Quebec’s proposal to prioritize sick patients for family doctors stirs debate over fairness

Some say the new system for prioritizing patients for doctors in Quebec is unfair.

A new provincial proposal could see Quebecers with complex health conditions fast-tracked for a family doctor - but not all patients are on board with the idea.

The Quebec health ministry’s plan would prioritize patients based on their health needs. While some support the idea, others argue people could fall through the cracks.

“I know as a healthy person I wouldn’t mind someone getting care ahead of me,” says Nick Quenneville, who sees merit in the system.

But Avi Ensafi says that “It’s discriminatory.”

The proposal would see patients categorized by colour, with doctors being paid yearly per patient based on that colour.

• $12 for green patients generally in good health
• $74 for yellow patients with minor chronic conditions
• $124 for orange patients with moderate health conditions
• $223 for red patients with serious complex health conditions

Even seniors, who could benefit from this system, are voicing concerns.

Tulin Yurtcu, 87, is worried the plan will have unintended consequences. “That will be a disaster.”

Daphne, who was worried about sharing her last name said “I’m grateful to be prioritized because I need the help, but I don’t feel it’s fair doctors should be paid more for that.”

Family doctor Michael Kalin explains that patients are already categorized as vulnerable or not, and doctors are paid an annual stipend for the former. He sees the proposed system as a more nuanced version that makes room for more variability.

He adds that it makes some sense why doctors should be compensated more for patients who require more visits, referrals, or time.

“The remuneration must be consistent with the difficulty, the challenges with that practice profile,” says Kalin.

He also says the plan has a good goal: to incentivize doctors to take on more patients, particularly vulnerable ones. But recognizes it could leave others behind.

“I can hear from my colleagues, there’s a lot of trepidation here, as there always is whenever there’s a new program being implemented. It will take time for us to understand it and to digest it.”

The fear is that green or yellow patients will have a harder time finding family doctors.

“First of all, having a family doctor is like, kind of a blessing. You’re blessed,” says Beko Dro. “You don’t need to stress anymore.”

The Quebec Federation of General Practitioners is currently in negotiations with the government to determine how to get more Quebecers the care they need.