Quebecers in good health would no longer be followed by a dedicated family doctor

François Legault’s government is evaluating the possibility of modifying the allocation of family doctors based on the state of health of Quebecers, so that the most vulnerable are taken care of.

Sources familiar with the discussions spoke to Radio-Canada regarding a scenario for allocating general practitioners that has been studied for several months.

This scenario would ensure that Quebec patients in good health or experiencing minor health problems would be directed to a front-line access window (GAP) amended.

This access window would now include all Quebec patients who do not have major or moderate health problems, including those who currently have a family doctor.

Only patients judged to be more vulnerable would be assigned a family doctor. For example, those who have complex or chronic conditions such as cancer, mental health disorders, cardiovascular disease or diabetes.

We do not have information on how such a scenario would apply.

The office of Quebec Health Minister Christian Dubé and the Federation of General Practitioners did not want to comment on the negotiations.

A report from the National Institute of Excellence in Health and Social Services (INESSS), commissioned by the government and made public Wednesday morning, however lays the foundations for such a model.

This report from theINESSS indicates that 500,000 sick Quebecers do not have a family doctor and suggests transferring up to 1.5 million annual appointments from patients who have a family doctor to those who do not.

Minister Dubé’s intentions

In an interview on the occasion of breast cancer awareness month with Radio-Canada on October 3, the Minister of Health mentioned that it was necessary trying to adapt to people’s own conditions.

At the moment, several people were given a family doctor without taking care of their condition, and the doctors asked us to say: “Well, if we want to take care of people properly, could we be more aware of those, I [ne] would not say the most vulnerable, but those who are most likely to be sick?

Who are the patients vulnerable?

Of the 2.1 million Quebecers who were not registered with a family doctor in 2022-2023, theINESSS estimates that nearly 500,000 of them have major or moderate health problems in their health profile. These patients are classified in the red and orange categories by theINESSS.

These categories include, among others, people struggling with depression, anxiety disorders, cancer, dementia, eating disorders and even acute palliative conditions.

Called to comment on the report on Wednesday, Minister Christian Dubé believes that it This is a good portrait of the clientele, people who have a severe to mild chronic illness […] it will be interesting in our negotiations with the FMOQ.

Remuneration changed?

The scenario evaluated by the government is part of the negotiations between Quebec and the Federation of General Practitioners of Quebec (FMOQ) started in May.

For several months there has been talk of finding a way to better care for patients judged more vulnerable.

The report of theINESSS made public on Wednesday was to fuel negotiations on the remuneration and organization of care of general practitioners.

In August, the Legault government tabled a first proposal.

In reaction to this proposal, general practitioners said they were ready to entrust the mildest cases to other professionals in order to concentrate on patients who absolutely must be seen by a doctor.

At this time, the president of the FMOQ had clarified that the current fee-for-service payment is not adapted to only seeing heavier patients.