Published November 6, 2024

Tashi Farmilo
Local Journalism Initiative

QUEBEC – In response to longstanding family doctor shortages, the Quebec
government is considering redirecting healthy residents away from regular family doctor appointments to the Guichet d’accès à la première ligne (GAP), a centralised access system for primary healthcare. This proposal, aimed at alleviating the load on family doctors, is a central issue in ongoing negotiations between the Coalition Avenir Québec (CAQ) and the Fédération des médecins omnipraticiens du Québec (FMOQ), the union representing Quebec’s family doctors.

Dr. Thomas O’Neill, a seasoned family physician practising in the Pontiac, voiced significant concerns over the proposed approach. “Redirecting healthier patients to GAP may appear efficient, but it risks stripping away the essential preventive care family doctors
provide,” O’Neill remarked. “Our role is not just about treating illness; it’s about knowing the patient’s history and providing continuity in care, which ultimately reduces pressure on emergency services.” O’Neill further noted that short-term visits to GAP cannot replace the depth of care offered by family doctors, especially in rural areas where options for healthcare access are already limited.

Quebec’s Minister of Health assured residents in a statement saying, “Quebecers who have a family doctor will keep them.” He emphasised the government’s commitment to fulfilling healthcare promises outlined in the 2022 health plan, with a focus on making healthcare access more straightforward for all Quebecers.

However, the CAQ’s approach has drawn sharp criticism from opposition parties. Joël Arseneau, health spokesperson for the Parti Québécois, condemned the proposal as a breach of the CAQ’s prior commitments to provide a doctor for every Quebecer. Arseneau argued it’s not a sustainable solution and could negatively impact Quebecers’ access to family doctors, especially those who have waited years to secure one. He expressed particular concern that GAP, which would be managed by the new Santé Québec health agency, could suffer from its own accessibility issues, thus creating additional barriers for residents in need of regular care.

Pontiac MNA André Fortin, Liberal health critic, questioned the potential impact of the proposal on patient-doctor relationships. “This approach is a reactive measure that could dismantle crucial bonds between patients and their family doctors,” Fortin stated. He argued Quebecers will ultimately be pushed to emergency rooms or private clinics, “leaving them with an inconsistent healthcare experience.” Fortin also stressed that instead of offering long-term solutions, the policy might cause greater instability in healthcare access, particularly affecting preventive health services.

Vincent Marissal of Québec Solidaire added that this measure could encourage a trend toward private healthcare. He highlighted that even healthy patients benefit from the continuity of care a family doctor provides, noting the history and insight physicians maintain about their patients are crucial, regardless of their health status.

Dr. O’Neill noted that policy decisions from over a decade ago contributed to the doctor shortages seen today, as medical school admissions were cut. “These past decisions are leading to complex gaps in care for Quebec’s aging and diverse population,” he concluded.

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