Nearly $500 million in bonuses at stake for family doctors

Quebec wants to put an end to piecemeal agreements involving bonuses for 9,800 family doctors. Minister Christian Dubé questions their effectiveness.

When the union of family doctors (FMOQ) publicly revealed in April that Quebec did not intend to extend a letter of understanding that was expiring soon, there was much talk of a bonus granted to doctors to encourage them to withdraw patients on the waiting list for the Access to a Family Doctor (GAMF) window.

Agreement No. 368, signed in June 2022, notably provided for a bonus of $120 per year ($30 per quarter) per doctor for each new patient registered at the clinic where he practices.

The measure aimed to collectively register 500,000 patients in clinics vulnerable and to offer them an annual meeting with one of the professionals in the clinics. This package has proven popular with doctors, who have registered more than 900,000 patients to date.

However, according to information obtained by Radio-Canada, the various fixed-price agreements signed by Quebec and the FMOQ in June 2022 total nearly half a billion dollars over two years. Agreements which are the subject of negotiations and whose cost-benefit ratio is questioned by Minister Christian Dubé.

For example, letter of understanding no. 368 provides, in addition to the $120 bonus, a measure aimed at offering patients without a family doctor time slots without an appointment in the clinic in order to to reduce the consumption of medical services in emergencies.

The package per doctor ranges from $625 to $13,750 per quarter, depending on the number of orphan patient visits.

A third measure aims to encourage family doctors to see their patients registered in timelyespecially those having an urgent or semi-urgent condition.

The package per doctor ranges from $250 to $8,750 per quarter, depending on the number of patients registered and the achievement of appointment targets in less than 36 hours.

According to data provided by the Ministry of Health, nearly $218 million was paid to a few thousand doctors under Agreement No. 368 for a period of 18 months, from June 2022 to November 2023.

If the trend continues, nearly $300 million will have been paid in total in two years, until May 2024.

Dr. Jacques Ricard, who was manager of the health network for many years, says understand the minister’s reluctance to renew this agreement.

In his opinion, doctors have a very appreciable financial package […] and it seems to me that we should have a result that ensures continuity of care and then ensures accessibility to these vulnerable patients. Dr. Ricard was a medical advisor to former Minister McCann’s office until 2020.

As the president of the FMOQ, Dr. Marc-André Amyot, pointed out in recent weeks, the Federation has already indicated to the government that it would be making a mistake if it maintained its decision to terminate the Letter of Understanding.

may2024, until we achieve the initial objective of its integration into the new framework agreement.”,”text”:”In the interest of the population, it is important that the Letter of Understanding on the accessibility will continue without interruption beyond May 31, 2024, until we achieve the initial objective of its integration into the new framework agreement.”}}”>In the interest of the population, it is important that the Letter of Understanding on Accessibility continues without interruption beyond May 31, 2024, until we achieve the initial objective of its integration into the new framework agreement.

The latest framework agreement with the FMOQ dates back to 2015 and notably provides this year for a total envelope of $3.1 billion for general practitioners.

Other bonuses

According to our information, other packages are coming to an end, notably $161 million for family doctors who practice in a hospital center or a detention center.

Nearly $23 million is also planned for those working on the front line in areas insufficiently staffed with professionals.

A total lump sum of 12 million is also planned for those who work with specific clienteles: geriatrics, homelessness, mental health, refugees, home care, etc.

368 and the other Letters of Understanding that were concluded in order to increase access to the provision of front-line services and interdisciplinarity, we are talking about a total funding of 494.1million dollars for the June period2022 to May2024, to be paid to doctors”,”text”:”Considering the Letter of Understanding368 and the other Letters of Understanding which were concluded in order to increase access to the supply of front-line services and ‘interdisciplinarity, we are talking about total funding of $494.1 million for the period from June 2022 to May 2024, to be paid to doctors”}}”>Considering Letter of Understanding 368 and the other Letters of Understanding that were concluded in order to increase access to the supply of front-line services and interdisciplinarity, we are talking about a total funding of 494, $1 million for the period from June 2022 to May 2024, to be paid to doctorswe confirm to the Ministry of Health.

As Minister Christian Dubé recently explained to Paul Arcand on 98.5, I want us to stop having little letters of understanding everywhere with bonuses, to have a global vision.

I am prepared to pay more money, but have there actually been more meetings?

In interview with Patrice Roy at TV newsthe minister insisted on emphasizing that access to clinic data would soon allow : you are doing excellent work in such and such a place, but perhaps in such and such a region we have a specific problem”,”text”:”to tell the doctors: you are doing excellent work in such and such a place, but perhaps in such region we have a specific problem”}}”>to tell the doctors: you are doing an excellent job in this place, but perhaps in this region we have a specific problem.

The entry into force of the implementing regulations is scheduled for May 23.