Against doctors' wishes Quebec passes its Bill 11, asking them to add to their patient loads

Quebec City–Family physicians have categorically rejected it, called for its withdrawal, but they will still have to deal with this new reality: Bill 11 was passed in the National Assembly on Tuesday, announcing a new showdown between Quebec and the medical profession. The new law, piloted by the Minister of Health, Christian Dubé, aims to increase the supply of front-line services, by reviewing the schedule of general practitioners, called upon them to make time slots available so as to see more patients. However, there is no constraint, nor any specific target to be reached as to the number of time slots to be cleared. There is no penalty provided, either, against possible recalcitrants. Upset, saying it was "attacked" by Quebec, the Federation of General Practitioners (FMOQ) had described the government's approach as a "slap in the face" towards its members, asking the minister in vain, in recent months, to back down. According to FMOQ, the new law, totally useless, will in no way solve the recurring problems of access to a family doctor. Minister Dubé tabled his bill in November. Rather technical, it plans to deploy a management platform for making medical appointments. The goal: that an orphan patient can see a doctor or health professional in less than 36 hours. The system will be managed by the Family Medicine Groups (GMF). When the Legault government took power in 2018, there were 400,000 orphan patients in Quebec. Four years later, the situation has only gotten worse. It's estimated that approximately 1.5 million Quebecers do not currently have a family doctor. In 2018, during the election campaign, Premier François Legault pledged to guarantee a family doctor to all Quebecers before the end of the mandate. Bill 11 also aims to provide, on a local and regional basis, detailed data on medical practice and workforce planning. Access to this data, it is hoped, will make it possible to better plan the service offer and medical staffing needs. Notably, Dubé said in November, when the bill was tabled, that if the cooperation from doctors the new legislation is meant to spur doesn't materialize in the coming months, he would retain the privilege of moving "to another stage." But he has not provided details on the nature of this "step," which will come in a possible second term. Read: Clinical pearls: Cessation tips The province believes too many family doctors take too few patients on. On many occasions, the FMOQ has replied that, on average, family doctors already work 45 hours a week, forced by the government to diversify their practice, outside their office, by going to the hospital or CHSLD. Some have teaching duties. Of note, one doctor in four in Quebec is over 60, an age when one can think of reducing his working hours, not increasing them. Last year, Legault added fuel to the fire, brandishing threat of a law that would force doctors to take at least 1,000 patients. He'd previously set the tone by claiming that he had the names of the doctors who did not comply with this minimum standard, from a list obtained from the Régie de l'assurance maladie du Québec (RAMQ). The FMOQ did not appreciate his tone. The problem of access is not new. In 2015, former Liberal minister Gaétan Barrette passed Bill 20, which created financial penalties of up to 30% of remuneration if doctors defied government dictate by not reaching the targets set by Quebec. In the end, the Couillard government backed down and the penalties were not applied. On Tuesday, Dubé argued that his law "will promote interdisciplinarity between network professionals by decompartmentalising practices". Physicians will also now have to go through the access desk to take new patients into their practice. Read: Sleep disorders: the civilization that no longer sleeps

Against doctors' wishes Quebec passes its Bill 11, asking them to add to their patient loads

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