Doctor Shortage

By Trevor Greenway

The head of family medicine in the Outaouais says that doctors in the region are feeling “undervalued” in the face of Bill 106 – so much so that 33 of them have already moved to Ontario or taken early retirement. 

Dr. Guillaume Charbonneau, president of the Association of General Practitioners of Western Quebec (AMOOQ), and his team conducted a survey of their doctors earlier this summer on the impact of Bill 106. The survey found that 33 doctors had already decided to either move to Ontario or close their practice. Hundreds more reported that they are considering leaving the Outaouais. 

Bill 106, tabled in May, would link up to 25 per cent of physicians’ pay to their performance in an effort to get them to take on more patients. And with the Outaouais already short 2,000 family doctors, practitioners are preparing for another healthcare crisis in the region. 

“If we lose 30 to 40 doctors, it will take years, maybe, to catch up, with the way it’s going now, and that will create a lot of difficulty for the people in the Outaouais, in a region where citizens already struggle to get access to healthcare,” said Dr. Charbonneau, “So we cannot be a side effect of the way that the government decides to approach the negotiation with doctors.”

Charbonneau and other doctors  the Low Down recently spoke to about this bill cited fear over Santé Québec’s push for “quantity over quality.”

“So with this bill, we feel that they will ask us to do fast food medicine, and we fear that we won’t be satisfied with the job that we do with the patient. And for us, that’s more important,” said Charbonneau about Bill 106.  “We want everybody to have access, but what is more important at the moment is the patient that we have in front of us, and that we feel that we don’t want to risk his or her safety because we have pressure to see the next patient.”

One of the doctors surveyed by Charbonneau and his team this summer and who said he’s leaving the province is CISSSO department head Dr. Joseph Youssef, who’s already taken steps to obtain a licence to practice medicine in Ontario. 

“In Ontario, doctors are valued,” said Joseph, who is the head of Home Support Services, CLSCs and Day Hospitals, and the medical coordinator for Hospitalization at the Hull and Gatineau hospitals. “Here, it’s the opposite.”

According to several doctors and health advocates the Low Down has spoken with, including SOS Outouais and Vigi Santé, the Outaouais region is particularly vulnerable because of its close proximity to Ottawa. Ontario’s health department has more resources, better working conditions and higher salaries for doctors, nurses and technicians. 

But Dr. Charbonneau says that a “blanket approach” to healthcare in Quebec won’t work because the region is so unique. 

SOS Outaouais president Jean Pigeon said the fact that 33 doctors have already left and hundreds more are considering leaving in the face of Bill 106 is concerning.

“It’s kind of worrisome to think that that’s already taking place and the law has not yet been put into service,” he told the Low Down. “[The government doesn’t] even care that a doctor can just say, ‘Well, I’m not happy with this. I’m just going to cross the bridge in the morning. I don’t have to move. I don’t have to change schools for my children. I don’t have to go and reside in a different province. I can stay in my nice home in Wakefield or Chelsea and just drive and go and work in Ottawa, and I won’t have to have this new law that I have to abide by.’”

According to Vigi Santé, Wakefield has lost four doctors at its two clinics in the past two years. There are currently close to 8,000 people in the MRC des Collines region without a family doctor, which represents about 18 per cent of the region’s population. 

Gatineau Emergency room practitioner Dr. Peter Bonneville told the Low Down that, “I’m not leaving and I’m not considering leaving.” 

However he said that he is “on the fence” when it comes to Bill 106, as the bill’s intention is about giving more patients access to healthcare. Where it falls short, according to Bonneville, is the forceful nature of the bill.

“We want people to have access to healthcare, mainly to the frontline. That’s sort of a good thing of the bill,” said Bonneville. “I think the bad thing of the bill is that it’s sort of being rammed down doctors’ throats.”

Bonneville said that he understands what Santé Québec is trying to do – to increase the number of patients a doctor sees, ultimately giving Quebecers more access to healthcare. However he and others have argued that the region lacks resources and technology to seamlessly integrate remuneration linked to performance, as family doctors need access to hospital staff, scanners and experts to fully care for a patient. 

He had a pointed message for Health Minister Christian Dubé: “You want me to be more performant, but when I see patients in my office, it’s a one-year waiting list for a scan, a two-year waiting list for an MRI. It’s a three-year waiting list for a cardiac ultrasound. And you want me to be performant, but those people, they keep on coming back to my office because their problem is not solved, because I did not have access to tests.” 

Vigi Santé is hosting a doctor’s recruitment event this week to woo some young doctors into practising locally in Wakefield, as well as at the new family medical clinic that is set to open its doors in Chelsea next year.