Accused of blocking the deployment of palliative care at home, the Federation of General Practitioners of Quebec (FMOQ) denies it and affirms that it is rather the lack of nurses and attendants that is in question.
In an interview published in The Press Sunday, the DD Geneviève Dechêne, who is preparing to retire after a career devoted to palliative care, argued that if so few Quebecers die at home compared to the rest of Canada, it is largely because the FMOQ , by its remuneration, discourages its professionals from embarking on this practice.
Even more, the DD Dechêne denounces the fact that since 2019, the government has imposed a seven-day limit on medical follow-up at home beyond which the doctor is illegal, while a person at the end of life needs care for several months.
The Dr Marc-André Amyot, president of the FMOQ, recognizes one thing: the agreement with the government must be corrected, which, according to him, has been interpreted “in a restrictive manner by certain doctors”.
In the agreement, he explains, it is stated that palliative home care should generally be provided for about seven days. “But that doesn’t mean, at 8e or at 14e day, that the carriage turns into a pumpkin. The intention of the parties – the Ministry and us – was not to be limiting. We are in the process of correcting that. »
Only one out of ten Quebecers dies at home, while this is the case for approximately 30% of other Canadians. The Dr Amyot believes that doctors are not responsible.
According to the FMOQ, at least 232 doctors provided palliative care at home in 2019-2020, to which are added other doctors working in CLSCs and who also make themselves available for end-of-life care.
The lack of doctors does not explain everything
There is a lack of doctors everywhere, recalls the Dr Amyot, but that only explains 10% to 15% of the problem, according to him. If more palliative home care teams cannot be deployed, it is primarily because of the shortage of nurses and orderlies.
The Dr Amyot also argues that outside major centers, the population is insufficient to justify the establishment of home palliative care teams that would devote themselves entirely to this practice.
This does not mean, he continues, that only city dwellers can aspire to die at home, but although outside the big cities it will be multi-skilled teams doing all kinds of home care that might arise. load it.
The Dr Amyot says it would be nice if more people could die at home, if they so wished, and money is certainly not the issue.
He notes that the sums devoted to this practice even remain unused, for lack of personnel.