This is unprecedented: the number of family doctors practicing in the Quebec public network saw a decline in 2022-2023, according to the Federation of General Practitioners of Quebec (FMOQ). The arrival of new doctors has not compensated for retirements, the exodus to the private sector and moves outside the province. The results were negative, for a total of 49 fewer doctors, reports the FMOQ. Nothing to help the various regions of Quebec replenish their medical staff.
“This is indicative of a deep unease and workforce planning that had shortcomings,” said the president of the FMOQ, Dr Marc-André Amyot. If we lose 50 every year like that, things won’t go well. That’s not how we’re going to improve accessibility for the population. »
Family doctors are retiring in greater numbers and at younger ages. More and more general practitioners are also leaving the public network to work in the private sector. According to the Régie de l’assurance santé du Québec (RAMQ), 446 family doctors — out of approximately 10,300 — had a non-participating status last July, compared to 333 in 2018-2019. “It’s not huge [en termes de pourcentage du nombre total]said the Dr Amyot. But it’s much more than anywhere else in Canada. »
According to him, we must improve the working conditions of family doctors so that they practice within the network and remain in Quebec. General practitioners need, he specifies, to obtain “support” for their patients requiring, for example, mental health services. Their administrative tasks must be reduced and their remuneration increased, he says. “It’s taboo, but there is a pay gap between family doctors in Quebec and [ceux du] rest of Canada,” says Dr.r Amyot.
In the office of the Quebec Minister of Health, Christian Dubé, it is argued that the number of admissions to medicine has increased since the arrival of the Coalition Avenir Québec to power in 2018. In 2023-2024, 1,043 students were admitted . This figure will increase to 1,225 per year in 2026-2027, “or 660 more in four years, as [ce à quoi] we were committed,” we specify.
The Ministry of Health and Social Services (MSSS) adds that the way of distributing positions and offering them to new doctors across Quebec has been made more flexible this year. From now on, graduates will be able to apply in more than one region, and not just one as was the case before. Positions will be announced in the coming days.
Strong competition
With the current shortage, competition is keen to recruit young doctors. And not just between Quebec regions. “We had a candidate who had a position in Verdun and who was due to start this fall, and she chose to go to the private sector,” says the DD Ariane Murray, head of the Regional Department of General Medicine in Montreal.
The Lacroix private medical clinics say they recruited four family doctors thanks to the Career Day of the Federation of Resident Physicians of Quebec (FMRQ) held last year. However, the company was unable to participate in the 2023 event, which attracted nearly 900 residents last Friday. Clinics offering services outside RAMQ were not invited.
A situation denounced by the president of the Lacroix Medical Group, Dr.r Marc Lacroix. “We consider it discriminatory to be deprived of being able to participate in the event as we have been doing for more than 10 years. Unfortunately, this is one of the only opportunities to introduce private medicine to medical graduates, who greatly appreciate our presence at the event. »
The FMRQ says it made this decision after the MSSS asked it to do so. “He’s our biggest exhibitor, we agreed to his request,” explains its president, Dr Cedric Lacombe. The MSSS claims for its part to have “expressed its uneasiness to the FMRQ given the place given to the private sector during the Day last year”. “That said, it has always been clear that the final decision rests with the FMRQ,” we wrote in an email.
The head of the Regional Department of General Medicine of Outaouais, Dr.r Marcel Guilbault believes that establishments from other provinces, such as Ontario, should not be at the event. They were present last Friday. “It’s still Quebecers who pay for a large part of the training of these doctors,” he said. I don’t see why the other provinces would come and take advantage of us like that and show their attraction. ” The DD Murray shares this “discomfort”. “We must do everything to promote the Quebec public network,” she adds.
The MSSS does not see things the same way, putting forward the argument of “reciprocity” between the provinces. “Quebec wishes to be invited to the activities of other provinces,” it is stated. We also recognize that New Brunswick is in a special situation, because it pays to train doctors in Quebec. »
The FMRQ believes that it is up to the regions and various establishments “to have an attractive offer for resident doctors”. “We, at the FMRQ, are here to offer the best for resident doctors,” says Dr.r Lacombe. After that, we will let the regions, the different provinces do their work to have candidates who will live up to their expectations. »