May 18, 2022

The government must ensure there are enough health professionals to improve front-line access, says physicians’ federation.

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Quebec’s federation of family doctors said its deal with the province to provide better access to front-line care announced on Sunday is strong in principle, but will only succeed if the government keeps up its part of the bargain.

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Specifically, it said the government will have to ensure there are enough health professionals, like physiotherapists, social workers, nurse practitioners and psychologists put in place to lighten their load.

“This solution will still require the expertise of family doctors, but they can’t be the only part of the solution,” said Marc-André Amyot, president of the Fédération des médecins omnipraticiens du Québec. “With a shortage of 1,000 family doctors in the system, we can no longer ensure the entirety of all front-line services in Quebec.”

In a statement released on the weekend, the government said the deal will allow patients who require critical care and have a family doctor to have access to that doctor or another one from the doctor’s group within 36 to 72 hours.

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For those without family doctors, an online platform under development will let them make an appointment to consult with the right health professional within a “reasonable” delay.

To improve access, family doctors will have to make room in their schedules to allow for last-minute appointments. Participation in this system will be voluntary.

The deal will also see “hundreds of thousands of patients” from the Guichet d’accès à un médecin de famille progressively signed up with a group of doctors doing front-line care by March 31, 2023, starting with the most vulnerable. There are 945,000 patients in Quebec on the waiting list, but the actual number who lack access to a family doctor is closer to 1.5 million.

Amyot noted successful pilot projects in places like Rimouski, where patients used a telephone or online service to request medical care, lessened the workload on family doctors by as much as 50 per cent because patients were steered to other professionals.

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Doctors have argued that while the hotline service may work in regions that are well served by health professionals, places like Montreal and Laval will likely lack sufficient medical service workers like family doctors and mental health professionals to meet the needs.

“In a place like the de la Montagne district of Montreal, where you only have 63 per cent of the population that has a family doctor — and that doesn’t include the refugees and students from other provinces and tourists and the homeless — you’re talking about 100,000 people there who don’t have access,” said Dr. Mark Roper, a family doctor and director of the division of primary care at the McGill University Health Centre.

“The bottom line is we can’t do it properly if we don’t have the staff, and in Montreal we don’t.”

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Patients’ rights advocate Paul Brunet said the plan has positive aspects, including that it allows patients to see a variety of medical professionals right away, as opposed to having to go to an emergency ward to try and find treatment.

“This is the first time in almost 25 years that I’m a spokesman that I hear the doctors’ union talking like this,” said Brunet, president of the Conseil pour la protection des malades. “They are opening up to other professionals like nurses and pharmacists. Let’s remind everyone that this multidisciplinarity is already in effect in other provinces. It’s not new, but it’s new in Quebec.”

What is missing from the plan are changes that would allow more home-care calls by doctors for seniors, when 25 per cent of hospital beds are occupied by seniors awaiting a transfer to a long-term care centre, Brunet said.

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His members are also concerned about proposals that clients be sent to family doctors other than their own, when necessary, because many have long medical files and fear a new practitioner won’t understand their needs.

The federation of physicians members have to ratify the deal, which will be presented in detail over the coming weeks. A vote will take place at the end of May.

La Presse Canadienne contributed to this report.  

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