(Quebec) Legault’s government sent its first offer to 10,000 family doctors on Tuesday: it wants to review the patient care model, to entrust other professionals with procedures currently reserved for doctors and their remuneration to ” maximize” 3 billion dollar expected results.
Published at 1:39 am Updated at 5:00 pm
“This coverage has greatly increased over time, and the citizen does not have the sense that he will get value for his money,” said the president of the Treasury Board, Sonia LeBel, in an interview with The Press Tuesday afternoon, after the proposal was submitted to the Federation of General Doctors of Quebec (FMOQ) in the evening.
The remuneration coverage for family doctors was 2.7 billion in 2018, when the Coalition Avenir Québec came to power.
“We will have to work to optimize the current coverage and relevance [des actes rémunérés] before even thinking about a discussion: should we put more or not? We will start by seeing what the actions are and see if they are useful for citizens. We have to review the actions provided for in the coverage to determine whether this action is necessary or not, whether the doctor does it,” explained Sonia LeBel.
PHOTOGRAPHS EDOUARD PLANTE-FRÉCHETTE, LA PRESSE ARCHIVES
Sonia LeBel, President of the Treasury Board
Quebec considers that other professionals may perform actions currently reserved for doctors. He has already entrusted certain actions to pharmacists and nurses, but he wants to go further to expand the scope of practice of professionals such as them within the framework of negotiations. “We want to refocus the role of the doctor on things that only the doctor can do,” Ms. LeBel summarized.
Support
The Legault government no longer aims to have a family doctor for every Quebecer. It has already deviated from this goal by recommending “collective” rather than “individual” registration, that is, registration with a group of doctors rather than a single doctor. This is a model of a Front Line Access Counter (GAP). However, he intends to push the patient care review further as part of the negotiations.
The support model has been based on individual registration for several years […]. Having said that we are going to trash individual care, we need to look at new ways of doing things.
Sonia LeBel, President of the Treasury Board
“An interdisciplinary group that is not just doctors in GMF could have cared more [groupe de médecine de famille] », supported by Sonia LeBel.
So she wants to “modernize the organization of primary care” so that the patient sees “the right professional at the right time”.
“People will be able to continue to have a GP, while others, like me, who don’t need one will have another solution. The idea is that when you need to see a doctor, you will be able to do so in a timely manner depending on your level of urgency. For me, at the end of these negotiations, the objective is to have access [aux services] in a timely manner depending on the degree of urgency and the extent of the need. If it’s a doctor, it’s a doctor, and if it’s another professional, it’s another professional. »
Quebec does not intend to set a quota of patients to be treated for each doctor. “It doesn’t have to be a mathematical objective to say: every doctor must have 2000 patients. This may not be the correct model. »
Each heavier doctor may have fewer cases, but different cases. What we want is to make sure that we have better access for citizens.
Sonia LeBel, President of the Treasury Board
Sonia LeBel stated that the FMOQ is “like a union” and “needs more money”. But she currently refuses to talk about any increase in remuneration. She still insists that the current coverage of 3 billion dollars be “maximized”.
The government’s offer, its “first deposit” as we say in negotiation jargon, is not detailed and above all it summarizes its main trends.
According to the latest data from the Canadian Institute for Health Information, the “average gross clinical payment” paid to a family doctor in Quebec was $276,809 in 2021-2022. This is the average for all doctors, including those working part-time.
The picture changes when we calculate the remuneration in “full time equivalents” (FTE), that is to say for full time work. A family doctor earned $383,359 that year. This is 10.8% more than the Canadian average ($345,859) and 17.3% more than in Ontario ($326,871).