News Release – NLMA Calls on Election Candidates to Commit to Overhead Funding for All Physicians who Provide MCP-Insured Services in the Community
The Newfoundland and Labrador Medical Association (NLMA) is calling on all leadership candidates in the provincial election to commit to extending overhead funding, recently announced for independent nurse practitioners, to all physicians who deliver medically insured services in the community.
This comes following the provincial government’s announcement of a new pilot project that will provide overhead funding exclusively to independently practicing nurse practitioners (NPs). The pilot, announced on August 27, 2025, will cover business expenses, such as clinic space, equipment, supplies, and administrative support for NPs operating outside NL Health Services.
The NLMA advocated for similar overhead support for community-based medical clinics during its recent contract negotiations that concluded this past spring. The NLMA also sought overhead support for family physician clinics that affiliate with the new Family Care Teams.
“The government made it clear it would not provide overhead support to community-based physicians operating outside the provincial health authority. Yet, that is precisely what it is doing now for independent nurse practitioners,” said NLMA President and St. John’s psychiatrist Dr. Cynthia Slade.
“While we support the important role that nurse practitioners play in our health system, it is deeply concerning that physicians continue to be excluded from overhead support. These doctors face the same business costs as NPs, and depending on their specialty, those costs can be significantly higher. They also provide comprehensive medical care to thousands of patients across the province, while NPs are required to see between 700 and 800 patients,” said Dr. Slade.
Unlike other independent health care professionals in the community, physicians cannot adjust their fees to reflect rising overhead costs, as their compensation is determined by MCP. These physicians deliver publicly funded health care through their privately owned clinics, which they themselves finance and manage, to ensure patients have access to care in their communities. In doing so, they are effectively subsidizing the public health care system by covering infrastructure and operational costs that government would otherwise have to fund.
The NLMA received a letter signed by more than 200 physicians, along with a letter from its Family Medicine Section representing all family doctors in the province, who expressed deep concern about the government’s announcement. They feel that by funding overhead for independent nurse practitioners, while continuing to deny similar support to family physicians, the government is signaling a shift toward replacing family doctors in community care. This raises serious questions about the future of longitudinal family medicine delivered by physicians who are specialists in primary care. It also undermines existing community clinics where independent NPs and physicians are already working together.
“This announcement erodes the role of family physicians who provide care in the community at a time when more are choosing to leave medicine early, while others are shifting to hospital and other NLHS settings due to the strain of maintaining a community practice. This sends the wrong message to new family medicine graduates whom we should be encouraging to practice in the community,” said Dr. Slade.
“If the province truly wants to improve access to medical care, then it must also support the existing medical infrastructure and the physicians who have been providing comprehensive medical care to patients in our communities for decades,” said Dr. Slade.
“Patient access to community-based medicine is under pressure across the country. Funding NP clinics while neglecting others risks worsening access, not improving it.”