{"id":31515,"date":"2024-04-11T11:25:21","date_gmt":"2024-04-11T15:25:21","guid":{"rendered":"https:\/\/www.getmaple.ca\/?p=31515"},"modified":"2025-11-24T12:46:50","modified_gmt":"2025-11-24T17:46:50","slug":"what-is-the-difference-between-a-family-doctor-and-nurse-practitioner","status":"publish","type":"post","link":"https:\/\/www.getmaple.ca\/blog\/what-is-the-difference-between-a-family-doctor-and-nurse-practitioner\/","title":{"rendered":"What is the Difference Between a Family Doctor and Nurse Practitioner"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">If you\u2019re like most Canadians, you may not be quite sure what the difference between a nurse practitioner (NP) and a<\/span> <span style=\"font-weight: 400;\">family<\/span> <span style=\"font-weight: 400;\">doctor is. After all, hearing that someone with \u201cnurse\u201d in their title is going to be your primary care provider may be confusing. If that\u2019s the case, you\u2019ve come to the right place. We\u2019re breaking down the differences between NPs and family doctors,<\/span><span style=\"font-weight: 400;\"> otherwise known as family physicians in Canada<\/span><span style=\"font-weight: 400;\">, so you can feel confident about choosing the health professional that\u2019s right for you.<\/span><\/p>\n<div>\n<div><div class=\"mpl-blog-inline-cta mpl-blog-cta--quaternary\" style=\"background:#f4f1f0;margin:2rem 0;border-radius: 1.5rem;padding:2rem;display:flex;flex-direction:var(--cta-dir);justify-content: space-between;align-items:center;gap:1.5rem;\"><div><h2 style='font-size:var(--cta-heading-size);line-height:1.2;margin:0;color:var(--cta-heading-color);'>Talk to a Doctor or Nurse Practitioner Online Today<\/h2><p style=\"font-size: var(--cta-text-size);line-height: 1.5;margin: 0.25rem 0 0 0;color: var(--cta-text-color);\">Connect with Canadian-licensed family doctors and nurse practitioners on Maple to discuss your health concerns.<\/p><a href='https:\/\/www.getmaple.ca\/onboarding\/get-started\/' style='background: var(--cta-button-bg);color: var(--cta-button-color);border-radius: 2.5rem;text-decoration: none;font-size: 1rem;display: inline-flex;justify-content: center;width: var(--cta-button-width);padding: 0.75rem 1.25rem;margin-top: 1rem;line-height: 1.3;font-weight: 500;'>Get care today<\/a><\/div><img width=\"300\" height=\"254\" src=\"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/09\/woman-on-laptop-300x254.jpg\" class=\"attachment-medium size-medium\" alt=\"\" decoding=\"async\" loading=\"lazy\" style=\"width: 100%;height:auto;max-width:var(--cta-img-max);min-height:var(--cta-img-min);object-fit:cover;object-position:bottom;margin-top:auto;border-radius:.75rem\" srcset=\"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/09\/woman-on-laptop-300x254.jpg 300w, https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/09\/woman-on-laptop-1024x865.jpg 1024w, https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/09\/woman-on-laptop-768x649.jpg 768w, https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/09\/woman-on-laptop.jpg 1136w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/div><\/div>\n<\/div>\n<h4><b>What\u2019s the difference between a <\/b><b>family doctor and a nurse practitioner?<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">Both family physicians and NPs<\/span><span style=\"font-weight: 400;\"> are highly-trained professionals. But, because the education each gets is different, they approach patient care a little differently. <\/span><span style=\"font-weight: 400;\">There a few key differences between the two:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Education and training<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Treating medically complex patients<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Prescribing controlled substances<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Option to train in obstetrics<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">NPs must practice full-time as a registered nurse for at least two years before completing a two-year Master of Nursing (MN) program. This training encourages NPs to look at their patients holistically, which means they aim to protect, promote, and optimize their overall health.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">F<\/span><span style=\"font-weight: 400;\">amily physicians<\/span><span style=\"font-weight: 400;\"> in Canada complete three or four years of medical school, followed by a two to three-year family medicine residency, with the third year being optional for additional specialization. This extensive technical education teaches physicians to look at patient care through a comprehensive medical lens. As a result, they focus more on diagnostics and specialized treatments.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ultimately, both NPs and<\/span><span style=\"font-weight: 400;\"> family physicians<\/span><span style=\"font-weight: 400;\"> treat and support a variety of patients \u2014 including those with chronic health issues. However, because of their more robust education and training, family physicians may be better suited to treating the competing health conditions of medically complex patients.<\/span><\/p>\n<h4><b>What can<\/b><b> family doctors <\/b><b>do that <\/b><b>nurse practitioners <\/b><b>can\u2019t?<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">Whether you see a family physician or an NP, you\u2019re going to get great primary care. However, there are some differences in how they operate. One of the major differences when it comes to <\/span><span style=\"font-weight: 400;\">nurse practitioners vs. family physicians<\/span><span style=\"font-weight: 400;\"> surrounds what they\u2019re able to prescribe.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Controlled substances like opioids, benzodiazepines, and sedatives are an important part of the medical toolkit. They\u2019re much-needed medications for patients experiencing conditions such as anxiety, pain, or sleep disorders. Unfortunately, these medications also have the potential to be abused, which is why they\u2019re controlled substances.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Family physicians<\/span><span style=\"font-weight: 400;\"> receive extensive training on these medications during medical school and can prescribe them when they\u2019re necessary and in the best interest of the patient.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">NPs, in contrast, can prescribe controlled substances only if they\u2019ve completed approved training courses. This controlled substances training is set to become <\/span><a href=\"https:\/\/www.cno.org\/en\/trending-topics\/nps-and-prescribing-controlled-substances\/qas-controlled-substances-education-requirement\/#title2\"><span style=\"font-weight: 400;\">a standard part of the curriculum<\/span><\/a><span style=\"font-weight: 400;\"> for all NP education programs. However, until that happens, NPs can\u2019t prescribe these substances unless they\u2019ve received specialized training.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A final distinction is that while both <\/span><span style=\"font-weight: 400;\">family physicians<\/span><span style=\"font-weight: 400;\"> and NPs can provide prenatal care, <\/span><span style=\"font-weight: 400;\">family physicians<\/span><span style=\"font-weight: 400;\"> can also train in obstetrics if they choose. NPs don\u2019t have this option, so you\u2019ll need to work with either a midwife or an obstetrician\/gynecologist (OB\/GYN) to deliver your baby if you have an NP for primary care.<\/span><\/p>\n<h4><b>What can a nurse practitioner do?<\/b><span style=\"font-weight: 400;\"><br \/>\n<\/span><\/h4>\n<p><span style=\"font-weight: 400;\">In Canada, nurse practitioners can practice without needing to be supervised by a doctor. This means that like a family doctor, NPs can provide primary care in community health centres (CHCs), family practice teams, and hospitals as well as work in NP-run clinics and other settings.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">NPs can take your medical history, perform physical exams, listen to your heart and lungs, and check your blood pressure. They can also diagnose medical conditions, prescribe medications, and provide referrals to specialists.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">On top of that, NPs can order MRI or CT scans as well as other diagnostic tests like X-rays. They\u2019re able to order and interpret lab results as well.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Many additional things are within the scope of practice for NPs including diagnosing and treating sexually transmitted infections (STIs), lancing boils, performing Pap smears and biopsies, prescribing birth control, and inserting or removing IUDs. And, just like a family doctor, NPs can provide prenatal care to you while you\u2019re pregnant.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Routine vaccinations are often given by NPs, but they can also perform other shots, such as joint injections. For example, if you need a cortisone injection in your knee, an NP can give it to you.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Whether you\u2019re looking to see an NP or a<\/span><span style=\"font-weight: 400;\"> family physicia<\/span><span style=\"font-weight: 400;\">n, <\/span><a href=\"https:\/\/www.getmaple.ca\/doctors\/\"><span style=\"font-weight: 400;\">we can help<\/span><\/a><span style=\"font-weight: 400;\">. Our providers are available day or night, seven days a week, within minutes. For all your diagnosis and treatment or <\/span><a href=\"https:\/\/www.getmaple.ca\/features\/online-prescriptions\/\"><span style=\"font-weight: 400;\">prescription needs<\/span><\/a><span style=\"font-weight: 400;\">, our Canadian-licensed doctors and nurse practitioners are here for you. If you need to <\/span><a href=\"https:\/\/www.getmaple.ca\/providers\/\"><span style=\"font-weight: 400;\">see a specialist<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.getmaple.ca\/features\/lab-work\/\"><span style=\"font-weight: 400;\">get lab work done<\/span><\/a><span style=\"font-weight: 400;\"> we can help with that too. No referral needed.<\/span><\/p>\n<h4><b>What\u2019s the difference between a registered nurse and a nurse practitioner?<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">Both registered nurses (RNs) and nurse practitioners are highly trained healthcare professionals. However, how they work with <\/span><span style=\"font-weight: 400;\">patients<\/span><span style=\"font-weight: 400;\"> differs. RNs work alongside doctors and other healthcare professionals to treat patients and must follow the doctor\u2019s orders when it comes to their patients\u2019 needs.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In contrast, nurse practitioners can assess and care for patients without being supervised by a physician. Some of the things NPs can do that RNs can\u2019t include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diagnose medical issues and formulate treatment plans<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Order and interpret lab tests<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Order diagnostic imaging<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Prescribe medications<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Refer to a specialist<\/span><\/li>\n<\/ul>\n<h4><b>How do I know which provider is right for me?<\/b><\/h4>\n<p><span style=\"font-weight: 400;\">Many Canadians are struggling to find a primary healthcare provider right now and are looking for the first one they can access \u2014 whether that\u2019s an NP or a family physician.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, if you have the luxury of choice and are wondering how to know which provider makes the most sense for you, here are some criteria to consider.<\/span><\/p>\n<ol>\n<li><b>What\u2019s your health history?<br \/>\n<\/b><span style=\"font-weight: 400;\">Patients who have multiple health conditions with conflicting treatments are known as \u201cmedically complex.\u201d Because they spend more time in medical school, <\/span><span style=\"font-weight: 400;\">family physicians<\/span><span style=\"font-weight: 400;\"> typically have more in-depth knowledge when it comes to multiple conflicting medications and diagnoses. If you have more than one chronic condition, you may benefit from seeing a doctor instead of a nurse practitioner.\u00a0<\/span><\/li>\n<li><b>Do you require controlled medications?<br \/>\n<span style=\"font-weight: 400;\">As mentioned, NPs can only prescribe controlled substances if they have specific training in that area. If you have a condition that requires controlled medication, it\u2019s important to find a provider that can prescribe them, whether that\u2019s <\/span><span style=\"font-weight: 400;\">a family physician<\/span><span style=\"font-weight: 400;\"> or an NP that\u2019s certified to do so.<\/span><\/b><\/li>\n<li><b>Do you have a chronic condition?<br \/>\n<\/b><span style=\"font-weight: 400;\">If you have a chronic condition like COPD or heart disease, you may think that you can only see a doctor as your primary care provider. The truth is that both <\/span><span style=\"font-weight: 400;\">family physician<\/span><span style=\"font-weight: 400;\">s and NPs can care for patients with and without persistent illnesses. If you have a chronic condition, there\u2019s no need to choose a <\/span><span style=\"font-weight: 400;\">family physician <\/span><span style=\"font-weight: 400;\">over an NP. Instead, look for a primary care provider that you feel comfortable with.<\/span><\/li>\n<\/ol>\n<h4><b>I don&#8217;t have a family doctor, can I see a nurse practitioner instead?<\/b><b><\/b><\/h4>\n<p><span style=\"font-weight: 400;\">If you don\u2019t have a<\/span><span style=\"font-weight: 400;\"> family physician<\/span><span style=\"font-weight: 400;\"> and you\u2019re looking to see a primary care provider in person, in many cases seeing a nurse practitioner can be a great alternative. This is especially true in telehealth where both NPs and <\/span><span style=\"font-weight: 400;\">family physicians<\/span><span style=\"font-weight: 400;\"> can address the <\/span><a href=\"https:\/\/www.getmaple.ca\/for-you-family\/conditions\/\"><span style=\"font-weight: 400;\">kinds of concerns<\/span><\/a><span style=\"font-weight: 400;\"> that can be treated virtually.<\/span><b><\/b><\/p>\n<p><span style=\"font-weight: 400;\">Besides virtual care, NPs practice in a variety of different community and hospital settings. That means you\u2019re likely to see them in community and sexual health centres, long-term care homes, rehabilitation clinics, and hospitals. They can also run their own clinics, work as part of a family health team, and work collaboratively with physicians and other professionals or provide home care.<\/span><b><\/b><\/p>\n<p><span style=\"font-weight: 400;\">What\u2019s more, having a nurse practitioner as your primary care provider doesn\u2019t stop you from seeing a doctor too. For example, if you have complex medical needs and your primary care NP feels that the situation is beyond their scope of practice, they can refer you to a <\/span><span style=\"font-weight: 400;\">doctor like a family physician<\/span><span style=\"font-weight: 400;\"> for care.\u00a0<\/span><\/p>\n<h4><b>Is my nurse practitioner visit covered by health insurance?<\/b><b><\/b><\/h4>\n<p><span style=\"font-weight: 400;\">Unlike <\/span><span style=\"font-weight: 400;\">family physicians<\/span><span style=\"font-weight: 400;\">, nurse practitioners can\u2019t bill the provincial government for the care they provide. So depending on where you see an NP, there may be a cost involved.<\/span><b><\/b><\/p>\n<p><span style=\"font-weight: 400;\">Within clinical settings, NPs are typically paid a salary by their employer. In a publicly-funded clinic \u2014 for example, one that operates out of a health centre or a hospital \u2014 that means that there\u2019s no cost to the patient for seeing an NP.\u00a0<\/span><b><\/b><\/p>\n<p><span style=\"font-weight: 400;\">However, within a private setting, you\u2019ll likely have to pay out-of-pocket to see a nurse practitioner. Many clinics also charge additional fees depending on what services the NP performs, such as injections or a Pap test. Some also require a monthly fee just to be able to access that care.<\/span><b><\/b><\/p>\n<p><span style=\"font-weight: 400;\">When it comes to telemedicine, visits with NPs or <\/span><span style=\"font-weight: 400;\">family physicians <\/span><span style=\"font-weight: 400;\">are only covered in some Canadian provinces currently.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For the millions of Canadians without a family doctor right now, their priority is simply to find a provider that\u2019s accepting new patients \u2014 whether that\u2019s an NP, family physician, or general practitioner (GP). However, if you&#8217;re medically complex or require controlled prescription medications, you may need to wait a little longer to find the perfect match for you. Depending on where you see your provider, you may also have to consider the financial implications.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For most, however, the bottom line is that both NPs and <\/span><span style=\"font-weight: 400;\">family physicians<\/span><span style=\"font-weight: 400;\"> are great options for primary care \u2014 especially when it comes to telemedicine. That\u2019s why Maple works with the best <\/span><span style=\"font-weight: 400;\">providers<\/span><span style=\"font-weight: 400;\"> across the country.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">We\u2019re committed to changing how Canadians access healthcare. If you need to see a<\/span><span style=\"font-weight: 400;\"> family physician or <\/span><span style=\"font-weight: 400;\">an NP today, <\/span><a href=\"https:\/\/www.getmaple.ca\/onboarding\/get-started\/\"><span style=\"font-weight: 400;\">our providers are here for you<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p class=\"p1\"><i>The information presented here is for educational purposes and is not meant to replace the advice from your medical professional.<\/i><i><\/i><\/p>\n<p class=\"p1\"><i>When using virtual care, all medical treatment is at the sole discretion of the provider. Virtual care is not meant for medical emergencies, and your provider will determine if your case is appropriate for virtual care. If you are experiencing an emergency like chest pain or difficulties breathing, for example, please call 911 or go to your nearest emergency room.<\/i><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>If you\u2019re like most Canadians, you may not be quite sure what the difference between a nurse practitioner (NP) and a family doctor is. After all, hearing that someone with \u201cnurse\u201d in their title is going to be your primary care provider may be confusing. If that\u2019s the case, you\u2019ve come to the right place.&hellip;<\/p>\n","protected":false},"author":33,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false},"categories":[7378],"tags":[],"acf":{"image":{"ID":31516,"id":31516,"title":"What-is-the-difference_1180x483","filename":"What-is-the-difference_1180x483.jpeg","filesize":78852,"url":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483.jpeg","link":"https:\/\/www.getmaple.ca\/blog\/what-is-the-difference-between-a-family-doctor-and-nurse-practitioner\/what-is-the-difference_1180x483\/","alt":"","author":"33","description":"","caption":"","name":"what-is-the-difference_1180x483","status":"inherit","uploaded_to":31515,"date":"2024-04-11 14:29:32","modified":"2024-04-11 14:29:32","menu_order":0,"mime_type":"image\/jpeg","type":"image","subtype":"jpeg","icon":"https:\/\/www.getmaple.ca\/wp-includes\/images\/media\/default.png","width":1180,"height":483,"sizes":{"thumbnail":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-150x150.jpeg","thumbnail-width":150,"thumbnail-height":150,"medium":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-300x123.jpeg","medium-width":300,"medium-height":123,"medium_large":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-768x314.jpeg","medium_large-width":768,"medium_large-height":314,"large":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-1024x419.jpeg","large-width":1024,"large-height":419,"1536x1536":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483.jpeg","1536x1536-width":1180,"1536x1536-height":483,"2048x2048":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483.jpeg","2048x2048-width":1180,"2048x2048-height":483,"square1200":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483.jpeg","square1200-width":1180,"square1200-height":483,"square600":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-600x483.jpeg","square600-width":600,"square600-height":483,"square300":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-300x300.jpeg","square300-width":300,"square300-height":300,"square200":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-200x200.jpeg","square200-width":200,"square200-height":200,"square100":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-100x100.jpeg","square100-width":100,"square100-height":100,"feature1200":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483.jpeg","feature1200-width":1180,"feature1200-height":483,"feature1100":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-1100x483.jpeg","feature1100-width":1100,"feature1100-height":483,"feature800":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-800x400.jpeg","feature800-width":800,"feature800-height":400,"feature400":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483-400x200.jpeg","feature400-width":400,"feature400-height":200,"facebook1200":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483.jpeg","facebook1200-width":1180,"facebook1200-height":483,"medium_retina":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483.jpeg","medium_retina-width":1180,"medium_retina-height":483,"large_retina":"https:\/\/www.getmaple.ca\/wp-content\/uploads\/2024\/04\/What-is-the-difference_1180x483.jpeg","large_retina-width":1180,"large_retina-height":483}},"intro_text":"","meta_description":"","add_promotional_banner":false,"add_call_to_action":true,"call_to_action_text":"See a doctor","call_to_action_button_text":"Register","call_to_action_link":"","show_age_gate":false,"meta_title":"","reviewer":false,"author":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v18.4 (Yoast SEO v18.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What is the Difference Between a Family Doctor and Nurse Practitioner - Maple<\/title>\n<meta name=\"description\" content=\"Family doctors and nurse practitioners both provide primary care services, but there are key differences in their training, scope of practice, and approach to patient care. 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