Agreement between FIQ and Quebec clarifies patient registration by nurse practitioners
Posted March 20, 2026 7:00 am.
Quebec Health must conclude agreements with each family medicine group (FMG) to allow nurse practitioners (NPs) to register patients directly in their name, which was previously reserved for doctors.
An agreement was reached on March 16 between the FIQ and the Ministry of Health to clarify and regulate the role of IPS within GMFs.
It was announced in Bill 19 (which rewrites Bill 2), but the agreement ensures that Family Medicine Groups (GMFs) implement the change. “The bill was quite general; it was an intention. There weren’t really any clear and defined means to compel or ensure that it was actually done,” commented Jérôme Rousseau, Vice-President of the Work Organization and Professional Practice sector and the Negotiation sector at the Fédération interprofessionnelle de la santé du Québec (FIQ).
He explains that the Ministry of Health provides resources from the public health network, but that it is up to Santé Québec to conclude collaboration agreements with each of the GMFs, which are private companies collaborating with the public system.
Those working in nurse practitioner (NP) clinics could already register patients in their own name, but they represent a minority of the approximately 1,400 NPs working in primary care in Quebec. “The vast majority of NPs in primary care work in family medicine groups (FMGs); this is currently our largest pool of NPs,” confirms Rousseau.
The number of patients a nurse practitioner (NP) can register varies depending on the complexity of the cases, but between 700,000 and 1.4 million patients could be registered. Many patients are already being followed by an NP, but they are registered under a physician’s name. It will be up to the family medicine groups (FMGs) to decide how they will handle the transfers.
The agreement concluded with the FIQ stipulates that Santé Québec has the necessary levers to intervene if a GMF opposes the registration of patients by IPS.
“We made sure that the GMFs had to respect the working conditions of the IPS because the IPS are unionized employees who are under the governance of Santé Québec. So, in the old versions, before Bill 19, it was not clear. There were many elements that contravened this,” maintains Rousseau.
“The other part, and this is the really interesting gain for nurse practitioners (NPs), is that we have come to recognize that the role of NPs will be well-defined. We are truly in a dynamic of collaboration with physicians; there is no longer a hierarchy between the physician and the NP. This will really allow NPs to register patients in their own name, and they will determine, between NPs and physicians, the best way to share these patient registrations. And that is what we came to conclude with the Ministry: Quebec Health has the responsibility in the coming days, in the coming weeks, to finalize with all the Family Medicine Groups (FMGs),” explains the FIQ spokesperson.
He clarifies that it was clear on paper that nurse practitioners (NPs) had autonomy in patient care, but not in practice. Rousseau believes this change could attract future nurses to this specialization. “Now, it’s confirmed by the registration process; that is, NPs in frontline care truly have autonomous practice and are able to follow patient cohorts just like physicians. From a professional perspective, this is extremely interesting. It’s finally a recognition of the role of NPs.”
—The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.
–This report by La Presse Canadienne was translated by CityNews
