Family physicians are considering reducing or abandoning the care of patients and contact their professional union on this subject. In a generic email that she sends them and that The duty was able to consult, the Federation of general practitioners of Quebec (FMOQ) says it is “extremely sensitive to their wishes on an individual level”, but warns them against possible “coercive measures”. She calls for solidarity between colleagues.
“Not only would a step in this direction inevitably increase the workload of physicians continuing to provide care, but in addition, the political, legislative, regulatory and ethical environment in which we operate is either uncertain or complex as never in this fall 2021, you could possibly be targeted, who knows, by new a posteriori coercive measures imagined by the government, ”writes the FMOQ in its electronic response.
In interview with The duty, the director of communications of the FMOQ, Jean-Pierre Dion, indicates that a “certain number of doctors” are thinking of reducing their support in order to devote themselves to a practice in an establishment. According to him, the words of Prime Minister François Legault, who criticizes general practitioners for not doing enough, hurt and “discouraged many of the most motivated and involved people”.
The FMOQ ensures that the mention of “coercive measures” in the email sent to members was made on the basis of the speech made by the Legault government in recent weeks and not from new information provided by Quebec.
At a press briefing last Wednesday, Christian Dubé signaled that he would no longer comment on this dossier in the media over the next few weeks so that the parties have “a very positive and constructive discussion”. More than 800,000 people are waiting to obtain a family doctor in Quebec.
The Dr Simon Benoit is well placed to appreciate the problems of the Quebec health system. Since 2015, the family doctor has been working almost full time in the emergency department of the Verdun hospital. He is also responsible for the GMF-R (Group of Family Medicine Network) in the South-West, where he practices at least two days a week to see his patients in the office and do “walk-in”.
From May or June 2022, the 48-year-old general practitioner will entrust his some 750 patients to the access counter. To abandon his clientele in this way was a heartbreaking “ethical dilemma”, he emphasizes. “I have been working way too much, for far too long. I have to slow down. “
The Dr Benoit calculates that he works 22 to 25 days a month just to see patients in the office or in the emergency room. Added to this is the paperwork (two hours of work, he estimates, for each eight-hour shift done at the GMF-R), continuing education and scientific readings. ” It’s too much. I don’t see why a citizen would work that much. It’s unhealthy, ”he said.
The man has the reputation of being indefatigable. Before injuring his hip, the athlete doctor did ultramarathons. He kept up the pace at work. But with 750 patients registered for one day of office practice per week, Dr.r Benoit indicates that he has “full arms” and that he is doing a lot more than expected. “We expect a doctor to take care of around 250 patients per equivalent of an office day,” he explains.
The doctor recalls that nothing obliges him to work in an office, his particular medical activities (or “AMP”, in the jargon, that is to say tasks imposed on doctors with less than 15 years of practice) being carried out. in the emergency room. “Me, I’m supposed to do about 6 to 8 shifts per four weeks in the emergency room. I do 10 to 12, and more, ”he says. He doesn’t complain about it. Critical care fascinates him.
However, he says he wants to participate in improving access to family doctors. He has also tried to reduce his hours at the hospital in order to be more present in the GMF-R that he manages. In vain. He explains that there are too many doctors in the emergency room for the Regional Department of General Medicine (DRMG) to agree to release him from his hospital duties. And “they are right,” he admits.
At the CIUSSS du Center-Sud-de-l’Île-de-Montréal, it is reported that two emergency physicians from the Verdun hospital are currently absent and that two others are on maternity leave. This is a “temporary situation”, and the unit is not threatened by an interruption of service, insists its spokesperson Jean-Nicolas Aubé.
The DRMG, he recalls that its decisions are taken to “avoid” causing “breakdowns in service both in emergencies and in support”.
Exhausted by the pandemic
For the Dr Benoit, this situation illustrates “that there are glaring needs for family physicians everywhere and not only for care”. “Our health care system has been greatly weakened by the pandemic,” he adds.
Him too. Over the past 21 months, the general practitioner has had to constantly adapt to new health protocols in the emergency room. The management of the GMF-R has not been easy. “As responsible doctor, just making sure that the secretariat does not resign en bloc, that was a major challenge,” he says. We had our window broken twice – once inside and once outside – by aggressive and impatient patients. “
Exhausted, the doctor admits to having considered taking sick leave. “It sure went through my head, but we can like not do that,” he said. We know very well that if we take a leave of absence, we put it on the backs of colleagues. “
He’s not the only one feeling short of breath. At the Quebec Physician Assistance Program (PAMQ), requests from general practitioners are exploding. Their number increased by 40% from 2019-2020 to 2020-2021 (30% in the case of specialists). According to the PAMQ, this increase has continued since June and is increasing month by month.
The Dr Benoit, he chose to “take actions to protect himself”. “I have the right to have a minimum of quality of life. “