Quebec family doctors are not working enough, according to Mr. Legault. The change in the method of remuneration will correct this situation, it seems.
But is Mr. Legault’s government really prepared for this significant increase in the productivity of family doctors?
Increasing the number of primary care consultations also means directly and significantly increasing the pressure on the health system: more requests for laboratory tests, more requests for radiological tests, more requests for access to the technical platform, more requests for care and interventions, more requests for consultations with other specialists, not to mention more expenditure on medical remuneration.
The health system is already cracking everywhere under the pressure of demand: long delays for examinations and for access to the technical platform, long delays for consultations with other specialties, dysfunctional referral system, problem of access to blood samples and their results, problem of access to surgeries within medically required time frames, major delays of 15 to 20 hours for consultations in the emergency room, inaccessibility of rehabilitation services, inaccessibility of psychological services. The list could easily be more exhaustive.
When, for several years, a family doctor has had to fight against the health system to get his patients treated, it is easy to understand that he does not want to have a larger clientele, for whom the health system will not be able to provide access to the services and care necessary for their conditions within acceptable time frames.
The front line is much more than the diagnosis of otitis, tonsillitis or sprain. Unfortunately, this front line has deteriorated for many years because of its restrictive rules, its bureaucratic burden, its excessive control, its chronic underfunding, but above all because of its difficulty in obtaining the services required for patients, so many things that have become constraints on medical productivity. And a new method of remuneration will not change anything.
The entire productivity of the health system is at stake, because the health system will not be able to support this additional pressure.