The Quebec government is considering the possibility of changing how family doctors are assigned based on Quebecers’ health to ensure that the most vulnerable have access.
Sources who are aware of the discussions told Radio-Canada about a scenario that has been studied for several months.
According to this scenario, Quebec patients in good health or with minor health problems would be referred to a modified Guichet d’accès à la première ligne (GAP), the service that is currently meant to give Quebecers without a family doctor access to medical appointments.
This GAP would include all Quebec patients with no major or moderate health issues, including those who currently have a family doctor.
Only patients deemed more vulnerable, such as those with complex or chronic conditions such as cancer, mental health issues, cardiovascular disease or diabetes, would be assigned a family doctor.
A report by the Institut national d’excellence en santé et en services sociaux (INESSS), commissioned by the government and made public on Wednesday morning, lays the foundations for such a model.
This INESSS report indicates that 500,000 sick Quebecers do not have a family doctor, and suggests transferring up to 1.5 million annual appointments from patients who have a doctor to those who do not.
Negotiations ongoing with family doctors
In an interview with Radio-Canada last week, Dubé highlighted the need to adapt to a patient’s specific conditions.
“At the moment, we’re giving many people a family doctor without taking note of their condition, and doctors are asking us to say: ‘Well, if we want to take care of people properly, could we be more aware of those who are, I wouldn’t say the most vulnerable, but those who are most likely to be sick?” he said.
Of the 2.1 million Quebecers who were not registered with a family doctor in 2022-23, INESSS estimates that nearly half a million have major or moderate health problems. These patients are classified in the red and orange categories by INESSS.
These categories include, among others, people with depressive disorders, anxiety disorders, cancer, dementia, eating disorders and acute palliative conditions.
Asked to comment on the report on Wednesday, Dubé said it is a good summary of the situation.
On Thursday in a statement on X, the minister said it was too early to determine what would come of the scenario proposed by INESSS.
The scenario being evaluated by the government is part of negotiations between Quebec and the Fédération des médecins omnipraticiens du Québec (FMOQ) that began in May.
The office of Dubé and the FMOQ declined Radio-Canada’s request for comment on the negotiations.