Posted yesterday at 11:00 a.m.
What do we do in Quebec when we fall ill and it is not Monday to Friday from 9 to 5? This very simple question is rarely addressed by our politicians.
Claude Dupuis
It’s a very simple question, and yet those who have been trying to answer it, for too many years, have struggled to do so effectively.
Because the fact is that access to first-line care, provided by the various clinics and other family medicine groups (FMGs) that constitute the gateway to the network, remains very difficult in Quebec.
And this, even if the FMGs must also open their doors on weekends. Indeed, at the Ministry of Health and Social Services, we are told that each “GMF must offer medical services covering at least 68 hours per week, spread over seven days”.
Let’s say you dialed 811, a nurse confirmed that you didn’t need to go to the emergency room, but she told you that you should still see a doctor.
Let’s also imagine that you are in Montreal… on a Sunday afternoon! Getting an appointment with a family doctor quickly could be a real cross. Even if you are part of a GMF.
But the problems of access to primary care are not limited to evenings and weekends, unfortunately. “The problem of access is widespread 24 hours a day, seven days a week, in the system,” emphasizes Professor Arnaud Duhoux, of the Faculty of Nursing at the University of Montreal.
We don’t have data that allows us to properly analyze the problem, but we manage to discern its contours. And what we observe remains very worrying.
First, because there are still too many patients on the waiting list for a family doctor. More than 800,000 people were registered with the Family Doctor Access Window last month.
Secondly, because we know that being on a family doctor’s list does not mean that getting an appointment will be easy. This is one of the reasons why we end up with so many patients in the emergency room who shouldn’t be there because their health problem should have been solved elsewhere.
In short, even if you are not looking for a doctor in the evening or on weekends, you could have trouble getting an appointment because the number of professionals available is not sufficient to meet demand.
Some believe that there is a lack of too many family doctors across the province (the CAQ promises to train 660 more doctors in four years). There are currently 9772 and, according to the Federation of General Practitioners of Quebec, there should be 1000 more.
One thing is certain, the CAQ government has just given up: it now judges that it is no longer possible to offer a family doctor to every Quebecer. It’s disappointing, but was it possible to do otherwise in the circumstances? It is hard to see how the Liberals would manage to fulfill the promise to provide a doctor to all Quebecers.
On the other hand, for orphan patients, Quebec is in the process of deploying what it has called the “front line access counters”.
When a patient comes into contact with a counter, their needs are assessed and they are recommended to see the healthcare professional who will be best able to meet them. And it’s not always a doctor.
Because the access problem, as we have known for a long time, is also a service management problem.
That said, the new system is not perfect either.
“It’s certainly very good for short-term access, if you have a child who has an ear infection, for example, says Arnaud Duhoux. But if you have a problem in the social field or in terms of long-term follow-up, for example, the continuity of care, you will flit about in such a system. »
There will be a total of 92 front-line access counters in Quebec and they should be deployed by the end of September.
We assume that it will then be easier to obtain an appointment for Quebecers who do not have a family doctor. And if one of these patients calls on one of the counters, but needs long-term follow-up, Quebec wants them to end up being taken care of by a family doctor.
Finally, it should be noted that if the CAQ is re-elected, it wishes to implement during the next mandate a centralized appointment system that will allow all Quebecers to obtain a service similar to that offered by the access counters for moment reserved for patients without family physicians.
They will be recommended the professional who will best meet their needs.
But since many hopes have been dashed over the past two decades with regard to access to health care, it would be prudent to show healthy skepticism.