With doctors leaving and clinics closing their doors, the effects of Bill 2 could seriously impact healthcare in the Montérégie-Ouest.
Doctors from the Association des Médecins Omnipraticiens du Sud-Ouest (AMOSO sounded the alarm over the provincial governments proposed measures during a general meeting on November 26.
The association’s president, Dr. Sylvain Dufresne, stated that a survey of members showed that 60 physicians are considering leaving, including around ten who are contemplating early retirement and another 30 who are “actively preparing” to leave the Quebec system.
These departures could mean a large portion of the region’s population may be left without access to a family doctor and emergency departments may become even more congested.
The effects of Bill 2 are already being felt in some family medicine groups (GMF) in the region. Dr. Gabrielle Grégoire, who heads the Hudson GMF, has already announced the clinic will close its doors on March 31. She indicated that none of the seven doctors currently on the team, including several young practitioners, were able to commit to continuing for the next year. This uncertainty has forced the GMF, which serves 11,000 patients, to close.
The frequency and speed at which the new law will force doctors to provide care to patients is at the centre of the issue.
Dr. Jean-Philippe Chouinard of the GMF Le Trait d’Union in Delson said that if no improvements are made to the bill, his clinic may also be forced to close on April 1. The proposed remuneration system is based on a capitation system, where doctors are paid a fixed amount per patient, which could prevent GMF managers from covering operating costs.
“We had an independent analysis done that clearly shows that we can’t keep going at this rate for two or three months… to support the healthcare system,” explained Chouinard. “That’s not what I want, it’s not what my team wants, and we don’t think this is the solution.”
Impacts on hospitals
The situation in hospitals such as Anna-Laberge in Chateauguay, the Suroît hospital in Salaberry-de-Valleyfield, and the Barrie Memorial in Ormstown could also be impacted by the effects of Bill 2.
According to Dr. Philippe Smith, the chief of general medical with the Centre Intégré de Santé et de Services Sociaux de la Monteregie-Ouest, the Suroît Hospital has seen the departure of five “hospitalist” physicians.
Doctors working in certain specialties, such as geriatrics, at the Anna-Laberge Hospital and Suroît Hospital have indicated they are already licensed to work in Ontario.
The Châteauguay CLSC has also seen its team shrink from eight to five doctors, including two in home care.
The new remuneration system is also driving away the next generation of doctors.
Since its creation, the GMF Universitaire Jardins-Roussillon has trained more than 40 doctors practicing in the Montérégie-Ouest. Dr. Mégane Lepitre says that Bill 2 threatens all her work. “This year, our open house welcomed one extern, compared to about 20 last year. Our graduates are no longer applying to our plans territoriaux des effectifs médicaux (regional physician staffing plans) or are leaving the region.”
Dr. Yasmine Moussaid explained that the current climate has led her to inquire about the possibility of practicing in Manitoba or the Yukon. “Bill 2 will prevent me from practicing the kind of medicine I want to practice,” she said. “I want to take my time with my patients, not practice fast-food medicine. I refuse to see my patients as coloured dots when they are people with complex stories.”
The current context is raising even more questions about whether the new Vaudreuil-Soulanges Hospital will have enough medical and nursing staff to provide services when it opens. Dufresne said he welcomes the addition of new medical beds in the region. “But I doubt that we will be able to staff the new hospital without closing another one,” he added.
Dufresne also welcomed the resumption of discussions between the government and the Federation des Médecins Omnipraticiens du Québec, but he admits the bond of trust has been broken and it may take time to rebuild.