The millionaire specialist doctors are in the crosshairs of their union, which is looking for a way to cap their income without risking harming the care of the population.
In 2022, an internal actuarial analysis was commissioned by the Federation of Medical Specialists of Quebec (FMSQ). However, it is unable to find a way to limit certain incomes without having a negative impact on medical procedures.
“It was more complicated than it initially looked,” admits Anne-Louise Chauvette, spokesperson for the FMSQ. It was not as simple as putting a ceiling and we stop there. If we did that, there would be an impact on the patients.”
Growls internally
For several years now, the number of doctors who earn more than a million dollars a year has been increasing in Quebec. In 2021, 294 doctors, a record, reached this milestone, of which 272 were specialists. Radiologists, ophthalmologists and cardiologists accounted for 69% of millionaires.
Moreover, the president of the FMSQ, Dr.r Vincent Oliva, had admitted in 2021 that these statistics aroused discontent internally, and that these figures “go badly in public opinion”.
“Invoicing is like a buffet, no one checks what you put on your plate. There are people who overcharge for acts more or less carried out, or use borderline billing codes, ”laments an orthopedist on condition of anonymity.
Over the past year, different types of ceilings have been studied by the FMSQ. The “high income” criteria have also been analyzed in different forms. Among other things, doctors who earned $800,000 and $900,000 were also evaluated, or those who stood out compared to the average for their specialty.
Types of caps studied by the union
- Cap income (annually, quarterly or daily)
- Adjust rates
- Cap activity, volume (per doctor, per day or per patient)
- Combination of the above*
“We wanted to try to understand how some manage to charge such large amounts, says M.me Chauvette. What we realized is that […] it is not out of deviance or dishonesty.”
According to the analyses, doctors with high incomes work a lot, often in remote areas, and on an urgent basis. Since doctors are paid on a fee-for-service basis by the Régie de l’assurance maladie du Québec, capping their income would amount to limiting the number of patients treated, argues the FMSQ.
The door remains open
Faced with this observation, the FMSQ will continue discussions with the Ministry of Health and Social Services (MSSS).
“The door is not closed [au plafonnement]assure Mme Chauvette. But, we must discuss the collateral issues to ensure that there is no break in service.
“Our priority is that patients are cared for,” she says.
The Association des radiologistes du Québec did not want to comment on the file, and the associations of ophthalmologists and cardiologists did not call back. The newspaper at the time of publishing.
*Source: FMSQ