Many Quebecers without a family doctor recently received a letter inviting them to use the first line access window (GAP) if they need health care that does not require a visit to the emergency room. This new service generates many questions. The duty answers it.
What is the first line access counter (GAP)?
It’s the gateway to obtaining health services when you don’t have a family doctor. GAP’s mission is to offer orphan patients the right care at the right time by the right professional. This new counter was rolled out in June throughout Quebec. Each region has one (Montreal has five). They all work the same way and must be completely “functional” from 1er september.
How it works ?
You must contact the GAP headquarters in your area (the phone number varies by region). An administrative agent answers the calls and carries out an initial screening. It verifies whether you are indeed an orphan patient using your health insurance card number and directs you to a nurse if you have a “one-off” or “active” health problem to be resolved. The nurse clinician assesses your case and offers you an appointment with a doctor or another professional (specialized nurse practitioner, pharmacist, social worker, physiotherapist, etc.) if she deems it necessary.
An appointment is not guaranteed?
Exact. It all depends on the problem. “If the general condition of the patient is good, it is not necessary to see a doctor for a fever of less than three days”, cites as an example the DD Pascale Breault, collaborating physician for the GAP of the CIUSSS de l’Est-de-l’Île-de-Montréal. On the other hand, a urinary tract infection will lead to a consultation with a pharmacist (if the patient has had a treatment prescription for this problem in the last five years), a specialized nurse practitioner or a doctor.
The objective of the GAP is to entrust the patient to the right professional so that the doctors devote themselves to the tasks that really require their expertise, explains the government.
According to the Ministère de la Santé et des Services sociaux (MSSS), nearly 43% of the 72,635 requests processed to date by the GAPs led to a consultation with a family doctor, 4% with a pharmacist and 19% with another professional or service (specialized nurse practitioner, social worker, Info-Santé 811, etc.).
Nearly 30% of calls resulted in no recommendation. Many people are currently contacting the GAPs because they are unaware of this new service and want to know more, indicate the health establishments consulted.
Will I get an appointment quickly?
The MSSS mentions a delay of 36 to 72 hours for “an urgent need”, according to the “clinical situation”. At the CISSS de l’Outaouais, it is specified in an email that “the medical appointment slots are available within 24 hours if the consultation is deemed a priority by the GAP nurse and can extend up to 14 days according to priority. Others mention a 36-hour delay.
In an online document, the CIUSSS de l’Ouest-de-l’Île-de-Montréal mentions a delay of one to two weeks in the case of a Pap test, a request for contraception or a medical consultation related to filling out an SAAQ or CNESST form.
Is it true that you can only address one problem during the medical consultation?
“We prefer that only one health problem be addressed,” replied the CIUSSS de la Mauricie-et-du-Centre-du-Québec by email.
The DD Ariane Murray, head of the Regional Department of General Medicine in Montreal, believes, however, that the patient is not obliged to limit themselves to a single problem. “But it is possible that if a patient arrives with a long list, he will be told that the priority problems are resolved at that appointment and that other appointments are necessary to complete,” says the doctor in charge. coordinate the deployment of Montreal GAPs.
Can I get an annual medical check-up through the GAP?
If you are a 35-year-old who has no particular symptoms or family history and is not at risk for sexually transmitted and blood-borne infections, the answer is no. “It’s not indicated”, says the DD Murray.
Those aged 50 and over, who are more at risk of colorectal cancer, may eventually be entitled to it. According to the DD Murray, “transitional clinics” will be created for this purpose this fall. Under collective prescriptions, nurses will be able to offer “relevant” blood tests and screening tests to patients depending on their situation.
I did not receive an invitation from GAP and yet I am an orphan patient. Why ?
CIUSSSs and CISSSs open the doors to their GAPs gradually, in waves: for example, people aged 60 and over registered with the family doctor access window (GAMF), then 0-17 year-olds, registered orphan patients to a family medicine group (GMF), etc. All orphan patients should have access to the GAP in their region in September.
This is already the case in certain regions: Bas-Saint-Laurent (where the first GAP was born), Saguenay–Lac-Saint-Jean and Lanaudière. There, the GAP phone number is public.
However, the Ministry of Health insists that the deployment of GAPs represents a great challenge and that a transition period is necessary.
I have a family doctor, but I am unable to get an appointment with him. Can I use the GAP?
No, this service is reserved for orphan patients. You will have to try to get an appointment with a doctor in your family medicine group (FMG) or in another clinic from Rendez-vous santé Québec or another site like Bonjour-santé.
I am registered with a family medicine group (GMF). Could I one day have a family doctor? If I use the GAP, will I lose my place at the counter for access to a family doctor (GAMF)?
You will not lose your place, says the MSSS. “The fact of being registered with a group does not prevent the individual registration with a family doctor”, specifies one in an e-mail.