Threat to penalize Quebec FPs will only lead to worsening morale

The Quebec government is once again threatening to force family doctors to have a minimum of 1,000 patients in their rosters and work 12 hours per week in hospitals, ERs and nursing homes. They can lose 30% of their income if they don't. Can you imagine this for any other professional? Lawyers would scream oppression and fight it to the Supreme Court. The Quebec government says that family doctors there have an average of a little over 500 patients in their practice and see 13 patients per day. They say this is half what Ontario GPs see. They forget that these doctors do much more hospital work than we do in Ontario and they are also including doctors who are teaching students and residents (which slows them down). Also, it includes part-time MDs, doctors who are in administration, or women with a whole other full-time job to go to at home after seeing patients. Read: Quebec tables bill that would force family docs take appointments from patients without FPs I think it is wrong to force any doctor to do anything. You will end up with low morale and an exodus to the rest of Canada or the U.S. The U.S. is starved for family doctors now that Obamacare is funding tens of millions of patients for the first time. They used to rely on “free” care in ERs and will now be able to afford family doctors. Also, a lot of family doctors are women with a whole other full-time job to go to at home after seeing patients. Quebec doctors have some of the lowest fee schedules in Canada. I think the Quebec ministry of health should try a carrot, not a stick. We in Ontario in the larger centres aren't forced to do any hospital work. We have hospitalists who can spend eight hours with patients, not the 10 minutes we as family doctors can afford. We have retired doctors assisting at surgery and enjoying it. We have full-time emergency physicians who have much more interest and skill in running the ERs than us (I know, I was one for 20 years). We have obstetricians and midwives with much more interest and training and time and funding than we do. We have long-term care house doctors very well paid who can visit three times a week, not a harried GP trying to shoehorn it in at lunch or after work. The nice thing is, we can do all these things but are not forced to do so. We get people doing them who want to, and are good at it. It also leaves us to concentrate on our offices. Ontario family physicians can see 30 patients a day comfortably without hospital interruptions. Many of us have government-funded nurses and/or nurse practitioners and/or social workers who can help us with the load. I, as an old GP of 74, can see 30 patients per day and have done so for 48 years. My roster is 1,500 patients, and I work 9 to 5 with an hour off for lunch and Wednesday afternoons off. I get eight weeks paid vacation per year, which costs the taxpayers nothing as I am covered for free by two fellow physicians and I reciprocate. Read Dr. Crosby on: Getting off the fee-for-service hamster wheel Avoiding Burnout Our call group is one in 30 on-call. So I have been able to give fast service to my patients and not burn out over 48 years. We offer after-hours instant service to our patients from 5 p.m.. to 8 pm. weekdays and 9 a.m. to noon on Saturdays and nurse and doctor phone advice in all our patients’ languages 24/7/365. I suggest the Quebec ministry of health sit down with their family doctors and some outside consultants from the rest of Canada who have happy, productive family doctors and try to work out a way to encourage Quebec family doctors to increase availability to their patients and have a good lifestyle as well. They can find a win-win-win for all. What do you think? Email me at drjohncrosby@rogers.com for my Time Management ebook and audiobook which tells how to do this and how to avoid stress as well.

Threat to penalize Quebec FPs will only lead to worsening morale

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