More and more companies in sectors such as real estate or IT are becoming owners of medical clinics. The Federation of General Practitioners of Quebec (FMOQ) fears a “commodification of care” and therefore believes that these clinics should only be owned by doctors. Instead, these new owners say they are taking on tasks that doctors don’t want to do.
This is a new trend in Quebec. Many entrepreneurs who are not doctors buy or set up medical clinics, a completely legal practice. Last week, the ELNA Medical Group acquired the two Cité Médical clinics located in the Quebec City region. The company now has 101 clinics and points of service in Canada. Its owner, Laurent Amram, is not a doctor.
ELNA Médical is not the only group investing in the health sector. The information technology company Tootelo has increased its purchases of clinics in recent years; she has four. The real estate developer Medway Group is now devoted almost exclusively to the construction and management of medical clinics. In four years, the Mieux-être medical center, led by an occupational therapist, has set up a network of 10 complexes in Montreal.
The FMOQ is concerned about this phenomenon which, according to it, poses “a certain risk for the future of the public health system and potentially [pour] the quality of care provided.
“We don’t understand why [être propriétaire d’]a pharmacy, you have to be a pharmacist, for an imaging laboratory, you have to be a radiologist, but for a medical clinic, you no longer need [d’être médecin] », summarizes its president, Marc-André Amyot.
The doctors’ union believes that Quebec medical clinics should “all be owned by doctors holding a permit to practice from the College of Physicians and who practice in Quebec.” “We have a code of ethics to respect,” argues the Dr Amyot.
The FMOQ expressed its concerns to Minister of Health Christian Dubé in a letter sent on November 28. She then asked him to amend Bill 15 so that Quebec requires that doctors hold the majority of voting rights and seats on the boards of directors of medical clinics. The bill creating Santé Québec was ultimately adopted under gag order without this amendment.
“The majority do not want to manage accounting”
The owner of Groupe Medway, Yan Boudreau, maintains that it meets a need and occupies a niche that is of little interest to doctors. “Take a survey of FMOQ members, you will find that the vast majority do not want to manage accounting and financial statements. They want to concentrate on their medical procedures,” he says.
In addition to property management, Medway takes care of the administration, accounting and human resources of its 10 clinics in the Capitale-Nationale and Chaudière-Appalaches regions. More than 180 doctors practice there within family medicine groups. “Doctors, like young people, do not want to take the risks, including financial risks, of starting a business,” says Mr. Boudreau. Not everyone has the same risk tolerance. »
The CEO of Tootelo, Annie Blanchette, is “not against” the FMOQ proposal. His company already offers its doctors the opportunity to become shareholders. However, no one has expressed interest, she says. “The reality is they don’t want to get involved in management. » And in the current context of shortage of family doctors, she admits that she prefers that they stay with patients. “If I have the choice between a doctor who says “I’m going to spend two hours doing administration with you, but I’m going to cut two hours of office time”, well, I prefer that he gives care. »
The Dr Michel Lafrenière is one of the five shareholders who sold the Cité Médical clinics to the ELNA Médical Group. He would have liked to sell them to doctors, but claims to have never received such an offer from a colleague in the last 15 years. “We were approached by easily five or six other groups, but there is no other doctor there,” says the man who, at 64, remains the medical director of the Sainte-Foy clinic of ELNA Médical. .
He points out that managing a clinic is demanding. La Cité Médicale has two family medicine groups and offers private services. “Personally, I will be happy to find time to take care of my patients and to have less administrative work to bear, because honestly, it’s daily life,” says Dr.r Lafrenière.
Although he claims to be “very sensitive” to the concerns of the FMOQ, he does not fear a “commodification of care”. “ELNA, they take administrative and financial responsibility for the clinic,” he summarizes. The quality of care remains the business of doctors, he emphasizes. Contacted by The dutythe ELNA Medical Group did not want to offer comments.
In the eyes of the owner of the Mieux-être medical center, occupational therapist Rémi Boulila, it is not “necessary” for a medical clinic to necessarily be owned by a doctor. However, according to him, the “administrators on the ground” must be health professionals. “The goal, at the end of the day, is that care is accessible, that patients see a professional and that care is as effective and with the best possible follow-up for patients,” he says.
Does Quebec want to intervene in the matter? Minister Dubé’s office did not respond directly to the question: “Over the coming weeks, we will continue to collaborate with various partners, including the FMOQ, to strengthen our front line through various initiatives. »