Family doctor in the region, a leading role

Throughout Quebec, the reGions are struggling to recruit family doctors. However, settling far from urban centers gives access to a varied and stimulating profession, according to practitioners who have chosen the call of the great outdoors.

Often seen as a temporary situation at the start of a career, family medicine in the region is for others a true vocation. For the D^r Guillaume Charbonneau, originally from the South Shore of Montreal and established in Maniwaki in Outaouais, it was clear: “I wanted to practice in a remote region, where the needs were numerous”. From Outaouais to the North Shore, via Bas-Saint-Laurent and Montérégie, family doctors occupy a key place in health institutions in the regions of Quebec.

A varied practice

Patient care in clinics or at the CLSC, but also on duty in the emergency room, health and travel clinics, sports medicine, CHSLDs, teaching, etc. While family doctors in urban areas tend to specialize, practice outside of big cities is very versatile. “The family doctor plays a more important role, and manages more things than in urban centers,” says the D^r Charbonneau.

In regional establishments, the family doctor occupies a central place, as there are fewer specialist doctors. “They are the ones who enable the existence of regional hospitals,” underlines the D^D Marie-Laurence Dionne, a young general practitioner who has taken up residence in Baie-Comeau, on the North Shore. “We manage more complex cases, and we have more responsibilities,” adds the D^D Alison Brebner, chief of doctors at Barrie Memorial Hospital, in Ormstown, in Montérégie.

“Regional hospitals are mainly run by family doctors. It requires them to have a good deal of autonomy,” estimates the D^r Roger Dubé, family doctor in Baie-Comeau for around thirty years. They are the ones who most of the time take care of obstetric care, emergencies and hospitalization. A reality that the government does not always grasp, believes the D^r David Lee, family doctor and former head of the Manicouagan university family medicine group in Baie-Comeau. “A few years ago, the government’s mentality was that we had to get general practitioners out of hospitals [pour qu’ils prennent en charge davantage de patients en clinique]. But in the region, these general practitioners are cost-efficientbecause they can handle a lot of things,” he argues.

Local care

In small circles, teams tend to stick together. Collaboration between the different local health and social services networks (RLS) is essential, despite the great distances that separate them. “If one RSL lacks staff, the other will help it out,” explains the D^r Dubé, who is also head of the Regional Department of General Medicine on the North Shore.

These family doctors know their patients, who are sometimes their neighbors, well. “We take care of them from birth to the end of life. We visit them at home, in palliative care beds…” says the D^D Julie Camiré, family doctor in Port-Cartier, on the North Shore.

But despite its educational and varied side, family medicine in the region has its share of challenges, and the practice is not made for everyone, all the speakers concede. Especially in the context of a labor shortage, family doctors who choose to establish themselves in these regions with pressing needs are in high demand. “It’s a lot of work!” With a diversity of cases, it is important to set your limits,” concludes the D^D Dionne.

This report was made possible thanks to excellence grants from the Association of Independent Journalists of Quebec (AJIQ).

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