Medical appointments offered at the Front Line Access Center (GAP) remain fewer than usual, two weeks after the conclusion of an agreement between Quebec and family doctors. Clinics want to reduce their participation in GAP and even put an end to collective registrations. Patients will become orphans again.
What there is to know
Appointments offered by family doctors at the Frontline Access Desk (GAP) are fewer in number than usual, two weeks after the conclusion of an agreement between the government and the Fédération des médecins omnipraticiens du Québec.
Nearly 12,500 medical consultation slots are planned at GAP for the week of June 30, compared to 18,000 to 23,000 in normal times.
Clinics are planning to reduce group registrations or even stop them altogether.
As of June 28, nearly 12,500 medical consultation slots were planned at GAP for the week of June 30, according to the Ministry of Health and Social Services (MSSS). This number rose to approximately 13,000 for the following week and 11,200 for the week after that. Normally, an average of 18,000 to 23,000 medical appointments are offered at GAP each week.
The Federation of General Practitioners of Quebec (FMOQ) says it has warned the government of the consequences of the non-renewal of the previous agreement, which expired on 1er June.
We have slowed down the momentum and now we will have to see how long it will take for the wheel to start turning at the same pace again.
Stéphane Gosselin, spokesperson for the FMOQ
During the negotiations, doctors left the GAP to work elsewhere – in the emergency room, for example. It remains to be seen, says the FMOQ, if they will come back.
In Outaouais, “many” clinics will reduce their number of collective registrations, according to the head of the regional department of general medicine, Dr.r Marcel Guilbault. “We have a group which had 20,000 registrations and which is down to 16,000,” he explains. Another with 14,000 which goes down to 9,000.” But some want to increase support. “It will obviously not compensate for the losses we are going to have,” he believes.
In the Montreal region, the “majority” of groups of doctors intend to maintain their number of collective registrations, according to the head of the regional department of general medicine of Montreal, Dr.D Ariane Murray. “We have a certain proportion of clinics that are going to reduce a little,” she says. Only one is dropping the GAP. Others want to increase their participation, she indicates.
No more collective registration
The Le Trait d’Union superclinic, in Delson, in Montérégie, has chosen to stop collective registration from 1er June. The 4,500 patients treated by the group of 20 doctors will receive a letter informing them that they are once again registered with the Family Doctor Access Desk.
The Dr Jean-Philippe Chouinard, doctor responsible for this superclinic (GMF-R in the jargon), explains that his team has “lost confidence” in this system. And it’s not a question of money, he insists.
We were really more in the mode of putting out fires, of responding to specific needs. We were not able to have the satisfaction of having updated patients’ medical records.
The Dr Jean-Philippe Chouinard, head of the Le Trait d’Union superclinic
The premium per patient registered collectively – reduced from $120 to $100 under the bridging agreement – did not influence their choice, he assures. “When we decided to stop, it was really because we thought it was not the right way to provide a service to the population.”
His group has seen “a few” of its group registrants over the past two years, he says. Many of the patients – orphans or those followed by other groups of doctors – were “heavy” cases that required multiple visits. “Sometimes, the patient was sent to another clinic to see another doctor for follow-up, or we picked up GAP follow-ups of patients who had been followed elsewhere,” he laments. “It was really disorganized.”
To have “a little more local control”, Le Trait d’Union chose to revive its “orphan clinic” launched a year before the GAP and abandoned in favor of the latter. The service – financed by a practice support measure in the GMF agreement – will be intended for orphan patients from the GAP or redirected by the emergency department or pre-hospital services. In total, 4,200 appointments will be offered each year. “About half of the appointments will be given by nurses,” specifies the Dr Chouinard.
The nurse will update the patient’s health assessment (blood tests, for example) before the medical consultation which will take place in the following weeks, specifies the Dr Chouinard.
New rules that change the game
In Saint-Jean-sur-Richelieu, the Médi-Soleil medical center will increase its number of patients registered collectively from 11,000 to 8,000, due to the new agreement, according to its president, the DD Joëlle Bertrand-Bovet.
From now on, the number of slots offered is modulated according to peak periods (influenza season, for example), and not equally each quarter.
However, the clinic’s doctors who work at the hospital have “more shifts in the winter,” she explains. In this context, it is impossible to maintain the 11,000 consultation slots.
The DD Bertrand-Bovet expects to have to reduce them even further in 2025. The “unhealthy climate” established, she says, by the Legault government has caused the departure of colleagues. “A second-line doctor who came to do GAP left completely,” she says. We have a doctor leaving in Ontario. » A third will go private on December 31.