Some 600 residents of CHSLDs in Montreal remain without a family doctor, despite a recent call to the medical community to be taken care of. Faced with this “worrying situation”, the College of Physicians of Quebec has since Friday allowed retired doctors to lend a hand in the CHSLDs of the metropolis. The Federation of General Practitioners of Quebec (FMOQ) has set up a crisis unit of which the government is a member.
The FMOQ and the Regional Department of General Medicine (DRMG) in Montreal are “actively” looking for volunteers to lend a hand in CHSLDs this summer. “We are going through a major crisis in Montreal, says the first vice-president of the FMOQ, Dr.r Sylvain Dion. We try to find arms. With the shortage [de médecins], this is not obvious. »
A month ago, the FMOQ, the Association of General Practitioners of Montreal and the DRMG of Montreal appealed to doctors for help: approximately 1,000 CHSLD residents risked being left without medical follow-up in the coming weeks. A dozen doctors raised their hands to take care, part-time, of about 400 patients, according to the head of the DRMG of Montreal, the DD Ariane Murray.
“There are still about twenty missing,” she estimates. And maybe even more. “We anticipate that 300 other beds will become doctor orphans by September 1,” said the DD Murray.
At the private CHSLD under agreement Champlain-Marie-Victorin, no doctor is on site to take care of the 200 residents, and this, for a month, deplores the head of the DRMG of Montreal. Seniors must be transported to the hospital for a “minor issue” of health. “That makes patients who are sent to the emergency room to hang around on a stretcher for hours and who risk having a delirium for a urinary tract infection or constipation, affirms the DD Murray. For us, of course, this is unacceptable. »
This “medical discovery” is explained according to her by “a lot of retirements, deaths, illness and cessations of practice”.
Use physicians outside RAMQ?
The Ministry of Health and Social Services (MSSS) sits on the crisis unit of the FMOQ, as does the DRMG of Montreal. He cites several measures, such as the “taking advantage of the skills” of nurse practitioners specializing in primary care in CHSLDs as well as the solicitation of doctors who have not obtained a position during the annual regional distribution (as part of a “PREM”, in the jargon).
However, the FMOQ believes that Quebec could go further. “Non-participating” physicians at the Régie de l’assurance maladie du Québec (RAMQ) came forward following his appeal to all. However, the current law does not allow these “non-participants” to work in the public network.
“When we experienced the pandemic crisis, the decree which had been adopted by the government allowed these doctors to practice as non-participants, in their offices, for example, and to come and lend a hand in establishments, in particular the CHSLDs, for a number of hours,” says Dr Dio. This decree has been lifted. But the FMOQ believes that with the current crisis, the government must put “a little water in its wine” and explore this avenue.
The Dr Dion adds that remuneration in CHSLDs is “not very competitive” compared to that of other places of practice and that it must be made “more attractive”. The granting of a bonus in CHSLDs is the subject of “discussions” with the FMOQ within the framework of the crisis unit, according to the MSSS.
The DD Sophie Zhang, co-president of the Community of Practice of Physicians in CHSLDs, believes that medical students should be more exposed to these living environments. “It is very difficult to develop an interest [pour l’hébergement] and say “I’m going to apply” for a position when you’ve never set foot in a CHSLD during your entire medical training,” she says.
The CIUSSS du Centre-Sud-de-l’Île-de-Montréal, where she works, experienced a significant shortage of doctors in CHSLDs about five years ago. Hundreds of patients have been orphaned. “We started to receive medical students, residents in several CHSLDs in our territory, says the DD Zhang, assistant co-head of accommodation. It was very beneficial for our recruitment. According to her, this “long-term solution” must be put in place “from today”.