For everyone in Kamloops who doesn't have a family physician, there is another argument for putting nurse practitioners in positions of primary care.

That chronic doctor shortage was among points made by Judith Shamian, president of the Canadian Nurses Association, on a visit to the city that culminated with a dialogue session at TRU Monday.

Shamian and her staff are on a cross-country tour, consulting with students, faculty and people in the health-care field as a lead-up to the next federal-provincial health accord.

She had lunch Monday with local nurse practitioners, who told her about the unusually high percentage of residents without family doctors. Nurse practitioners are advanced-practice nurses who can diagnose and treat diseases and health conditions. In B.C., they work in private practice, emergency rooms and walk-in clinics but not in primary care.

"This is not an acceptable solution," Shamian said. "Much more can be done here in Kamloops."

"The cost is that of hiring nurse practitioners, a minimal cost compared to what the cost would be to the health-care system when people show up in emergency or with chronic illness.

"Five million Canadians don't have access to primary care and nursing has a lot of solutions," she added, noting that 67 cents of every health-care dollar is spent on managing chronic diseases such as diabetes.

The CNA visitors also heard about what's working in the region.

"First, on a very positive note, to find the integration between university and health authority is good and you don't see that everywhere," Shamian said. "That's good for nurses and it's good for patients."

A set of presentations by TRU school of nursing students who have been working hand-in-hand with the Conayt Friendship Society in the Nicola Valley made an impression on Shamian.

The school and the society signed a partnership in September, which is unprecedented in B.C. The arrangement is mutually beneficial, supporting better health outcomes in the Aboriginal community while teaching nurses cultural awareness.

That could, in turn, encourage specialization and a greater willingness among graduates to help address a critical shortage of nurses in Aboriginal communities.

"That is pretty innovative and it's something that should be done across the country," Shamian said. "And they know what they're getting into. Too often it's romanticized and then there's a reality shock."