Make way for readers | Reactions to the text “The bureaucratic pitfalls of a doctor”

The testimony of the DD Sylvie Dufresne on bureaucracy in the health sector, published on May 14, generated many comments, in particular from medical colleagues. Here is an overview of the emails received.

Posted at 2:00 p.m.

wasted time

The DD Dufresne sums up our reality as a family doctor so well. Administrative tasks and the time lost justifying our requests and prescriptions eat up our time available to our patients.

Dr Daniel Choiniere

Bureaucracy and revenue

The speaker forgets an important detail: the exponential remuneration of her profession compared to the rest of society. More bureaucracy? Perhaps. More income? Certainly.

Martin Laplante, Montreal

Return to a liberal practice of medicine

It would be very interesting to return to a liberal practice of medicine, to a disengaged practice, and this, on a predetermined date. It would therefore be interesting to see whether governments remain interested in committing to universal and free healthcare. This would shine a light on those who oppose it through countless complexities where many doctors are still struggling to survive…and abandoning an inexorably sinking boat.

Luc Morin, physician

Say thank you, Minister

What a simple, clear text that clearly explains 40% to 60% of the problem. “What is conceived well, is clearly stated and the words to say it come easily”. Mr. Dubé, you have just saved yourself yet another study. Tell him thank you…

Francois Sansregret, Repentigny

Where is the problem ?

In Haiti, after the earthquake, all the administrative staff of the St-Marc hospital had left. There were a few nurses and volunteers, like us, from elsewhere. My friend Maxime, an emergency physician from Quebec, triaged patients in the emergency room and came to see me with X-rays to find out who should be operated on. Those who were operated on, after having “mopped” the operating room myself, returned to a room with a file consisting only of a white sheet from a printer on which was written the operating note and a few prescriptions. Everything was going very well. Here, for the same procedure, it takes more than 50 people, 75% of them invisible in an air-conditioned office and a 100-page file with a similar result for the patient. Where is the problem ?

Karl Fournier, orthopedic and spine surgeon, Charles-Le Moyne Hospital

When saving money comes first

What more can I say, the bureaucracy, the decentralized managers, the dehumanization of the services… what a waste. Unfortunately, “managementism” is not only aimed at doctors, it is aimed at RPAs, the police, immigration, the DPJ. In fact, he has been able to establish himself in several areas where saving money takes precedence over the well-being of the clientele. The bonuses of civil servants vary according to the savings they manage to make during their time in the organization. Customer service, employee well-being, food quality, etc., are only part of the equation (or very little). All of this, of course, is done with total impunity. We hide behind committees, boards of directors, which make already predetermined recommendations, which serve the interests of the organization. So who is to blame ?

Bernard Gauvin

Think about retirement every day

There. Very well expressed, Doctor. Dufresne. I could copy-paste. I had never really planned my end of career. The needs are there, the patients were grateful, which fully compensated for the too many hours of work. We felt like we were participating in something like a public service. Over the past two years, I find myself contemplating the end of my career every day. What I had left of hope to participate in the improvement of care, both in the organization of these in my large CIUSSS and on a daily basis with my patients, who are largely elderly if not very elderly, has melted like snow in the sun. . Here I am to target a date for my retirement. In three years, for no very specific reason other than that I will be 60 years old and that I wish to prepare my departure well for my patients and my sisters and brothers. Every day since, I wonder how I will be able to continue three more years and I am very sad about it, believe me.

Dominique Tardif, family doctor, Nicolet

A hard-to-stop monster

A sad reality that does not date from yesterday, but which worsens from year to year. Bureaucracy is a monster that has no limit in its expansion. It’s exponential. Unfortunately, when a third party pays the bill or provides a service, they want to exercise control over what they pay for or provide. This leads to the creation of jobs (controllers, inspectors, clerks, accountants, computer technicians, programmers, etc.). If there were more good faith, more responsibility, a sense of duty, fewer people abusing the systems, etc., it would be possible to curb the monster and improve performance and efficiency.

Claude Menard, Laval

Right on target!

In the past, a patient could go to a specialist without going through his attending physician. Since then, it’s the opposite, to which has been added the “ticket or form” attesting to this or that, thus eating up precious hours for patients. This is the heart of the problem, let’s look no further. Another issue that she rightly raises: everything rests on the shoulders of the general practitioner and the specialist takes over after a battery of tests which, in some cases, will be repeated, a duplication of procedures. Finally, the statistics revealing our higher doctor/patient ratio than elsewhere are true but are distorted by the mountain of paperwork. An abuse of bureaucracy that could be reduced if our “patient file” computer system included all the services received: dentist, physiotherapy, etc. It would be enough to create a few positions within the clinics or, better still, the CLSCs to respond to the mountain of forms required.

Lise St-Laurent

The direct human relationship is the basis of medicine

I myself have been a general practitioner since 1975. Your article describes the situation we are experiencing in a fair and calm way.

The healthcare system, and medicine by the same token, is awash in paperwork and forms imposed by the various regulatory bodies and the various technocratic and highly centralized authorities of the healthcare system.

Moreover, we are being brought to a system where everything will pass through channels where human contact disappears. The CRDS (specialty consultation request platform) is the best example of this. More contact between specialist colleagues. Loss of human relationship. And what about private telemedicine platforms where you get a unique and disembodied consultation.

But I remain optimistic. The direct human relationship, face-to-face to use a fashionable word, is the basis of medicine and it will save us from all the ambient technocracy. For this reason, practicing medicine remains an exciting profession and our greatest gratification comes from our clientele who love us and whom we love.

Marcel Fortin, doctor


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