Health Plan Recommendations | A great absence: the contribution of medical specialists

Several proposals in this Health Plan call for collaboration between health professionals and the sharing of responsibilities for greater accessibility to care. However, it is quite worrying and even paradoxical to note that medical specialists, who are largely responsible for the current situation due to their insufficient contribution to hospital care, are once again going under the radar.

Posted at 12:00 p.m.

Jacques Ricard

Jacques Ricard
Physician and manager in the retired health network

In Quebec, about 40% of the general practitioner workforce is dedicated to hospital tasks. I remind you what the Dr Louis Godin, former president of the Federation of General Practitioners of Quebec (FMOQ), said in an interview: “We have to stop playing with numbers. A doctor in Ontario or Alberta certainly takes care of 1,200 patients, but he does not have to devote 40% of his practice to tasks in the hospital environment. »

In the rest of Canada, the workload of general practitioners represents 18% to 20% of their hospital activities. If tomorrow morning, we had the same proportion as in the other provinces, we could have between 1,500 and 2,000 more general practitioners available for the first line. Imagine how the contribution of these doctors to other professionals could facilitate the management of the 800,000 patients who are registered on the waiting list.

Do we have enough medical specialists in Quebec for this hospital care? Yes, we have in Quebec a medical specialist/population ratio that is higher than in the rest of Canada. In Quebec, we have 126 medical specialists for every 100,000 inhabitants. In Canada, that’s 119 medical specialists per 100,000 population.1

This is not to exclude all general practitioners from hospital practice. They are essential, particularly in small hospitals and in remote regions, where the critical mass of medical specialists is insufficient to assume this hospital management. It should also be noted that, in our emergencies in Quebec, the general practitioner plays a major role; in the hospital departments of geriatrics, obstetrics and palliative care as well.

On the other hand, how is it that we find general practitioners who carry out hospital activities in hospitals in the Montreal region, the South Shore, the northern shore and even in the Quebec City region, where the number of physicians specialists is more than enough to allow this hospital treatment?

The populations of these same regions are particularly affected by the lack of family doctors.

Several reasons contribute to maintaining the status quo of this problematic situation. On the one hand, hospital general practitioners like this medical practice in a hospital environment and, on the other hand, it is very lucrative. In addition, medical specialists prefer to play the role of consultants rather than having the responsibility of on-call doctors for hospitalized patients. For the two groups concerned, it must unfortunately be noted that this situation responds more to their needs and not to the health and follow-up needs of the population.

Honestly, I wonder about the privileged treatment that the government once again grants to medical specialists. How is it that in a plan that affects a group of health professionals, there is no objective that concerns medical specialists? Would this group of professionals have no contribution of productivity and relevance to the organization of our health system? It’s up to you to judge, considering their remuneration.


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