(Quebec) The Legault government is “on the wrong track” in wanting to link the remuneration of 10,000 family doctors to performance indicators such as patient satisfaction, replies their federation, which fears “excesses”.
As The Press As revealed on Tuesday, Quebec intends to impose penalties on those who do not achieve the expected results. It wants to discuss this with the Fédération des médecins omnipraticiens du Québec (FMOQ) at the negotiating table.
“Certain performance indicators associated with penalties, I think we are on the wrong track,” said the president of the FMOQ, Dr.r Marc-André Amyot at a press conference in Quebec on Tuesday.
“In medicine, we always say that we cannot guarantee the result. The doctor has an obligation of means,” he argued. He considers that achieving the expected results “depends on many factors that are not within the authority” of the doctor, such as the organization of services, the effectiveness of services offered by other professionals or the operation of the Frontline Access Desk. “If I am not responsible and you say that the result is not achieved, ultimately you are making obtaining remuneration conditional on something that I do not control.”
Quebec mentions three performance indicators: the time to obtain an appointment, the care of vulnerable patients and patient satisfaction. This last indicator particularly worries the FMOQ.
PHOTO MARTIN TREMBLAY, LA PRESSE ARCHIVES
The president of the FMOQ, Dr.r Marc-Andre Amyot
For example, explained D.r Aymot, “you go to see a doctor, your child has a respiratory infection that does not require antibiotics, but you would have liked your doctor to give him antibiotics. The doctor explains it to you, but you leave and you are dissatisfied. You condition the remuneration of doctors on the dissatisfaction (caused by the fact) that the doctor did not respond to the patient. It becomes a bit strange. There is a risk of drifting away from that.”
The FMOQ would rather agree with the government on “indicators of good health of the population” unrelated to remuneration, “and not indicators of volume and performance.”
The Dr Amyot fears the government’s intention to “optimize” the $3 billion per year compensation package for 10,000 family doctors. Will there be “cuts” in services? he wondered.
This press conference was also an opportunity for the FMOQ to present the “good figures” according to it in order to demonstrate that its members “are not lazy” as the government suggests according to it.
“We need to stop making family doctors seem like the source of the access problem in Quebec. It distracts from the real problems. If we want to establish a good treatment plan, we need a good diagnosis with good data,” said its president.
The 9,887 family doctors work an average of 223 days per year, according to data retained by the FMOQ. Nearly 3,100 work less than 175 days, but there are different reasons for the situation, according to her. She acknowledges that 5.6% of doctors (553) work less than 175 days “for no identifiable reason.” There is a shortage of 1,500 family doctors in Quebec, she adds.
A family doctor earns an average of $330,000 per year, which is lower than the salary in Ontario, which is around $390,000, according to data used by the Federation. It is calling for a catch-up, but it also recognizes that the cost of living is higher in the neighbouring province. In Ontario, an authority has just granted family doctors a 10% increase in their salaries.