The number of family doctors practicing in the private sector has exploded in Quebec. For the first time, there are more than 500 general practitioners disaffiliated with the Régie de l’assurance santé du Québec, four times more than 15 years ago.
As of January 19, a total of 501 doctors had given up taking patients from the public. In 2009, this number was 123.
The shortage of family doctors has encouraged the expansion of these clinics where you have to pay to have an appointment. There are around 80, mainly in the Montreal and Quebec regions.
In 2018, when the Coalition Avenir Québec (CAQ) came to power, more favorable to a place for private health, there were 326 disaffiliated doctors, or 175 fewer than today.
Some patients whose doctor is retiring have no choice but to turn to these services while waiting to have a doctor available to the public again.
“Yes, of course the rest of us do follow-ups, we take patients. We are their family doctor, so that’s really what’s interesting for the patient,” says Frantz Jean-Louis, director of the Contact MD private clinic in Repentigny.
- Listen to the interview with Éric-Yvan Lemay, journalist at Journal de Montréal on microphone by Alexandre Dubé via
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Young doctors
The managers of the clinic which opened its doors a few months ago are already considering expanding to meet demand.
As in many places, it is a young doctor who recently finished his studies who monitors the patients. In some cases, this is a way of evading the rules put in place by the government to ensure coverage in the regions or in hospitals (see other text).
The private price varies from a few dozen to a few hundred dollars for an emergency consultation.
“The sickest patients often do not have the means to go to the private sector,” laments the DD Isabelle Leblanc, from the Quebec Doctors for the Public Plan (MQRP) group.
Dr. Isabelle Leblanc from the Quebec Doctors for the Public Plan group.
Photo courtesy, Isabelle Leblanc
Intervention requested
According to her, the government should intervene to counter the phenomenon which accentuates the shortage in the public network.
As surprising as it may seem, some patients who have a family doctor still consult privately because they are unable to get an appointment quickly with their doctor.
“The advantage of private is that we will treat more than one problem per consultation, which is not the case with a walk-in,” adds Frantz Jean-Louis.
Some doctors who disaffiliate will opt for aesthetic treatments or specialties such as hormone therapy.
Doctors outside RAMQ represent 4.9% of all general practitioners compared to 1.4% in 2009. In total, there are 10,291 doctors eligible to bill RAMQ compared to 8,488 15 years ago.
– With the collaboration of Yves Lévesque
The public is not attractive enough, says the FMOQ
The Federation of General Practitioners of Quebec is concerned about the fact that many doctors are opting for the private sector and wants the government to make the public system more attractive.
“There is definitely a concern. This is a reflection of a lack of attractiveness and a lack of support from doctors on the front line,” says Dr.r Marc-André Amyot, president of the FMOQ, who speaks of an erosion towards the private sector.
Dr. Marc-André Amyot of the Federation of General Practitioners of Quebec is asking the government to make the practice of family medicine in the public more attractive to counter the exodus to the private sector.
Archive photo, Chantal Poirier
The Federation is campaigning for the government to take action. He also invites us to take inspiration from Ontario to improve the front line.
The most glaring problem, however, remains the lack of doctors. Since 2013, it indicates that 535 positions have not been filled in the profession.
“The problem is everywhere in Quebec. We have too low a ratio of doctors,” he denounces.
The Dr Amyot also points out the special medical activities (AMP) imposed on doctors to provide coverage in the emergency room or in CHSLDs, for example.
Targeted advertisements
The other irritant for young family doctors is the Regional Medical Workforce Plan (PREM) which sometimes forces them to go into exile in the regions.
He gives the example of a doctor whose spouse works in Montreal and who would be forced to work far from his family.
The DD Isabelle Leblanc, who teaches at McGill University, says she has seen several resident doctors being tempted by the private sector in recent years for these reasons.
She also emphasizes that they are the subject of intensive solicitation from private clinics, particularly with targeted advertisements on Instagram.
To try to stem the crisis, she indicates that for the first time last year, the Career Day of the Federation of Resident Physicians of Quebec was not open to private clinics.