Doctors speak out against Bill 20

By Michelle Pucci
www.thesuburban.com

Laval family doctors feel threatened by Quebec’s latest health care bill, which imposes quotas on the number of patients and how often they see other doctors.

“It’s evident that we have to give better access to the population for medical service,” said Michel Breton, president of Laval’s association of general practitioners (AMOL). “We totally agree with that, we just don’t agree with the way it’s done.”

The bill is that latest part of a tradition in Quebec to control medical practice through pressure tactics, Breton says. Under the new law, family doctors are expected to follow up with 1,000-1,500 patients and ensure that they visit them 80 per cent of the time. If not, doctors can have their wages cut up to 30 percent. Most young GPs, Breton says, only have 500-800 patients.

It’s a simple answer for a complicated problem, according to doctors at the Centre Médical Laval. The bill is meant to catch underperforming doctors, who work fewer hours and see fewer patients than their private counterparts, but it doesn’t consider diverse working situations.

“Doctors are professionals and they are supposed to know how to practice medicine,” said Breton.

New doctors are obliged to work at least 12 hours in health centres, like hospitals or old-age homes. The more hours they work, the fewer patients they are responsible for. But the Laval association says more and more people are opting for hospital work and hours are difficult to find.

Geneviève Coté says the law doesn’t count the work she does at her own anonymous walk-in clinic on des Laurentides, because she doesn’t follow-up with all the patients she sees. She works with street workers and addicts that often won’t visit clinics and will often go to food banks or communal areas to offer treatment.

Doctors that take on vulnerable patients like addicts, patients with chronic or mental illness, or elderly patients will be taken into account, according to an open letter by Health Minister Gaétan Barrette. They could count for more than one patient, encouraging doctors to spend more time with them.

Some families find doctors in Laval, before eventually moving to more remote regions like the Laurentians or Lanaudière. When these displaced families cannot find doctors in their new towns, they’re forced to travel back to Laval for checkups with doctors like Geneviève l’Écuyer to maintain her loyalty requirements.

“I can’t just abandon these patients and I’m not going to ask them to come see me when they have an emergency,” she said.

L’ecuyer’s loyalty rate stands at 68 per cent right now and if unchanged, will mean a 20 per cent salary cut. Meanwhile, the doctor’s delivery rate of about 400 births per year goes unnoticed, she says.

The ministry has plans in place to increase accessibility in rural regions, according to Barrette’s press attaché Joanne Beauvais.

But doctors should not feel obligated to keep on patients who have moved away—although Beauvais says she understands that patients may prefer to have the same family doctor when they move.

“The issue is not whether there are enough doctors, the issue is that 60 per cent of GPs work an average of 117 days,” Beauvais told The Suburban.

Despite claims from doctors that the bill is unfair, Beauvais says there are many options for them and consultation is ongoing.

“We will make sure the leverage is there so doctors see as many patients as they need and patients are taken care of,” she said.

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