By Christopher Curtis
Just like Santa Claus and Richard Nixon before him, François Legault is making a list.
And while we can’t confirm if he's checked it twice, we know that
list contains the names of 4,000 doctors who aren’t working hard enough —
according to Legault, at least.
Two weeks ago, the premier admitted that his government used
emergency powers granted during the pandemic to circumvent privacy laws
and obtain the patient lists of family doctors across Quebec. By his
government’s reckoning, some 40 per cent of family physicians in the
province don’t have enough patients in their practice.
He’s ready to draft legislation that would force these allegedly lazy
doctors to provide care for a minimum of 1,000 patients. I suppose
that’s easier than breaking into their homes and leaving a lump of coal
in the sock drawer.
But who are these lazy doctors?
Last week, we decided to take a deeper look at the state of family
medicine in Quebec. What we found was a lot of so-called lazy doctors
who work 60 hours a week, balancing their duties as family clinicians
with night shifts at the ER and days off spent catching up on paperwork.
A ‘negotiating tactic?’
Take Simon-Pierre Landry, for instance. According to our government,
his 1,000 patients constitute the bare minimum workload for a family
doctor. He pulled out his daily planner to show how he spends his days.
“Okay, so Thursday and Friday I did two night shifts at the emergency
room and had a day off Saturday,” said Landry, a family doctor in the
Laurentians. “Sunday I was at the clinic seeing patients, and Monday I
was back in the ER. Tuesday as well. Wednesday I was on call for 24
hours at the ER and worked a day shift at the hospital. I had a day off
Thursday but spent it doing paperwork.
“Today I’m at my clinic seeing patients. Saturday and Sunday too.
Monday I’ll be at the emergency room, and Tuesday it’s back to my
clinic. In the winter I try to have one day off a week to be with my
To break it down, Landry — a family doctor — spent just five of his
last 12 shifts seeing patients in his clinic. He doesn’t choose to work
so many hours at the hospital: he’s legally required to. Beyond work at
their clinic, family doctors are required to choose an additional
practice to help with Quebec’s bottlenecked healthcare system. They can
do shifts in an ER, a long-term care centre, in palliative care or in
When Legault and Minister of Health Christian Dubé say people like
Landry need to take on a bigger workload, are they aware doctors have
these additional responsibilities?
“Do they really believe what they’re saying? Because if they do, then
they don’t understand how their own healthcare system works and that’s
worrying,” said Landry. “Or is this a negotiating tactic? I don’t know.
It’s cynical, it’s discouraging and it’s harmful. Doctors coming out of
school see this witch-hunt and they’ll just avoid working in the public
Roughly 860,000 Quebecers are on a waiting list to get a family
doctor. That’s more than twice what the number was when Legault’s
Coalition Avenir Québec came to power three years ago.
Access problems are bigger than doctors
In a press conference last week, Legault said his “patience is
wearing thin” with family doctors and implied there would be
consequences for physicians who don’t dramatically increase their
“I can see him, three months from now, making this a platform for his
re-election,” said Claudel Pétrin-Desrosiers, a family doctor in
Montreal. “He’ll say, ‘We forced 400 doctors to take on 1,000 new
patients each. That’s 400,000 Quebecers that now have a family doctor
because of us.’
“Well, good luck getting an appointment. Because even people with a
family doctor know how long it takes to see them. If we all take more
patients, the problem of access won’t be solved. People will wait months
to see their doctor, they’ll wind up going to the ER and adding to the
Because family doctors have to contribute to the healthcare system
outside of their own practice, their time is split between their clinics
and other facilities. In other words, there are almost no full-time
family doctors in Quebec.
Catherine de Montigny has been on the front lines of the worst
overdose crisis in Quebec’s history. While opioid overdoses kill an
average of roughly one Quebecer each day, de Montigny works with
patients trying to find a pathway out of addiction.
Because she’s one of the rare doctors in the province specializing in
substance use disorder, there are weeks when de Montigny is on call for
the entire province. Any nurse, doctor or medical professional who
needs advice on detox or rehab will reach out to de Montigny. In
addition, she sees patients in her family clinic.
“I am what François Legault considers a lazy doctor,” she said. “I
have patients with dementia, patients who are homeless, older patients
who are getting sicker and sicker. People are not just numbers on a
spreadsheet. I’m not even close to having 1,000 patients but I’m working
six days a week, some weeks, just trying to keep up with what I already
Mathieu Pelletier runs a family clinic and teaches on the side. He
works about 60 hours a week but, with 865 patients to his name, he
doesn’t meet Legault’s minimum standards.
“Going after doctors makes for good politics,” said Pelletier.
“There’s an election in one year. Do you really think they can run on
their record — a healthcare system that’s collapsed, skyrocketing
waiting times for surgeries, the sheer number of nurses who quit because
they couldn’t take it anymore? So why not attack doctors? Why not
change the conversation?
“Last year, when med students had to choose their field of expertise,
there were 75 spots in the field of family medicine that remained
vacant. There may have been two vacancies in the specialized medicine
field. This year, I know people who have to reach out to med students
and say, ‘Cover your ears, ignore what the premier is saying, it’s just
politics, it’ll blow over.’ We really have to give them the hard sell
because who wants to join our ranks when you’re being bullied by the