceeded Atcheson's hourly rate of $25.

But three years later, in 1991, following a written complaint by one of its members the college ordered the clinic to stop the billing practice and Atcheson contract was terminated. She then initiated a civil suit against the college for $50,000 in lost wages, adding $25,000 for general damages in 1993.

She attempted to open her own practice in Fort McMurray following the termination of her contract with the Thickwood clinic, but encountered legal obstacles in attempting to obtain X-ray and laboratory privileges.

Under Alberta legislation, lab requisitions need to come under a physician's name.

Leanne Dekker, AARN registrar, agrees that nurses are forced to work under double standards in those conditions. While her organization recognizes the College of Physicians was acting within its jurisdiction in ordering the northern clinic to stop the billing, the AARN also maintains the underlying issue of nurse practitioners' role must be addressed.

"We do not agree with the double standards for nurses working in isolated areas and nurses working in cities," Dekker said. "The full scope of their profession, like physician's practices, is regulated by legislation.

"The profession should not be determined by geographical location and access to physicians. Rather they should be governed by cost efficiency, quality of service and consumer need."