Replica | Am I a ghost doctor?

In response to Stéphanie Grammond’s editorial “The ghost doctors”, published on October 17 in the Context section



Samuel freeman

Samuel freeman
Pediatrician in Montérégie, writer and host of the Practicing podcast

Reading Stéphanie Grammond’s editorial on October 17, I asked myself: “Am I a ghost doctor?” ”

I am not a family doctor, but, as a pediatrician, I have already provided care. For me, it was difficult work, unsuited to my qualities and completely different from the medicine I had been trained to practice. So, I stopped this practice to provide emergency pediatric care: a completely different rhythm that suits me much better. I felt a lot of guilt before making my decision, I was afraid of letting vulnerable patients down, and of stirring up the anger of certain families. I worked hard to make sure my patients got the care they needed after I left. People were generally very understanding, but I didn’t avoid everyone’s anger.

Now, in my new environment, I still work for the people of Quebec. I am not in the private sector. I did not quit the job. When I hear about imposing even more patients on family physicians who provide care, I think about what I would have done if I had been forced to continue to follow up on my little patients ( as a specialist physician, I am not obliged to register patients such as family physicians). The answer is simple: I would have quit medicine.

Dehumanization, coercion, intimidation

That’s what comes to my mind when we talk as a society about forcing nurses and doctors and others, who are human beings with values, obligations, dreams and everything in between. do more than they are prepared to do. With the job market as it is today, and the traumas of this pandemic still on the skin, would you allow yourself to be treated that way at work?

The anger of those who need care and who have been waiting for a year for their first appointment with a doctor who refuses to see them is completely valid and justifiable. It is an unacceptable situation. But do we really think that it is by putting more pressure that we are going to make this doctor free himself? And will he do it in a sustainable way, if he does it out of fear of sanctions or by being tempted by a bonus of $ 100 (or $ 200 or $ 300)?

Unfortunately, we always use the same levers to try to change the system: money and threats. When are we going to understand that it doesn’t work?

Here they are, the questions we should be asking ourselves. Why do we need a family doctor at all costs to have access to care? It is not a law of nature, but a choice of the system. Could we demedicalize the management and evaluation of the most frequent health problems by training and giving more autonomy to other professionals, who would be supported within teams if the situation became more complex or did they need support? Training nurse practitioners is a great idea, but not if you put them in exactly the same practice circumstances as exhausted, discouraged, depressed family physicians.

Can we finally stop expecting a single doctor or professional to be responsible for the health of hundreds of individuals? Can we start to conceptualize teams and networks that would care for patients? Do you want to be treated by an isolated doctor, often unhappy and overwhelmed by his work, or by a dynamic team of four or five professionals who support each other and are motivated to take care of you, because we trust them? and give them the skills they need to help you?

A patient is “taken care of” by a doctor. The expression is pejorative: a load is heavy! The model of the family doctor who has to carry everything and who is the only gateway to the system is completely obsolete.

Phantom doctors are not good, but a phantom system is much worse.

Read “The ghost doctors”, the editorial by Stéphanie Grammond What do you think? Express your opinion


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