Published April 9, 2024

Family doctor shortage concerns health advocates

Ruby Pratka, Local Journalism Initiative reporter

editor@qctonline.com

The shortage of family doctors in the Quebec City region is real, and expected to worsen in the next several years, according to data from the Association des médecins omnipraticiens de Québec (AMOQ), the regional branch of the province’s federation of family doctors.

According to the AMOQ, the region had a net loss of 16 family doctors in 2022, while the population of poten- tial patients rose by 20,000. Nearly three out of 10 doctors in the region are 60 or older, and those doctors care for a combined 34 per cent of the region’s patients.

By the end of this year, Dr. Mary Delafield and Dr. Alec Cooper, two of the only anglo- phone family doctors in the region, are also expected to step down. Cooper is retiring after a motor neuron disease diagnosis, while Delafield’s retirement was long-planned, according to former patients. The absence of anglophone doctors in the region has advocates for English-language health access worried.

“Language concordance in health care between the patient and the provider is a very important factor in patient compliance, comprehension, readmissions and even out- come,” said Jennifer Johnson, executive director of the Community Health and Social Ser- vices Network. While patients have the right to receive health services in their preferred official language, she pointed out, “The right to receive services in English is often challenged by the system’s capacity to do so.”

“I’m not losing my doctor, but I know a lot of people who are, and they’re concerned because they appreciated being able to talk to their doctor in English,” said Richard Walling, executive director of Jeffery Hale Community Partners. “They’re concerned that they’re now technically ‘or- phan patients’ and wondering what the comfort level of the doctor they’re assigned to will be. My doctor is bilingual and we speak in both languages, but that’s in a normal situation – knock on wood, I’ve never been in a situation of extreme stress. If I was a parent and had a child in difficulty, I could only imagine.”

“I could have [spoken to a doctor] in French, but there’s nothing like using your mother tongue when you’re talking about yourself,” said Mary Robertson, a longtime Quebec City resident and soon-to-be “orphan patient” who has been with Dr. Delafield for more than 20 years. “You don’t have to be creative trying to find ways to say things … you’re more relaxed when you don’t have to look for your words.

“If you lose your family doctor, you go on ClicSanté and register [with the Guichet d’accès à un médecin de famille (GAMF; family doctor access portal)], but I know people who have been on the waiting list for three years or more,” she added.

Jeanne Chambers has also lived in Quebec City for many years. Although she speaks French, her comfort level doesn’t extend to medical terminology. “All the vocabulary is different – you have to bring a dictionary with you,” she said. “I have been fortunate in that time I’ve been referred to another doctor, I’ve been able to find someone to speak to me in English; I just tell them it’s easier.”

Chambers and Robertson said they hoped the provincial government would facilitate credential recognition for immigrant doctors and pay more attention to work-life balance for young doctors, to bring more doctors into the profession. Robertson also suggested that patients put things into perspective. “If you have a medical emergency, you go to [Jeffery Hale Hospital] and wait for five or 10 hours, but you will get seen,” she said. “If we lived in Gaza or Ukraine or one of those [war zones] we wouldn’t get anything. Spending hours in a hallway is better than being in a conflict zone.”

Walling said patients whose family doctor is retiring should sign up with the GAMF as soon as possible; those who need a prescription renewal or an appointment in the short term, or have health questions, can call the province’s bilingual 811 health helpline. When minor medical emergencies arise, the minor emergency clinic at Jeffery Hale Hospital is mandated to serve patients in both English and French. At other health facilities, if no one is available to provide service in English, patients have the right to an interpreter, although, as Walling acknowledged, “it may take time to find the person.”

AMOQ spokesperson Line Parent told the QCT the association doesn’t record data on the first language of its members, but “most doctors in the region get on pretty well in English, given that the text- books used during their studies are exclusively in English.”

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