Nearly 15% of Quebec family physicians take care of less than 500 patients, learned The duty. They are far from reaching the “acceptable threshold” of 1000 patients determined by Quebec. The Legault government judges that 4000 general practitioners could “contribute more to the collective effort”. The federation that represents them warns Quebec against a “stupid analysis” of raw data.
Prime Minister François Legault has been repeating for months that family doctors do not have enough patients registered in their name. He once again expressed his impatience with them last week. “There are really a good number of family doctors who do not take care of many patients,” François Legault said at a press briefing on Wednesday.
How much ? The duty obtained data from the Ministry of Health and Social Services (MSSS), dated March 31, 2021. It can be seen that 483 family physicians, out of the 3,530 full-time practicing in an office, have less than 500 registered patients. This represents 14% of primary care physicians.
The situation is the same for family physicians with mixed practice, that is to say who work in an office as well as in hospitals or in CHSLDs. Of these 5,371 doctors, 771 take care of less than 500 patients, which corresponds to 14% of them.
At the office of the Minister of Health and Social Services, Christian Dubé, it was pointed out that “the majority of the 10,000 family physicians in Quebec offer excellent service to their patients”.
About 4000 could however “contribute more to the collective effort”, indicates the press secretary of the minister, Marjaurie Côté-Boileau. These general practitioners have about 650 patients enrolled on average, she says. “Even if we do not have a precise management target, we consider that 1000 patients is an acceptable threshold, which Quebecers are entitled to expect,” she said. As the Prime Minister has said, if all physicians take care of a sufficient number of patients, the list of 800,000 waiting patients could decrease dramatically. “
Minister Christian Dubé believes that general practitioners must also “offer more appointment slots” to their customers, orphan patients as well as to those who are redirected from emergencies, currently “overwhelmed”, adds Marjaurie Côté. Boileau.
The FMOQ tempers
The president of the Federation of general practitioners of Quebec (FMOQ), Dr Louis Godin, thinks that we “must be very careful when interpreting” figures such as those provided to the To have to. His federation carried out a more detailed analysis of patient care about three years ago. “When we look at the number of doctors to whom we can say ‘really, yes, these people could do a lot more’, when we look at the whole situation, we are talking about barely a few hundred doctors in Quebec” , supports the Dr Godin.
The FMOQ reminds that family physicians are required to perform 12 hours per week of specific medical activities (“AMP” in the jargon) in the hospital or in a CHSLD during their first fifteen years of practice. To meet the needs of institutions, they often do more, which limits the care of patients with some doctors, says DD Julie Choquette, director of planning and regionalization at the federation.
Several other reasons may explain why a doctor has fewer patients enrolled, according to Dr.r Godin: health problems, the occupation of an administrative position in the network or in a private company, a teaching load and less experience (beginning doctor). He points out that doctors at the end of their careers also work part-time. According to the FMOQ, 26% of the 9,791 general practitioners practicing in the public plan are aged 60 and over.
In the office of the Minister of Health and Services, it is indicated that “the contribution of the members of a GMF [groupe de médecine familiale] can be modulated according to their personal reality ”. “The organization must itself allow the work to be distributed among the different physicians who are members of the clinic,” says Marjaurie Côté-Boileau.
Consider other avenues
According to the FMOQ, there is a shortage of 1,000 family physicians in Quebec. Since 2013, more than 400 residency positions in family medicine have remained vacant, indicates the federation.
The DD Julie Choquet, a general practitioner who has more than 1,000 registered patients, believes that the government must take more account of the feminization of the profession in its calculations. According to the FMOQ, 70% of general practitioners under the age of 60 are women.
“We have to realize that, when women have this job, they will have to go on maternity leave one day, they will have to take care of the majority of children during the first year and even after,” said the woman. 54-year-old doctor, who works in obstetrics at LaSalle hospital. The division of labor has improved in Quebec, but women still often bear the burden of the mental burden, notes Dr.D Choquet.
The stick is not the right approach to increase the care of doctors, judges the Dr Mathieu Pelletier, deputy director of GMF-U north of Lanaudière. “We can slap them on the head, tell them ‘you’re going to take more patients, you are going to take more patients’, we, what we hear on the ground from our women colleagues, is’ I’m going to take the penalty” [si le gouvernement Legault en impose une] He said.
According to the Dr Pelletier, Quebec should consider other solutions to improve access to family physicians, such as making greater use of specialist physicians in hospitals, in order to allow general practitioners to work there less.
The DD Choquet, she thinks that AMPs for the care of 500 patients should be offered to general practitioners on the island of Montreal, in the same way as those imposed in hospitals or in CHSLDs. “Legault whines [parce] that the doctors do not want to take charge, but he is not granting any AMP in charge at the moment in Montreal, she said. Me, I know doctors who want to take charge, and they are not able to have an AMP. They have to go to work in the long term or in the emergency room. “