(Quebec) A new standoff is emerging between Quebec and general practitioners. Christian Dubé wants to force family doctors to take care of more vulnerable patients. Their union sees it as an attempt to make them bear “the odium of the mammoth’s failure”.
The Council of Ministers authorized on Wednesday a draft regulation aimed at implementing certain provisions of the Act to increase the supply of front-line services and improve supply management, adopted in June 2022.
The Minister of Health wants to force family doctors to prioritize the care of more vulnerable orphan patients, such as those suffering from cancer or serious illnesses. According to Mr. Dubé, some 13,000 vulnerable patients are still waiting to be cared for by a family doctor or a family medicine group (GMF).
“There has been a great effort by doctors for more than a year to take 900,000 patients who were [sur le Guichet d’accès à un médecin de famille]but there is still […] 13,000 vulnerable patients and it is they who need care from the doctor,” the minister explained on Wednesday.
In 2022, the Legault government and the Federation of General Practitioners of Quebec (FMOQ) entered into an agreement for the care of at least 500,000 orphan patients by deploying in particular the Front Line Access Center (GAP) which allows a patient without a family doctor to be cared for by a GMF and not a single general practitioner.
Some 900,000 patients are registered with the GAP as of January 15. However, there are still 500,000 Quebecers on the waiting list, including 13,000 vulnerable patients. A year ago, this number was around 40,000, said Mr. Dubé.
“I want to bring this back to zero,” illustrated the Minister of Health, without specifying a timetable. Christian Dubé also does not support this new obligation of sanction or penalty for family doctors. “I am capable of making, I think, good negotiations with the [FMOQ] “, he stressed.
“Incomprehension” at the FMOQ
The FMOQ welcomes Quebec’s decision to proceed by regulation “with incomprehension and great disappointment”.
“Today we are trying to place the blame on family doctors when it is a mammoth failure in this matter,” indicated the president of the FMOQ, Dr.r Marc-André Amyot, who rather blames the health network for its poor distribution of orphan patients.
PHOTO HUGO-SÉBASTIEN AUBERT, LA PRESSE ARCHIVES
The Dr Marc-André Amyot, president of the FMOQ
“It’s smoke and mirrors to let you believe […] that he expects us to empty him. If those who are there have not been sent by the officials to the family doctors in collective registration (GAP), do not blame the family doctors,” he repeated. The Dr Amyot recalls that the agreement concluded with Quebec already provides for the prioritization of vulnerable patients.
The FMOQ fiercely opposed Minister Dubé’s law and even called for its complete abandonment. According to the family doctors’ union, the legislative text “trampled” the normal negotiation process and was an “incomprehensible slap in the face” to general practitioners.
For its part, the College of Physicians was rather favorable to Minister Dubé’s intentions. “We favor measures that will give the public more access to the first line of care or expand services in the territory. This is part of our vision of quality health care and the social responsibility of health professionals towards the population they serve,” it was noted.
Data access
The Minister of Health also wants to have access to data from medical clinics to “act” on the offer.
“We have been connected for a while, the 700 clinics that are connected [au GAP], I have this information. I just don’t have the right to use it. Let’s be clear, we put a lot of money into this. All the regulation does is say that the minister now has access to it,” indicated Mr. Dubé.
“This shows why in such a region for example, I have many more emergencies which receive [des cas non urgents]is it because the GMF time slots are not respected? […] Strengthening the first line means knowing our offer,” added the minister.
The FMOQ is not against better access to data, but fears that this will result in the addition of obligations or administrative tasks for doctors.
In parliamentary committee, the Auditor General supported the Legault government’s approach to having access to data on the occupation and care of family doctors.
The draft regulation will be published in the Official Gazette within two weeks. A 45-day consultation period will then follow its publication.