Every year the injustice repeats itself. The citizens of Montreal are victims of a medical staff allocation process with serious shortcomings and we expect similar results in the coming weeks.
The Regional Medical Workforce Plan (PREM) in family medicine, despite its intentions, generates blatant inequalities. It creates disparities in the short term and in the medium and long term, gaps in access to care which cause consternation and concern.
The exasperation of the medical community, clinic managers, local and provincial elected officials is palpable, enough is enough!
The PREM is a resounding failure!
Established in 2004, the PREM aimed to guarantee equitable distribution of medical services across the province by assigning family doctors to the regions with the greatest demand. Today, we are rather seeing its perverse effects. Barely 63% of Montrealers are registered with a family doctor (less than 55% in certain sectors of the island). The CAQ prides itself on being the government of the regions, but it does so at the expense of the population of the metropolis. Are we second-class citizens for the current government?
Did you know that nearly 400,000 patients from other regions are registered with Montreal doctors? If these patients were Montrealers, our registration rate would increase to nearly 87%. As incredible as it may seem, the population area to be served is not taken into account when allocating PREMs.
Nearly 800,000 island residents are without a family doctor, the equivalent of the population of Quebec or the Estrie and Center-du-Québec regions combined. Imagine telling them that none of them have a doctor! It’s unimaginable!
We understand that the shortage of family doctors affects all of Quebec, but we consider that the method of calculating PREM distribution greatly disadvantages Montreal.
Despite improvements announced each year, and without serious study of the results, the PREM methodology still does not reflect the specific realities and needs of each region. The indicators used not only compromise access to care, but devalue this profession. Indeed, medical students consider the PREM as one of the main obstacles to their decision to continue their studies in family medicine.
Montreal: A unique metropolis of its kind
According to the Quebec Statistics Institute, the population of Montreal increased by 89,600 people in one year, representing 44% of Quebec’s total growth. With its unique sociocultural and linguistic diversity, Montreal also welcomes the largest number of asylum seekers, students and foreign workers, consumers of care who are not considered by the PREM.
Our doctors adapt daily to this complex reality, exacerbated by an aging population and multiple health problems. The cases are heavy and require continuous and rigorous follow-up, testing our resources and our ability to provide quality care.
It is also without remembering that Montreal doctors train nearly half of Quebec’s residents, in addition to having two of the four universities where externs and students receive their training. A reality that seems to elude the method.
These beautiful young people, the future of care in Quebec, find themselves exposed to an exhausted medical community… Our political decision-makers then wonder why family medicine is being shunned!
Montreal doctors are also aging: nearly 30% are of retirement age, and there is a shortage of between 300 and 400 doctors in Montreal. This is almost as many as the doctors based in Laval or in Chaudière-Appalaches.
Montreal urgently needs additional doctors, NOW!
It is crucial to completely review the PREM method with all the stakeholders concerned. On July 4, we demand that an immediate moratorium to find a fair and equitable solution be announced! Political authorities must no longer be able to intervene in the distribution of family doctors in Quebec.
Élyanthe Nord, FMOQ
Dr Samer Daher
President of the Association of General Practitioners of Montreal (AMOM)
