Positions intended for new family physicians are slow to find takers on the outskirts of Montreal. As of Monday, 35 places were still vacant, mainly in Montérégie and Lanaudière. The Ministry of Health and Social Services (MSSS) assures that “several” of them should be filled by January 15. But doctors doubt it. And are sorry that this delays the care of patients.
“It is very atypical that 35 places remain unfilled on the outskirts of Montreal after two rounds of allocation”, supports the DD Ariane Murray, local table manager at the Regional Department of General Medicine (DRMG) in Montreal. “It means that graduates, young doctors, will do something else. »
But what exactly? The question remains, according to the DD Lyne Couture, interim president of the Laurentides-Lanaudière Association of General Practitioners. “Have they gone more private this year? Did they go to Ontario? Does the famous doctor bashing and administrative red tape scared away more candidates? »
In Quebec, graduates in family medicine are invited each fall to apply for a new billing position under the regional medical staffing plans (PREM), a system aimed at distributing medical resources equitably in Quebec. .
Future doctors must select a place of practice — for example, the local service network (RLS) of Vaudreuil-Soulanges, in Montérégie — and hope to obtain a place. If they can’t, they can make another request in the second round and then in the third round.
Have they gone more private this year? Did they go to Ontario? Does the famous doctor bashing and administrative red tape scared away more candidates?
They can also give up and turn to other options: doing emergency repairs in a remote region, doing additional three-month training (in perinatal care, for example), practicing privately or moving to another province.
“We will hope that there are several who have done additional training,” said the DD Sewing. If so, they could practice as early as December in a position on the outskirts of Montreal, she says.
The President of the Association of General Practitioners of the South West, Dr.r Sylvain Dufresne has little hope that new doctors will be recruited in the Vaudreuil-Soulanges RLS (three vacant positions) or in the Suroît RLS (seven vacant positions). “There is no hospital in Vaudreuil-Dorion,” he explains. Young doctors, for many, want to do second line [en centre hospitalier] he says.
Positions filled in Montreal
The DD Murray, head of the PREM committee and special medical activities at the Montreal DRMG, deplores the fact that so many positions are unfilled, while the counters for access to family doctors are exploding in the city and doctors are ready to go there. to work.
She did not digest that Montreal lost around thirty new billing places in favor of the 450 last summer, after an unprecedented intervention by the Minister of Health and Social Services, Christian Dubé, and unveiled by The duty.
“Because of this imbalance in the distribution of PREMs, there may be vacancies because doctors who really want to be able to come and work in Montreal, often for very good reasons (e.g. spouse), rather than ‘be forced to go work further away, they will wait before settling down and will come back next fall,’ she explains. Meanwhile, patients are waiting for a doctor, she argues.
During the Première ligne en santé conference in Montreal last week, Minister Dubé said that this transfer of positions from Montreal to the north and south crowns had been a “difficult” but necessary decision. “We knew we had to go to the 450 because there was more of it there,” he said. The President of the Federation of General Practitioners of Quebec, Dr.r Marc-André Amyot, for his part, described as “completely arbitrary” this decision based “on the color of the electoral map”.
At the MSSS, it is noted that the Montérégie region has found an incumbent for 85 of the 100 new billing positions in family medicine. The Lanaudière region provided 20 out of 31 of them. Quebec”, specifies the MSSS. This is the case for the territory of the CLSC Matawinie (two vacant places) and the RLS du Suroît (seven).
A more flexible system
The Dr Marc-André Amyot believes that the government must review the system for allocating places to new billers. Currently, the positions posted are associated with specific medical activities (AMPs, in the jargon, that is to say tasks imposed on physicians with less than 15 years of practice). A doctor who wishes to practice only in an office may be obliged to work in a CHSLD or in a hospital.
“We adapt the constraints according to the needs [de la population]that’s one way of seeing it, said the Dr Amyot. But it has a very negative effect on doctors per se. Young people prefer to work elsewhere (in the private sector, for example), because their practice in the public network does not correspond to their aspirations, according to him.
The Dr Amyot believes there is a way to be more flexible in job description. “If last year, we had a doctor who was ready to just do CHSLD, why wouldn’t we have allowed him to just do CHSLD? That might have allowed, this year, a doctor who wants to do just care to do just care. »
The DD Marie-Ève Fortin chose to practice in a private clinic. She did not get a job in the region where she lives, Chaudière-Appalaches. “I have two children, and my spouse has his veterinary clinic in Lévis. I cannot be mobilized to go to another region,” explains the 40-year-old woman.
Marie-Ève Fortin is also a veterinarian. She began studying family medicine at the age of 34 in the hope of taking care of orphan patients only. However, his region requires new physicians to carry out various AMPs, at the hospital or in a CHSLD, for example. Impossible for her to get a job. “I am very sensitive to vulnerable clients,” she says. It is a mourning that I do by going to private. »
The new doctor claims not to be the only one to make the leap to the private sector: two other of her colleagues will do the same this summer.