Family doctors have rejected the Quebec government‘s latest offer in the negotiations to renew the framework agreement. The 150 delegates of the Fédération des médecins omnipraticiens du Québec (FMOQ), which represents family doctors in the public health system, unanimously rejected the offer in a vote held over the weekend. The offer tabled by the government on March 19 would have changed the remuneration model for family doctors, particularly by introducing colour codes for each patient. The offer published on the Treasury Board’s website stated the government wanted to introduce “a performance-based principle, with relevant clinical performance indicators determined by the Ministry of Health.” In late April, Health Minister Christian Dubé tried to reassure Quebecers they won’t lose access to their family doctor or be bumped down by the new system. But family physician and head of the Montreal Association of Family Physicians, Samer Daher, doesn’t buy it. “The government came back again with the coloured sticker offer for patients, and this, as soon as we saw that point, everyone went, ‘I was insulted,’” he said. “We said ‘We’re not going to go with that. We’re not going to deregister patients.’ And they keep on saying, ‘No, no, it’s not that,’ except it’s written, it’s in there, and we’ve been waiting for over a week now for them to prove it and give us another text. And they’re not doing it.” Proposed colour system The government‘s proposal relied on colour codes established by the Institut national d’excellence en santé et services sociaux (INESSS) based on a patient‘s health condition to determine family doctor remuneration. The colour codes were: $12 for a green patient (patients with episodic problems); $74 for a yellow patient (minor chronic health problems with no functional impact); $124 for an orange patient (moderate health problems requiring regular follow-up, such as cancer); and $223 for a red patient (major health problems with complex conditions). But Daher said the colour system is flawed because people’s health status can change suddenly. “I’m green, so the government is telling me I’m going to lose my family doctor. What if something comes up? I mean, I can change from green to red in a few seconds. A stroke, heart attack, a car accident, God forbid. Why would we go there?” he said. Daher said the government is trying to force doctors to bear the burden of its inefficiencies. “Sorry to say that doctors do not trust this government anymore,” he said. He said he agrees with the government that the health care system’s performance needs improvement. However, he said, doctors are not being given the tools to perform. Lack of health care professionals He pointed to ongoing issues with the Maisonneuve-Rosemont Hospital renovations, the lack of family doctors and the distribution of nurses in clinics as ongoing problems. Quebec is lacking up to 2,000 family physicians and has about 104 family doctors per 100,000 people, according to Daher, adding that the “policies of this government are pushing doctors away from the province or into the private system.” “Every single bad step they’re taking, they’re blaming it on someone else ... so we’re not going to be relying on a government’s performance,” said Daher. In Saturday’s announcement, the FMOQ said it also rejected the Quebec government‘s proposal to withdraw family doctors from patients who are registered individually in order to register them collectively. “What we want to give as a message to the population is we’re not letting you down. It’s this government that needs to reassess their own priorities,” said Daher. Treasury Board President Sonia LeBel’s office said it has taken note of the FMOQ’s rejection of the proposal. “We will continue discussions with the FMOQ. No one will lose their family doctor. We are working to ensure that Quebecers have access to the right professionals and care when they need it,” it said in a written statement Sunday. With files from The Canadian Press
