Uneven efficiency by region

The effectiveness of the new appointment system for orphan patients varies greatly from region to region, and citizens of the North Shore of Montreal are significantly less well served than others, found The newspaper.

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• Read also: Orphan patients: 288,000 additional Quebecers enrolled in a family medicine group

Set up in early June, the first-line access window, called GAP, is used to offer consultations to Quebecers without a family doctor.

By means of a regional telephone line, an administrative agent directs the patient to a professional, according to his need. However, the effectiveness is uneven depending on the region, as indicated by the figures from the Ministry of Health and Social Services (MSSS).

6% versus 100%

In Lanaudière, only 6% of requests had been processed in 36 hours or less (86 out of 1,506), on August 6. This is the deadline mentioned several times by the Minister of Health Christian Dubé. This is a flagship measure of its health reform.

However, the MSSS specifies that a processed request only means that the evaluation is complete. This means that the patient knows where to go and that an appointment has been given, if relevant, but not that he has seen a doctor.

“6% is terrible”, reacts the D^D Lyne Couture, President of the Association of General Practitioners of Laurentides-Lanaudière.

In the neighboring region of the Laurentians, only 36% of requests are processed within 36 hours. Conversely, 100% of requests met this deadline in Montreal and Chaudière-Appalaches.

Moreover, the system intended to speed up access to the first line does not help everyone at the same speed. An Outaouais mother failed to get an appointment for her sick daughter after a month (see other text below).

According to the D^D Couture, computer and administrative failures explain the weak performance.

“We use the telephone and fax to circumvent the problems of the HUB [système informatique]. We don’t want to leave empty beaches,” she said.

Moreover, she notes that the lack of staff at the GAP “seriously hurts”: “I don’t blame them. The problem is that they are few, ”she continues.

Doctor in the Laurentians, Simon-Pierre Landry also notices that his region has a chronic lack of staff.

“Do they have the staff to process all these requests? “, he asks. He was surprised to see his Mont-Tremblant clinic receiving patients from Mirabel with the GAP, which represents about an hour by car to get there.

The MSSS also mentions “a volume of requests exceeding the processing capacity”.

Request that doubles

Demand for the counter has more than doubled since May, rising from 3,878 to 9,489 queries per week.

The number of GAP patients referred to a family doctor varies from region to region, notes the FMOQ. In places, about 40% of patients see a doctor, but the figure climbs to 67% in Montérégie.

“We are under investigation,” says the president of the FMOQ, Dr.^r Marc-André Amyot, also describing as “ambitious” the objective of implementing 100% of the GAP at 1^er september. Two-thirds of the territories are currently functional (61 out of 92).

• At this time, only orphan patients who receive a letter inviting them to contact the GAP can do so, using the telephone number indicated on the letter.
• Currently, more than 710,000 people have received an invitation, which corresponds to more than 60% of the target population.
• As of September 1, all citizens registered with the Family Doctor Access Window (GAMF) and registered with a group of family doctors will be able to join the GAP in their territory. The contact details will then be available to the general public.
• Calls are received and handled by an administrative agent.
• If a nursing assessment is required, the nurse calls the patient back within a short but variable time, depending on the volume of the request and the level of priority.
• A doctor’s appointment is not guaranteed. The GAP is more about the right care, at the right time and in the right place.
• The health professional in charge of making an assessment can refer the patient to a pharmacist, a social worker, a physiotherapist, for example.
• In a serious emergency, always call 9-1-1.

^{Source: MSSS}

• Lanaudiere 6%
• Mauricie 35%
• Laurentians 36%
• Abitibi-Témiscamingue 60%
• North Shore 83%
• Capital-Nationale 92%
• Eastern Townships 92%
• Saguenay–Lac-Saint-Jean 95%
• Monteregie 95%
• Outaouais 97%
• Lower St. Lawrence 98%
• Laval 98%
• Chaudière-Appalaches 100%
• Montreal 100%
• Gaspésie–Îles-de-la-Madeleine N / A

Average of all requests in Quebec 72%

^{Source: MSSS, data as of August 6, 2022}

Editor’s note: No recent request had been made in Gaspésie

Unable to get a date for her daughter

A mother from Outaouais was quickly disillusioned after two calls to the new front-line access counter, since she remains unable to have an appointment for her sick daughter.

Hugo Duchaine, The Journal of Montreal

“Atrocious” and “ridiculous”, this is how Valérie Langlais describes her experience with the new G

First line access window (GAP) launched this summer by Quebec. The 39-year-old mother has been unable for months to obtain a time slot to see a doctor in the walk-in clinics in her region, in Val -des-Monts. Calls, websites, places available at specific times, she tried everything without success.

His family has not had a family doctor for two years. Her five-year-old daughter, Lexa, is not seriously ill, but periodically suffers from extreme fatigue, painful stomachaches and headaches.

In mid-July, she decided to try GAP. She had received a letter inviting her to use it to “obtain a medical or social consultation”.

On the phone, after describing her daughter’s symptoms, the employee replies that she needs laboratory tests.

At the pharmacist

She does not give him a doctor’s appointment, but instead tells him to go to the pharmacy.

M^me Langlais says she was told the results would then be posted online in her daughter’s health record and if they were abnormal she could call back to see a doctor.

Skeptical, she calls her pharmacist. However, the latter confirms to him that he does not prescribe such tests. Sometimes pharmacists will order blood tests to make sure that a drug is not interacting with a health problem, but this was not the case for Mr.^me English.

In the meantime, she went to the emergency room of the Children’s Hospital of Eastern Ontario, the one with the least wait in her region. They did stool tests, not detecting anything abnormal in her daughter, but not blood, because these require follow-ups not offered in emergencies.

Discouragement

M^me Langlais therefore decided to try the GAP experience again on August 10th. This time, the employee had no indication on file that this was his second call.

When she then described her daughter’s symptoms, he didn’t know what the word “lethargic” meant, the mother of the family said with discouragement.

“And it’s the person who takes the calls to decide whether or not people have the right to have an appointment,” she says.

The employee finally suggested that a nurse call him. It is the latter who will be able to decide if the symptoms of her daughter deserve a consultation.

The problem is that the call will come in two or three weeks, he was told.

One problem at a time

According to M^me Langlais, she was also told that “it’s one problem at a time” and that before the doctor, she will have to choose only one of the ailments affecting her daughter. She adds that she was told that if the doctor detects a second problem, she will have to call the GAP again and repeat the process.

“It’s a service that serves to look good and camouflages the real problem, which is the lack of doctors. It’s a bandage on a large open wound, ”she laments.

“And when you really need a doctor, there’s still none,” remarks the mother of three.

“It’s great to have a nurse call me back to do a triage, but there are delays in talking to the nurse and there will be delays in seeing a doctor. It’s endless, ”she breathes.