Created in 2001 to improve access to primary care in Quebec, family medicine groups (GMF) have “not delivered the goods” and are “a failure”, according to a new study by the Institut de socio-economic research and information (IRIS).
Posted at 12:00 a.m.
A researcher at IRIS and York University, Anne Plourde indicates that FMGs were initially supposed to “increase access to family doctors, relieve emergency room congestion and improve access to psychosocial services”. However, “the general indicators of the MSSS [ministère de la Santé et des Services sociaux] clearly show that, out of these three objectives, no target has been achieved,” the study reads.
Between 2014-2015 and 2020-2021, “the ratio of registered patients per GMF doctor only increased by 2%”. In addition, one out of six GMFs has “made agreements” with certain emergency rooms across Quebec so that they treat certain FMG patients, especially in the evenings and on weekends, says Ms.me Plunder.
To be funded by Quebec, FMGs must generally offer 68 hours of services per week. But those who do not succeed can sign agreements with other establishments, including emergencies, explains the researcher. “However, the FMGs had to unclog the emergency rooms. It is difficult to understand this logic”, notes Mme Plourde, who adds that access to psychosocial services has not improved with the arrival of FMGs.
For meme Plourde, it is obvious that “the GMF model has not fulfilled its promises”. She notes by the very fact that the majority of FMGs are private entities “funded largely by the public”. A kind of “medicine inc.” which, according to her, is for the benefit of doctors and not of patients.
Several factors involved
At the Federation of General Practitioners of Quebec (FMOQ), it is explained that the problem of access to the first line is caused by multiple factors “and not only by the model of organization of care”.
The director of communications of the FMOQ, Jean-Pierre Dion, notes for example that there was “an equivalent number of general practitioners and specialists” in 2001. “Today, there are 1100 general practitioners less”, says -he. More than 500 family doctor positions have been left vacant since 2013. The special medical activities that are mandatory for general practitioners, especially at the start of practice, bring doctors “to several places, except in FMGs,” he says. As for access to psychosocial services, Mr. Dion affirms that the shortage of workers in the public has never been so glaring.
Mme Plourde acknowledges that “other factors come into play”. “But the FMGs themselves are not fulfilling their mandate,” she maintains. This study is published as the FMOQ is about to announce the results of its members’ vote on the agreement in principle concluded with the government and which aims to improve access to primary care in the province.