In the middle of the election campaign, the Quebec Interprofessional Council (CIQ) calls out to the next government. The association of Quebec professional orders believes that physicians must share their diagnostic power even more with other professionals — psychologists and podiatrist surgeons, for example — in order to improve access to front-line health care.
“We are telling the next government that it must be a priority,” says CIQ president Danielle Boué. Too many Quebecers, she laments, have to take a “pilgrim’s staff” to obtain physical or mental health services.
She cites as an example the case of a person who presents symptoms of depression and who consults a psychologist. “It is certain that the psychologist will evaluate it and will be able to treat it, says Danielle Boué. Except he can’t diagnose her. He cannot establish the discomfort or the precise cause [du trouble]. He has the competence to know, but legally he cannot. »
This gives rise to nonsense, according to her. People followed by a psychologist must obtain a consultation with a doctor if they need a ticket for sick leave or for reimbursement of expenses by the insurer. Same fight for patients who have undergone an intervention with a podiatrist surgeon and whose state of health requires a work stoppage, she continues.
“We are short of manpower! said Danielle Boué. We seek to be more and more effective and efficient, but we always duplicate [les ressources]. »
Twenty-nine orders consulted
The CIQ makes public on Tuesday a 24-page document entitled Act now to improve access to health and social services. Written in collaboration with 29 health and human relations orders, including the College of Physicians of Quebec, the report offers various possible solutions. It is the result of work begun in the spring following the presentation of the reform of the health system by Minister Christian Dubé.
In its document, the CIQ notably puts forward the idea of expanding the coverage of the basket of services insured by the Régie de l’assurance maladie du Québec (RAMQ). Thus, a patient with a knee injury could, for example, directly consult a physiotherapist in a private practice, a service that would be reimbursed by the RAMQ or its insurer.
“This expansion of the basket of insured services would prevent patients from choosing to go to hospital emergency rooms or walk-in medical clinics solely for financial reasons,” the document states. This would improve the flow of care for the entire population. »
The CIQ pleads in particular in favor of the creation of a new job title in the health and social services network: marriage and family therapist. “These professionals exist, they are already members of an order, they have activities, but there is no job title in the network. Why don’t we hire these people to help the entire mental health network take care of patients more quickly? asks Danielle Boué.
Other measures are listed, such as allowing dentists to perform “X-rays using a portable device in a private residence” or allowing nursing assistants “to assess a stable clientele with predictable evolution”.
According to the CIQ, “many discussions” are underway to make legislative changes that broaden the scope of practice of professionals. But the process could be accelerated.
“What we have observed in recent years is that when there is a political will to make legislative changes, they happen very quickly. We saw it with specialized nurse practitioners and pharmacists,” says Danielle Boué.
Contacted by The duty, the College of Physicians of Quebec did not wish to comment on the document “at this stage”. In the report, the CIQ writes that the College “says it is in favor of an approach to reviewing professional activities specific to each order, centered on accessibility to health care”.