Healthy Quebec kids can no longer see pediatricians, must now find a family doctor

Alix Née says when her son Lucas was born, she searched high and low to find a pediatrician who could follow him as he grew up, ensuring he met all his milestones and kept up developmentally.

Now, she says she's furious that after her frantic search, she has to start all over -- this time in pursuit of a family doctor.

Why? Because of a move in Quebec to stop pediatricians from following healthy children.

"I had to network my way to find a pediatrician," she tells CTV News, adding that she doesn't have a family doctor for herself. "He was very well followed after being born at Sainte-Justine [Hospital]. Then, eventually, they were like, 'you're on your own.'"

Née points out she's been on the waitlist for a family physician for the last five years -- despite being considered a priority case since she has diabetes.

"It's petrifying," she says of potentially not having a doctor to follow her son regularly. "They're so small; you have so many questions. It's really scary. You go from being very well taken care of [at the hospital] to being all alone."

A COMMON PROBLEM

Camille Dolbec is just one of many Quebecers living in a mix-and-match situation -- both she and her three-year-old daughter have family doctors (albeit not the same one), but her husband and newborn son do not.

She says when little Léon was born she noticed he had a hernia-type growth near his bellybutton.

"I called 811, who told me to call a CLSC nurse who checked it," Dolbec said. "But she didn't do a complete exam."

Dolbec says her son hasn't seen a doctor since that day.

"Of course it makes me anxious," she said. "There are moments where I see him, and I say, 'I see him. He's healthy.' I can be rational, but when there's a little something, I worry. He could be missing something or there could be a problem I don't see."

She says she thought she had lined up a family doctor for Léon, but received some bad news when he was just a few weeks old.

"I was told they were full and couldn't take him," she said. "I tried another place when he was six weeks old, but they told me they only take babies four weeks and under. Honestly, I'm not very emotional post-partum, but that affected me. I cried for days."

Dolbec says she has taken her son to see several specialists, such as an osteopath to fix a torticollis issue -- but it was always up to her to keep a keen eye on any issues he might have.

NOTHING NEW

This move to bar pediatricians from following healthy children is an initiative that was agreed upon between the Quebec government and the Quebec Association of Pediatricians (APQ).

"Since Dec. 1, 2021, the general examination for the evaluation of the growth and development of a healthy child by pediatricians, whether in the office or in the hospital, has been abolished," the Quebec Health Ministry (MSSS) tells CTV News.

The goal is to allow pediatricians, who specialize in treating children, to take on the more dire cases rather than follow healthy children -- something a general practitioner (GP) is qualified to do.

"Pediatricians are mostly trained to take care of kids that present with either acute or chronic complex conditions," explains Dr. Amélie Du Pont, vice president of the APQ. "Healthy children who can be taken care of, for example, very well by family doctors and nurse practitioners, are reoriented towards those health care professionals so that we're sure every kid has access to the right type of care."

The issue in Quebec, however, is there are thousands of people still waiting to be paired with a GP.

One solution: parents heading to the CIUSSS with an 18-month-old can select the ABCdaire 18 months+ check-up, which allows them to consult with a medical specialist on their child's growth projections.

"Questions are asked about your child's general development," says the MSSS. "Following this appointment, if difficulties are identified, early action screening or another appropriate service may be suggested."

The ABCdaire 18 months+ service has been offered across the province since spring 2022, according to the Quebec health ministry.

Since then, it notes more than 28,000 children have been seen by a health care professional as part of the program.

"We have seen very good results so far," the MSSS states. "Children at risk of developmental difficulties are being detected earlier and taken into care according to their needs."

So far this year, the health ministry says that 4,632 children have received referrals for screenings to detect potential developmental difficulties.

Nevertheless, this isn't good enough for some parents, who say they would rather have a doctor regularly follow their child from birth.

"We had a CLSC nurse, and I e-mailed her a few times with a few questions, and at some point she told me, 'You have to talk to your doctor,'" Née says. "I'm not happy about it; I don't want to hear about this."

Du Pont says there are no consequences for pediatricians who continue to see their healthy patients.

"To my knowledge, there are no consequences in terms of sanctions," she tells CTV News. "There's no payment [from the Régie de l'assurance maladie du Québec (RAMQ)] if they see healthy children, but there are no sanctions."

Née, who immigrated to Quebec from France 12 years ago, argues it might just be easier to have her son see a doctor when they travel back to Europe to visit family.

"I'm travelling to France for the holidays, and it's so easy to see a doctor in France," she said. "It would be easier to wait for my travels to another country to book an appointment with a doctor there than to see one in a country where I live and where I pay my taxes."

As for Dolbec, her daughter's family doctor is currently on maternity leave. 

She says her only hope is that she will accept Léon as a patient upon her return to work.

Until then, his name waits patiently on Quebec's Family Doctor Finder (GAMF), along with his dad's.

WHAT TO DO

According to the Quebec government, children under the age of two are classified C on the ABCDE priority scale of the GAMF.

Anyone looking for a family doctor can register on the wait list.

To qualify, a person must:

• Not have a family doctor;
• Have a valid health insurance card;
• Live in Quebec at the address currently indicated with the RAMQ (excluding Nunavik or Terres-Cries-de-la-Baie-James);
• Be 14 years or over to register for themselves or someone under this age restriction.

Those already on the waitlist can get a medical appointment through the GAMF by calling 811 and selecting option 3.