one in four quebecers is in need of a family doctor , a proportion that has risen, according to the institut de la statistique du québec . the latest numbers show that only 73.3 per cent of the quebec population was assigned to a general practitioner in 2023, down from 76.6 per cent in 2022, 79.8 per cent in 2021, 81.4 per cent in 2020 and 82 per cent before the covid-19 pandemic.
and all signs suggest the situation in quebec is worse than anywhere else in the country. according to the canadian institute of health information, 88 per cent of the population outside quebec had a family doctor from 2019 to 2021, including 90 per cent in ontario and new brunswick. the analysis contained no information from quebec because the province did not participate in the most recent joint reporting exercise.
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but the last batch of cihi comparables dating from 2019-20 demonstrated that 79.5 per cent of quebecers had access to a primary caregiver, below the canadian average at the time of 85.6 per cent. the situation was again worse in montreal, where just 69.8 per cent of the population had a family doctor.
“the agreement between the ministry of health and social services and the fédération de omnipraticiens du québec, which seeks to increase access to front-line and interdisciplinary services , introduced the notion of group registration,” the isq analysis said. “these group registrations contributed to a decrease in individual registrations among patients.”
despite opening up more spaces to train family doctors in medical school, graduates are giving the specialty the cold shoulder. of the 75 family residency positions across canada that went unfilled after the annual matching process, 70 were in quebec in 2024.
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also, some newly minted gps aren’t even bothering to apply for permits that dictate where in quebec they can practice. these plans régionaux d’effectifs médicaux (or prems), are supposed to ensure an equitable distribution of physicians across quebec, but instead create hurdles that deter many from choosing family medicine or prevent young gps from living and working where they want. as of july 31, 92 of the 479 prems for new billers were unfilled .
a record number of quebec doctors left the public system in the last year, a federal study on the state of the canadian health act revealed. the total number of “non-participating” general practitioners and specialists reached 780 in mid-july, an increase of 22 per cent from a year earlier, when there were 641 people practicing private medicine in quebec. for comparison, only 14 doctors in the rest of canada left the public system over the past year.
not surprising then, quebecers are not only struggling to find a family physician, the wait time to see a specialist in quebec has doubled over the past five years, to 14 months in march 2024.
in the words of one front-line physician, the gap system has transformed family practice into “mcmedicine.” doctors may see a patient through the booking service only once. they may deal with one-off problems that take the pressure off ers, but they don’t do prevention, followup or build a rapport — the backbone of family medicine for both doctors and patients.
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on top of that, a new language crackdown under bill 96 is casting a pall over health care and putting the imperative of protecting french above providing the best care . doctors could be prevented from communicating with their patients in “a language other than french” if they don’t meet narrow criteria and expose themselves to disciplinary sanctions if they address the wrong person in the wrong language.