Medical professionals to receive remuneration on an hourly basis, working in collaboration.
New and improved! Here's a fresh spin on the story about Quebec's plan to change the way family doctors are paid:
Easing Access with a New Pay Structure:Quebec's government has stepped up its game in addressing the issue of access to family doctors. To catalyze this change, they're proposing to revamp the doctors' remuneration system, incorporating three methods: per-act payments, capitation, and hourly wages.
This groundbreaking plan was put forth in Bill 106, introduced by Health Minister Christian Dubé on Thursday. Premier François Legault expressed his long-awaited support for the bill, stating, "I've been waiting for this for 23 years."
Family doctors affiliated with a Group Médecine de Famille (GMF) will now receive a collective payment for caring for a certain number of patients, with the amount dependent on the patients' levels of vulnerability. Meanwhile, they'll continue to earn per-act payments for their interventions, with additional hourly payments acknowledging work outside of medical acts, such as office work and phone calls to colleagues.
The ultimate goal of this reform is to ensure that every Quebecer will be linked with a doctor or a team of professionals by the summer of 2026, as per the Legault government's promise.
A Million Quebeckers Uncovered:Currently, about 1.5 million people, or 17% of the province's population, don't have such coverage. Approximately 590,000 of these individuals are considered "vulnerable," meaning they have chronic health issues, or more severe health problems. However, the Legault government emphasizes that this initiative isn't about yanking family doctors away from healthy citizens to prioritize fragile individuals.
Pushback from the Medical Fraternity:The bill has stirred up some resistance within the medical community, particularly from federations representing Quebec's 22,000 doctors. While they've remained relatively quiet on the topics of capitation and hourly pay, they've expressed disapproval towards the idea of linking remuneration to new performance criteria.
The Quebec College of Family Physicians directly criticized the government, stating, "The government has reached a new peak in reality denial." This group has been advocating for improved access to doctors for years, an argument that was reinforced by a panel of government-appointed experts on Thursday.
Mastering the Details:Bill 106 remains vague regarding these performance criteria, which will be finalized through regulation. Christian Dubé, the Health Minister, revealed that up to 25% of doctors' remuneration could be tied to these criteria. He commented during a press conference, "We're putting in 10 billion dollars... So, today, there must be a minimum of management rights."
However, performance evaluations will primarily be conducted collectively, rather than assessing each individual doctor's performance.
Specifics for Specialists:The changes in remuneration only target family doctors. Specialist doctors will experience more indirect impacts, such as reduced waiting lists for surgeries, improving access via less frequent visits to family doctors during the waiting period.
Nevertheless, specialist doctors have also expressed dissatisfaction with the new performance measures, which will be regulated through "collective supplements." The exact nature of these additions will be determined during negotiations with medical federations.
Further Reading:- Family doctors reject Quebec government’s latest offer- 90-minute emergency room target still far from being reached- At the heart of the launch of the book "The Indomitable Mammoth", the question of access to care
- The Legislature of Quebec has proposed a new remuneration system for physicians, largely revolving around three methods: per-act payments, capitation, and hourly wages.
- Under the proposed system, family physicians affiliated with a Group Médecine de Famille (GMF) will receive a collective payment for caring for a certain number of patients, with the amount dependent on the patients' levels of vulnerability.
- In the realm of health-and-wellness, this new strategy aims to ensure that every Quebecer is linked with a doctor or a team of professionals by the summer of 2026.
- However, the new performance criteria, which could make up to 25% of doctors' remuneration, are yet to be specified, and will be finalized through regulation.
- Amidst these changes, the Quebec College of Family Physicians has critically addressed the government, stating, "The government has reached a new peak in reality denial."
- The reform plan also effects specialists indirectly, such as reducing waiting lists for surgeries, thereby improving access through less frequent visits to family doctors during the waiting period.
