Family physicians want to be part of the solution to the problem of lack of access to health care in Quebec. On the other hand, they denounce the continuous pressure of the last few months aimed more at achieving statistics in this pre-election period than the well-being of patients. Patients will be the first to be affected by these measures presented as efficient, but which in reality are only a thinly veiled instruction to do more, without thinking of doing better.
Health professionals have been key players in the past two years. Exhaustion and fatigue are felt in our ranks, and the introduction of Bill 11 will sound the death knell for the careers of many. Already, hasty retirements, migration to the private sector or to other provinces, the lack of succession among our students who shun family medicine are announcing an imminent disaster for the population in terms of access to care. This is reminiscent of the situation of nurses with the compulsory overtime and the situation of significant deficit that followed.
Quebec is the only Canadian province that imposes constraints on physicians regarding their location and type of practice (PREM [Plans régionaux d’effectifs médicaux] and MPA [Activités médicales particulières]), which is already creating an exodus of professionals. For example, a physician who wishes to adopt an obstetrical practice in the same region as his spouse may be required to practice geriatric medicine in a remote region. Following the announcement of Bill 11, several residents who wanted to work in Quebec announced that they would go to Ontario to practice medicine without constraint.
Minister Dubé keeps repeating that he must have access to physicians’ work data to better organize the supply of health care, and we fully agree. The computerized appointment system being deployed in Quebec allows him to obtain all the information he needs. A bill giving it additional control was not necessary for this purpose and will only accelerate the exodus of doctors.
Comments suggesting that physicians need to do more ignore the fact that today’s generation of physicians is different from that of their predecessors who typically had a spouse at home. The era of Dr Welby is gone. It is important to take this new reality into account in planning for physician resources, which has not been done until now and contributes to current access problems. The media releases on their number of hours of work which never take into account the third of additional administrative time in addition to the hours spent with the patients are shocking and demotivating.
We should also mention that one of the important elements of Bill 11, little discussed until now, is that it prevents patients from accepting care by a doctor they would have already known in a walk-in or by a doctor who is already following a member of their family. The very essence of family medicine is once again drowning in unprecedented government control. He must question himself about the consequences for patients in great psychological or physical distress who will then have to turn to the access counter and wait for treatment.
We ask that the current political circus give way to real reflection, based on solutions that emanate from the field. Let us think, in particular, of the gradual release from compulsory activities in institutions, the questioning of the plans that manage the place of practice of doctors, the coverage by the public plan of services for other professions such as physiotherapy or psychology, the reduction of administrative tasks. We welcome, in this sense, the deployment announced by the government of the front-line access counter, which will direct patients to the best health professional according to the problem to be treated.
We are concerned that any agreement or bill in which doctors cannot inevitably “deliver the goods”, given the current lack of resources and their already overburdened schedules, will end up destroying the mental health of many of them. We can only contest the measures presented by the government which announce an assured failure. It is through a complete overhaul of the organization of multidisciplinary care that we will be able to better meet the health needs of Quebecers. It is certainly not by continuing to blame family physicians for the failure of the reforms implemented by the Department of Health in recent years. Will you have that political courage, Mr. Dubé?
* Signatories:
DD Rosemarie Bergeron Drew
DD Julie Gagnon
DD Marie-Eve Turgeon
DD Joelle Bertrand Bovet
Dr Rejean Thomas
DD Brigitte Bedard
DD Michael Tran
DD Neil Gaul
Dr Yahia Cherif Tewfik
DD Gael O’Shaughnessy
Dr Francois-Pierre Gladu
This letter is also supported by nearly 150 other physicians.