You could hear the relief in Danielle Romain’s voice as she provided an update on the status of Pontiac’s family doctors since the province arrived at an agreement with Quebec physicians about its controversial Law 2.
“We only have two confirmed [leaving the Pontiac] at the moment. And everyone else who is staying on board is working as a team and they are going to be accepting transfers from the physicians that are leaving the Pontiac or are ending their family medicine practices,” said Romain, the coordinator of the Pontiac GMF that manages family medicine across the county. “So it’s a really great team effort.”
In December, Romain said she had heard from six family doctors who had plans of some form to leave their practice in the Pontiac.
Law 2, originally set to come into effect on Jan. 1, would have tied doctors’ pay to performance metrics including the number of patients they see and how vulnerable these patients are. The province positioned these new regulations as necessary to getting 1.5 million or so Quebecers, currently on waiting lists for family doctors, connected with primary care.
In response to this legislation, hundreds of doctors threatened to leave the province, applying for permits in New Brunswick and Ontario, including in the Pontiac.
But in a phone call with THE EQUITY last week, Romain confirmed only two of the six were going through with it – one moving their practice to Ontario and the other closing their family practice while continuing to work as an ER and in-patient doctor in the Pontiac. Romain said both have cited Law 2 as the reason behind their departures from family medicine here, and will be gone by the end of March.
The change from the remaining four, she said, can be attributed to the new tentative agreement reached between Quebec and its physicians at the end of December.
New agreement brings ‘much better outlook’
On Dec. 19, 97 per cent of doctors voted in favour of this new tentative agreement that committed to paring back some of Law 2’s most controversial measures including financial penalties for doctors who don’t meet performance targets.
The new deal abandons the obligation for family doctor groups (GMFs) to take on the province’s 1.5 million patients without doctors by Jan. 2027. Instead, doctors have agreed to take on 500,000 new patients by June, and will be financially compensated for reaching that target but not be penalized for falling short. The new legislation is set to come into force on Feb. 28.
Dr. Thomas O’Neill is a family physician at the Lotus Clinic in Shawville who has spent many decades working at the Pontiac Hospital and is also on the executive of the Pontiac GMF. He said the important change he sees in the tentative agreement is the difference in the government’s approach to working with the doctors.
“The initial thing was that the government was going to impose it, and now they’ve agreed to negotiate some of the aspects of it,” O’Neill said.
“So I think both parties have agreed that capitation makes sense. It’s done in many other jurisdictions – that’s where you get a flat rate and you also get some compensation for acts that you may do.”
He said as he understands, there is a new pay system being negotiated, but the focus for the moment is getting the promised 500,000 additional patients connected with care.
“The plan is to try and get that moving, and then to delay the implementation of some of the other aspects of Bill 2, and to negotiate rather than have them imposed on the doctors.”
O’Neill was adamant, though, that the government’s attempted approach to healthcare reform, which would have pushed doctors to perform what has been called “fast food medicine”, prioritizing volume over quality of care, was “missing the point.”
“And the point is that you’re not producing enough doctors to cover the needs of the population, and compelling them to do more isn’t necessarily going to solve the underlying problem of access to care,” O’Neill said. “The government is trying to do some patchwork with that but it’s limited because it’s basically a problem of supply and demand.”
Romain said for now, the Pontiac remains in good standing when it comes to primary care access, thanks to two new doctors from France who will be setting up their practices here this winter, keeping the region at 23 doctors for some 18,000 registered patients.
“It’s a much better outlook than whenever we had our [protest],” she said. “Some may change their minds in the coming months, but it doesn’t seem like the exodus will be as bad as we were fearing.”
She said most patients of the two doctors leaving will be absorbed by the doctors already here or those just arriving, and if not they will become GMF collective patients to ensure they continue to have access to primary care.
She urged anybody who is still without access to a family doctor to make sure their name is on the waiting list with the Quebec government.
“They need to be on this list if they’re expecting to get a family physician. It gives us a clear number as per the need for family physicians.”
