What is the difference between a Family Doctor and a Nurse Practitioner in Primary Care?

“The Nurse Practitioner was very nice, but when will I see the doctor?” 

We hear that question from time to time at Mentor Clinic. Politicians, news outlets, and groups like The College of Family Physicians of Canada often say that everyone should have a Family Doctor. But many healthcare leaders and professionals now say the focus should be on making sure everyone has access to good primary care, no matter who provides it. 

It's no surprise that many people expect to have a Family Doctor (FP) and only see a Nurse Practitioner (NP) as a temporary fix. NPs are often seen as "fill-ins" for when there aren't enough doctors. But that’s not fair — and it’s not true.

Is one better than the other? No. The best care happens when Family Doctors and Nurse Practitioners work together, as a team, along with others in healthcare. The care should be based on what the patient needs. That’s called patient-centred care. 

But don’t doctors have more training?

Yes and no. Let’s break it down:

Family Doctors (MDs): 

·       Do about 3–4 years of university first (often in science). 

·       Then 4 years of medical school (2 years learning in small groups and classrooms, 2 years seeing patients). 

·       Then 2 years of residency working in clinics and hospitals.

Nurse Practitioners (NPs): 

·       Do a 4-year university nursing degree to become a Registered Nurse (RN). 

·       Work at least 3000 hours (around 2 years) as an RN before they can apply for NP training (most do much more). 

·       Then they do about 2 more years of NP education — classes, exams, and mentored hands-on learning. 

·       If an NP worked as a RN for eight years before NP training, that is a type of on-the-job training and experience. 

Because nurses work in hospitals and clinics before becoming NPs, they often have a lot of real-world experience when they start their advanced training. 

What do they focus on? 

Doctors are trained to diagnose, order tests, and prescribe treatments. They study a broad range of science: biology, pharmacology, pathology, etc. In medical school, most training is focused on specialties (like cardiology or surgery), while family doctors are trained to look at the whole person in everyday life with possible problems anywhere in the body or mind.

Nurse Practitioners start with a nursing background, which focuses on the whole person — not just the illness. NP training then adds more advanced medical knowledge, including how to diagnose and treat common health problems. 

So, while the paths are different, the end goal is similar: to take care of people, ‘where they’re at.’ 

Working Together 

Healthcare is always changing. No one person can know everything. That’s why it’s important for doctors and nurse practitioners to work as a team, and know when to ask for help or refer to specialists. 

In a well-run clinic with good teamwork and communication, NPs and doctors can both care for patients — they’re complementary, not competing. 

Think of a hockey team: there are six players on the ice, and no one is more important than the other. They each have a role, and together they win games. 

So next time you see a headline like this: 

Try to think of it like this: 

“Meet the Canadians without access to primary care.” 

That’s the real issue.