A family doctor for 500,000 patients, really?

The Legault government repeats that 500,000 orphan patients will have a family doctor by March 31, 2023 thanks to the agreement in principle recently concluded with the Federation of General Practitioners of Quebec (FMOQ). However, even supported by a group of doctors, these patients will have to go through the triage of the first line access counter (GAP) each time they wish to obtain a medical consultation.

“The patient can’t just call the clinic and say ‘I need to see the doctor,'” Dr.^D Joëlle Bertrand-Bovet, president of the Médi-Soleil center, a superclinic (or GMF-R) located in Saint-Jean-sur-Richelieu. To get an appointment, you will have to go through the GAP and you will be sorted by a nurse who will see if you will have to see a doctor or another professional. »

The D^D Bertrand-Bovet attended the presentation of the agreement in principle by the FMOQ. Its president, Dr.^r Marc-André Amyot has been touring the regions of Quebec since Monday. It has so far stopped in Mauricie, Montérégie and Estrie.

Physicians’ participation in the measures of the agreement is voluntary. “If we adhere to it, what we undertake to give is not unlimited follow-up, specifies the D^D Bertrand Bovet. He is not a “family doctor” as we understand it. This is one range per patient per year. Thus, if 1200 patients are taken care of, 1200 slots will be reserved for them.

The D^D Bertrand-Bovet wonders if the planned number of beaches will be sufficient. “The FMOQ tells us that it works, that they did a pilot project in the Bas-Saint-Laurent, that out of 100 patients at the GAMF (access window to family doctors), only 60 called [au GAP] and that 30 were seeing a doctor, she says. But is this realistic in a region like ours (Montérégie), where there are 195,000 patients on the GAMF who have not seen a doctor for years? »

At the Médi-Soleil center, the 16 doctors have already decided not to collectively take care of orphan patients, according to the D^D Bertrand Bovet. ” We can not ! Our 16 doctors have an average of 1062 patients. Six of them are over 60 years old. The majority of the others practice in hospitals. “As we are a FMG-R, we have 20,000 visits per year from patients not registered for walk-in,” she adds.

Skepticism

The duty asked the FMOQ for an interview with Dr.^r Amyot to further discuss the tentative agreement presented to the members. She declined it. An article, published on May 5 in the FMOQ magazine The Doctor of Quebec, confirms however that the groups of doctors adhering to the program will offer “a range of appointments per year per patient” and that the patients “will be referred by the GAP”. After the call of To have tothe FMOQ removed the text from the website in order, it justified, to carry out checks.

The D^D Karine Talbot, administrator at the Association of General Practitioners of the Mauricie, was “a little skeptical” before attending the presentation of the agreement in principle on Monday. Under it, 250,000 patients – out of the approximately 990,000 registered with the GAMF – will have to be taken care of by groups of doctors by July 31.

The D^D Talbot now sees the deal “favourably”. She believes in GAP and its triage system. But it is still necessary, she nuances, that the other health professionals are sufficient to meet the demands. “We do a lot of mental health,” she observes. Access to psychologists and social workers in the network is really not easy. According to her, the government will have to “reduce certain tasks” for doctors, such as reducing “red tape”, to improve access.

The D^D Marie-Pierre Laflamme, head of Clinique médicale 3000, a GMF-R located in Montreal, describes the agreement in principle concluded with Quebec as “very ambitious”. “It will depend on a lot of things that are not in our pockets, family doctors,” said the one who sits on the general council of the FMOQ.

It will be necessary to find staff, in the midst of a labor shortage, to “run” the GAP in Montreal. But she prefers to see the glass half full rather than half empty. “If it works well, it can be interesting to start by giving, for example, three appointment slots per week, she thinks. If you receive cases where you make a difference and you have been used for something, at least it is rewarding. »

In addition to encouraging the care of orphan patients, the agreement in principle encourages physicians to free up time slots for their clientele already registered and requiring a quick consultation. Within a year, 30% of time slots will have to be offered within 72 hours, including a third (10%) in 36 hours or less.

If physicians participate in one of these two measures, the attendance rate will be “obsolete,” says an email sent by a regional association of the FMOQ to its members. The Department of Health and Social Services currently uses this rate to determine the family physician’s accessibility to its registered patients.

When announcing the agreement, the FMOQ emphasized that “no additional sum of money to those already provided for in our current envelopes will have to be disbursed within the framework of the realization of this agreement”.

Its president will end his regional tour on May 19. The advisory vote will take place at the end of the month.

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