Interview with the new president of the FMSQ | Reduce waiting time by eliminating unnecessary acts

After taking office a little over six months ago, the new president of the Federation of Specialist Physicians of Quebec (FMSQ), Dr.r Vincent Oliva, wants to reduce the wait in specialized medicine which exploded during the pandemic, in particular by continuing work on the relevance of care.



Ariane Lacoursiere

Ariane Lacoursiere
Press

With the Institute on the relevance of medical acts, the FMSQ is in the process of “doing a little cleaning up in the services”, explains Dr Oliva interviewed at Press. “It is clear that with the waiting lists which have swelled, we have to make decisions and make choices. But you have to be careful: the idea is not not to provide services that are relevant. The idea is not to put energy where there is little added value because the waiting lists are very long. ”

The Dr Oliva began a tour of Quebec hospitals at the end of October. Its objectives: get closer to the field and mark a “change of tone” in its organization.

The tour has already started in Victoriaville and Sherbrooke. A deliberate choice. “We wanted to start with an intermediate region to send the signal that we do not only want to listen to the large centers. We want to do an extended tour, ”he said.

Among the major files which occupy the Dr Oliva since her election and which worries its members: the waiting lists in specialty.

Catching up with activities, not just in surgery, it is perhaps the file that makes me turn the most at night. Because there are all kinds of bottlenecks there. Including the lack of staff.

The Dr Vincent Oliva, President of the Federation of Specialist Physicians of Quebec

While more than 150,000 people are on waiting lists for surgery, the health network will have to work extra hard to achieve the goal of having 100,000 people waiting in the spring of 2023. “We will eventually have to open the blocks in the evenings and weekends, ”says Dr Oliva. But to get there, more staff will need to be hired, he says.

In the meantime, the FMSQ is continuing its work on the site of the relevance of care, which had started before the election of Dr Oliva. During his opening speech in mid-October, Prime Minister François Legault recalled that he had signed an agreement with medical specialists in 2019. According to this agreement, the FMSQ in particular undertook to recover 240 million recurring by the through a review of the appropriateness of care. These sums will be reinvested to improve access to specialized medicine. “We expect this agreement to be fully respected by medical specialists,” said Mr. Legault. “We are committed to respecting this agreement”, assures Dr Oliva.

Decisions have already been taken. If some “are more consensual”, there is still “nothing easy”, according to Dr Oliva. The impact of each decision must be weighed. Pediatricians, for example, want to focus on children with pathologies and limit their physical examinations of patients without illness. “But is the first line capable of absorbing this volume? We want to ensure that patients do not fall between two chairs. This is the kind of domino effect that we see in certain measures where the assumption of responsibility will be transferred to other professionals ”, says Dr Oliva.

Low value-added activities are already being phased out. For example, after an operation, patients had to be seen four times a year by their specialist. “But there is no added value to that. So let’s see them twice a year. It will save costs. And above all, it will allow patients who really need a specialist to have one, ”says Dr.r Oliva.

Collaboration with the omnis

The end of the reign of the previous president of the FMSQ, the DD Diane Francoeur, had been overshadowed by the allegations of a former director who spoke of “toxic climate” to the Federation, who denounced the “abusive behavior of its president” and who sued the FMSQ. The organization defended itself by accusing the director of being the architect of its own misfortunes.

According to the Dr Oliva, “the atmosphere has changed at the FMSQ”. “We agreed with the board of directors that we wanted to turn a page and change the way we discuss and the way we approach our partners,” he says.

The Dr Oliva also lingered in reaching out to his counterparts in the Fédération des médecins omnipraticiens du Québec (FMOQ), in open confrontation with the government these days.

We have always witnessed certain tensions between the FMSQ and the FMOQ. But family doctors are our cousins.

The Dr Vincent Oliva, President of the Federation of Specialist Physicians of Quebec

“We don’t have to agree [avec la FMOQ] above all. But there are many issues on which we have an interest in converging. Because we are here for the same reason: the patients. And there are intersections between the first line and us. And we have to help each other ”, says the Dr Oliva.

Already, the FMSQ and the FMOQ have had discussions on their vision of vaccination, telemedicine and medical assistance in dying. Differences remain in particular on the distribution of medical students. Currently, 45% of them are directed to specialties against 55% in family medicine. “Of course we want to train more specialist doctors,” says Dr.r Oliva, who still believes that he can establish “a relationship of trust” with the FMOQ.

Elected in March 2021, the Dr Oliva has a term of only two years. Until then, he wants us to see that the FMSQ “has come closer to the field” and “got involved to be a leader who is committed to improving health care”.


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