2024-04-09 16:44:12
Family doctors are urging the Legault government to abandon a proposed regulation which might further limit access to health care, according to them. After sending a formal notice to the Minister of Health, Christian Dubé, a few weeks ago, their federation hopes for a final turnaround in the situation before the new rules come into force.
General practitioners fear that the regulation will prevent them from spontaneously accepting to take care of a person who comes to their office using the walk-in service, even those coming from the First Line Access Desk (GAP), whose Minister Dubé nevertheless promotes people without a family doctor. It will be necessary to prioritize people registered on the list of the Access to a Family Doctor (GAMF) list.
If I see someone in a walk-in context because they do not have a family doctor, I can currently choose to take care of them because I judge that they have significant health needs. I do this by only signing a form, sent to the Régie de l’assurance santé du Québec, explains Dr. Chantal Guimond.
Now, we will have to justify this treatment, since this is not a patient offered by the Family Doctor Access Desk. I listened to him, I partially took charge of his problem, I want to see him once more to continue the care, but that puts a brake on him.
A quote from Dr. Chantal Guimond, family doctor and president of the Ma Clinique network
The doctor-patient relationship that develops naturally during a consultation should not take precedence over the GAMF waiting list, according to the interpretation of the regulation also made by Dr. Anne-Marie Beaulieu.
I am a doctor of a small family, two parents and two children. They ask me if I can take care of their third baby. If I want to register this new baby, I fear an additional administrative burden, with additional forms that I will have to complete, explains Dr. Beaulieu.
Minister Christian Dubé sees this as an erroneous interpretation of the regulation, which provides for several exceptions, such as the care of members of the same family. A new baby might therefore be followed by the same doctor.
Our priority is to ensure that vulnerable patients are taken care of. When a healthy person comes to see their doctor, the doctor has no obligation not to take that person. The only thing he needs to check is whether there are vulnerable people in his area who should be prioritized. If there aren’t any, he can take all the patients he wants.
A quote from Christian Dubé, Minister of Health
The minister hopes to force doctors to take care of 13,000 vulnerable patients still waiting at the GAMF.
The minister is not going regarding it the right way, claims the FMOQ
This risks freeing up less time for doctors who want to provide clinical services to patients, says the president of the Federation of General Practitioners of Quebec (FMOQ), Dr. Marc-André Amyot. He claims that doctors will have to justify on paper the reasons for choosing certain patients over others.
Minister Dubé refutes this other assertion. He replies that doctors will indeed have to share data concerning their care, but that everything will be done entirely automatically.
The FMOQ sent a formal notice to Christian Dubé a few weeks ago to discourage him from implementing its regulations.
I am not suggesting that there are no access issues. On the contrary, we know that it is difficult, specifies Dr. Amyot.
In its comments sent to the minister last Friday, the FMOQ argued that the regulation affects the professional autonomy of family doctors.
To accept a patient other than the one registered on the GAMF, you will need to make a prior authorization request to the medical coordinator. General practitioners argue that this process largely eliminates the clinical judgment a doctor must exercise as to whether a patient would benefit from registration.
The 45-day consultation period following the publication of the regulations has just ended. It should come into force shortly. We will have modified certain things by then to ensure that the process is simplified. The counter medical coordinator is there in a supervisory role, not coercion. There will be much less paperwork, adds Minister Dubé.
He ensures that the objective of the regulation remains the care of priority patients. Others, whose health conditions are not considered urgent, will be able to continue to consult a health professional through the GAP, while waiting to be assigned a family doctor.
It is our responsibility to ensure that vulnerable patients are treated as a priority in the health system. We are talking here regarding Quebecers living with HIV or having suicidal thoughts, in particular. Caring for a new patient should not be to the detriment of a person who is vulnerable. It is therefore entirely logical that these people should be given priority care.
A quote from Cabinet of Minister Christian Dubé
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