(Quebec) Another point of tension has arisen between the Legault government and the Fédération des médecins omnipraticiens du Québec (FMOQ), this time over the place reserved for telemedicine.
While the government is now keen to cap the number of teleconsultations at 30-40%, family doctors are opposed and are calling for greater flexibility.
“We do not want to determine a maximum number of teleconsultations, […] because it depends on the types of clienteles, the circumstances ”, explains in an interview the president of the FMOQ, Dr Louis Godin.
According to him, patients and doctors have taken a liking to telemedicine since it was deployed under the state of health emergency linked to the COVID-19 pandemic.
“We do not want to put cash quotas, say:” You cannot do more than 30% or 40% of teleconsultations “. It is inopportune ”, slices the Dr Godin.
“We are not comfortable with that. Of course, we have discussions to have on how to manage it, because we don’t always agree on this. ”
He gives the example of a doctor whose patient “works, has experimented with telemedicine and likes it”, who arrives in December having reached his “quota” of teleconsultations for the year.
“The doctor will have to say: ‘No, no, I cannot see you in teleconsultation, I have reached my quota’. On that, I mean, we don’t have the same approach as the government. ”
In recent months, the Ministry of Health has felt the need to disseminate guidelines calling on doctors to exercise great caution and resume their face-to-face activities.
Because although appreciated, telemedicine remains inappropriate in several cases, according to the ministry, in particular when a physical or neurological examination is necessary.
“A rate of more than 90% of the activities […] telehealth is considered unacceptable “, even specified the ministry in a document entitled” Use of telehealth under the decree of health emergency “.
Are there plans to penalize physicians who see patients at a distance more than 90% of the time?
” Discussions are ongoing […] in order to determine the application parameters […], especially what happens in the event of non-compliance, ”replies ministry spokesperson Robert Maranda.
The FMOQ also says it finds it unacceptable that a doctor only does teleconsultation.
“A patient who wants to be seen must be seen. You are a doctor […] you organize yourself to see it, you or your colleagues. This patient should not be sent to the emergency room to see a doctor, ”says Dr.r Godin.
“But at the same time, we don’t want to put a number on it. We don’t want to say: “The standard is 40-45%”, we don’t want it to be that, “he adds.
Discussions are continuing with the aim of making telemedicine sustainable in Quebec.
Asked about this, the Federation of Specialist Physicians of Quebec (FMSQ) told The Canadian Press that it had not ruled on the establishment of a ceiling, which “can have a perverse effect”.
“The federation believes that a doctor must use his clinical judgment, taking into account the characteristics of the patient and his health problem, to determine the best mode of consultation,” she said.
The College of Physicians does not comment on “precise figures” either. It refers to the declaration of its president, published last February, which is “still relevant and represents the position of the College”.
Is telemedicine always an option? ” No. Some situations will still require an in-person assessment. It is a question of prudence and discernment, ”wrote Mauril Gaudreault at the time.