Bill 67 expands powers of allied health professionals

“We’re in favour of this bill. It’s the result of several years’ work with the various regulators concerned. It took time, but we didn’t go backwards. We’ve kept an open mind.” So said Dr. Mauril Gaudreault, the president of the Collège des Médecins du Québec (CMQ), the province’s medical regulator, who seems to feel a sense of accomplishment since the tabling of Bill 67 at the provincial assembly on June 4. The bill proposes amending the professional code to modernize the professional system and broaden certain professional practices in the health and social services field. Dr. Gaudreault considers that the new powers granted to healthcare professionals under Bill 67 are part of a fundamental trend. The practice of caring for people is not just a matter for doctors, he explained in an interview with Profession Santé, a sister media brand to the Medical Post in Quebec. “Cases are increasingly complex. The same person can have several chronic illnesses. This requires teamwork. We’re talking more and more about the future practice of medicine. It will take place within interdisciplinary teams where the complementary skills of different professionals will be recognized and exploited.” As for the doctor, they “will be the expert on this team,” Dr. Gaudreault said.Does this mean we should give the ability to diagnose to other healthcare professionals? “At first, the medical community was resistant (to the idea). We’ve long since moved away from that,” the CMQ president observed. As for the nurse clinicians, psychologists, guidance counselors, sexologists and speech therapists who will be able to diagnose certain mental disorders, he points out that the bill puts an end to semantic confusion. “It recognizes that the assessments made by these professionals are indeed diagnoses. It just made sense.”The same goes for the new powers granted to pharmacists, who will be able to prescribe drugs directly to their patients to treat certain common illnesses—such as urinary tract infections, conjunctivitis or pharyngitis—or take samples, for example to detect and then treat type A streptococcus in the throat. Here again, “it’s a natural progression,” Dr. Gaudreault said. Over the past ten years, “pharmacists have developed competencies,” and they will be able to “play a greater role in a first line of access for the public, which will sometimes save them a long wait in the emergency room, at a walk-in clinic or with the family doctor.”Read: Newly tabled Quebec bill would introduce sweeping changes to scope of pharmacists and other healthcare prosTherein lies the appeal of this bill, which not only aims to modernize the professional system, but also to improve access to healthcare. “The collège’s mission is to protect the public by offering quality medicine. But it must also be accessible,” stressed its president since 2018, who insists on the notion of competent access, specifying that this is “not a warning from the collège.” These professionals empowered to make a mental health diagnosis will have “accredited training and the required competencies,” Dr. Gaudreault guaranteed, adding that doctors aren’t the only ones with judgment. “When a family doctor needs to confirm a diagnostic hypothesis, he or she will call on a specialist colleague. It will be the same for (these professionals), who also have judgment in this area,” he insisted. To achieve this, “we’ll have to make it easier for them to consult a doctor” by creating service corridors.Had it not been for the current issues of access to the healthcare network, and to the frontline in particular, “we would still have gone in that direction,” asserted the CMQ president, who recalls that when the healthcare professions were first decompartmentalized over 15 years ago, “there was no talk of access problems.” In his view, the credo that has guided the successive expansions of competencies since the nurses’ act, or Loi sur les infirmières, passed in 2009, is truly team practice. “To continue working in interdisciplinary teams, professionals need more autonomy. For the benefit of patients, not for everyone to work in their own corner,” said the family doctor, who encourages everyone to trust each other, while acknowledging that communication between healthcare professionals remains a challenge.The other challenge to be overcome concerns the fee-for-service remuneration of doctors. According to several researchers, it produces perverse effects that don’t encourage interdisciplinarity. Dr. Gaudreault doesn’t wish to comment on this subject, as he presides over a medical regulator and not a medical association. On the other hand, “to practice effectively as a team,” he finds it “essential to have an adequate remuneration system. If we want doctors to take part in teamwork and meetings, we have to see how they can be remunerated. This reinvented frontline must be properly financed, with new arrangements for all professionals.”Read: Resident matching can’t start with CaRMS: Why we need a national plan for the health workforceGoing a step furtherSonia LeBel, president of the treasury board and minister responsible for government administration, indicated on June 4 during the presentation of Bill 67 that nurse practitioners, psychologists, guidance counselors, sexologists and speech therapists will not be able to prescribe after making a mental health diagnosis. “We’re taking the first step,” she stressed, suggesting that she might one day go further.Using the same rhetoric, the president of CMQ believes that a “good step” will be taken with the opening up of mental health diagnoses. “We’ll be taking more steps with Ms. LeBel,” he continues, looking ahead to the next stage: “After the diagnosis, we need the treatment plan.” In the longer term, he’s also talking about opening up diagnoses involving physical health. “Discussions may be more complicated, because it’s a more recent subject than mental health diagnosis, which we’ve been talking about for a long time.”This article was translated from French and originally ran in our sister publication Profession Santé.Read: Health minister tables bill to regulate tech vendors working with health data

Bill 67 expands powers of allied health professionals

Register for free access or login.

Related Topics