Many Quebecers still do not have access to a family doctor and the solutions are not simple. The Canadian Press spoke with several family medicine students and seasoned doctors about promoting their profession. They are all convinced that the political discourse must first change.
The results of the second round of residency matching showed an increase in students choosing family medicine. Despite the increase, the majority of vacant positions are in family medicine in Quebec (70 positions).
The Legault government assures that it is making “considerable efforts” to increase the training capacities of medical faculties.
The Minister of Health, Christian Dubé, announced this week that the doctoral policy will authorize 1,165 new registrations for a doctorate in medicine for 2024-2025, or 335 more than in 2018. The government hopes to train 660 new doctors over four years .
“It’s true that there is a problem recruiting positions in family medicine. Every year, we do not fill all the positions for a variety of reasons,” declared Sarah Guertin, from the University of Sherbrooke, who will do her residency next year at GMF-U Jacques-Cartier.
“Every year, there are positions that remain vacant, there is a huge shortage of family doctors and we are not working to improve the situation because the doctors who retire are often doctors who have a lot of patients in their care,” said Laura Mandjelikian, a family doctor in the Montreal region.
In Quebec, 25% of family doctors are over 60 years old, which suggests some retirements in the coming years.
To replace a retiring doctor, we often need two or three new graduates to take over due to the specific medical activities to be respected. From what I see, we are on track to have more and more patients without a family doctor.
Laura Mandjelikian, family doctor in the Montreal region
Mme Guertin acknowledges that retirements are a challenge, but for now, in the context of her young career, she isn’t too worried about it. “I think we are working on this aspect to promote the profession,” she shares. We are trying to reduce the paperwork that family doctors have to do on a daily basis. These are small details that will reduce irritants over time, but you can’t take a magic wand and change that overnight. »
Pamela Hafazalla, a family doctor in the Laval and Laurentides region, who subspecialized in pediatrics, is experiencing the effects of retirements.
“We are more and more saturated, which means that these patients have returned to the list of the access window to a family doctor,” she explains. They find themselves without a family doctor until there is new availability. »
Stop blaming doctors
DD Mandjelikian believes that recruitment in family medicine is difficult, particularly since externs see the challenges associated with the profession. “The students see it when they do their internship with us in family medicine that our practice is becoming more and more cumbersome. We lack resources, we lack support,” she says, adding that this probably pushes some to choose another specialty.
“It’s complex, but there is a big reorganization of the practice which is necessary so that it is more interesting for family doctors and so that we are less exhausted and used wisely,” declared DD Mandjelikian.
Gabrielle Guillemet, from Laval University, who will begin a residency in family medicine in July, agrees.
“What makes me panic a little is seeing how many people still don’t have a family doctor,” she admits. And even if we are going to have more (patients) in our care, necessarily, we cannot take on hundreds more. »
She criticizes the limit of patients per family doctor that Minister Dubé wishes to increase. “If we put too much in, well, the doctors are going to burn out and we’re going to end up with even fewer family doctors for all the patients,” she says.
She recognizes that it is a difficult issue to manage, but she wants to see the government’s discourse change.
Camille Boileau, from the University of Sherbrooke, who completed her first year of residency at GMF-U Charles-Lemoyne, would also like a more positive speech from our politicians.
“We hear political speeches that too often blame family doctors who do not help reduce waiting lists. We never put the emphasis on these doctors who will work hard to treat lots of patients every day,” she emphasizes.
Mme Boileau also argues that in Quebec, we often speak in terms of statistics. “In political speeches, we place a lot of emphasis on flow in a practice instead of humanity,” she notes. Yet the reason most of us chose family medicine is for the human contact with the patient.
“This duality can sometimes be heavy to bear,” she continues. The organizational constraints at the moment are constantly fighting our desire to offer the best services to patients in a time which is ultimately limited. By attracting a lot of negatives to the first line, you discourage people from engaging in it. »
DD Hafazalla made the same observation. She said there is often a focus on access to doctors and accusations that they are not taking on enough patients. “The government’s speech suggests that as family doctors, we are not doing our part enough, even though we saw it during COVID, we were very mobilized to change our front-line activities to support the system. »
Population and universities
Promotion among the population also plays a role in attracting the profession. Mme Guillemet said that during her academic career, she was often asked if she wanted to specialize or if she “just wanted to be a family doctor.”
“My specialty is family medicine and I am proud of that. It’s a specialty like any other,” defends the student.
According to her, we must succeed in making the population aware of the fact that family medicine is a specialty. “When you study medicine, you don’t automatically become a family doctor. So a surgeon does not have the skills that the family doctor has and the family doctor does not have the skills of the surgeon either. It’s vice versa,” she explains.
Mme Boileau also emphasized that universities are making significant efforts to promote family medicine. However, she wishes more family doctors would teach. “That would be a good step forward, in my opinion.”
Mme Guillemet shares his opinion. She said that at the university the theoretical courses are mainly focused on specialties. “There are a few family doctors who come to see us, but there are mainly other specialists,” she says. Giving us courses more focused on family medicine could be interesting, but I also understand that we already have busy schedules. »
The students and doctors surveyed by The Canadian Press also shared the passion they have for their profession. Family doctors accompany a person throughout their life, they develop a relationship of trust with them. They can see the patient as a whole and each day is very diverse, being able to go from cardiology, to sexual health, to musculoskeletal in a few hours.
They also highlighted that family medicine is teamwork and that several other professionals can help relieve congestion on the front line.
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