No family doctor? One phone number will soon connect you to health services in Montreal

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"Gradually," is the word the president and director-general of Montreal's South-Central CIUSSS used several times to explain how a new primary care network will be deployed for people in Montreal who don't have a family doctor.

Sonia Belanger's cautious tone reflects the complexity of the ambitious project, which will officially launch in April.

Its success will depend on a sound technical setup and most of all on finding enough health professionals in Montreal, especially nurses, to answer calls and consult with patients.

"I'm convinced it will improve access. No system is perfect but I hope it's several steps in the right direction. We'll adjust as we go,” Belanger said as she provided a sneak peek at exactly how the new hub is expected to operate when it officially launches in April.

Of the 1.8 million people residing in Montreal, nearly 800,000 of them are without a family doctor. Only half have put their names on the approximately two-year waiting list.

That waiting list can be accessed online or by phone and is known in French as the 'Guichet d'access a un medecin de famille' (GAMF).

This new project is broadening the role of the GAMF and will transform it into five ‘guichets d'acces a la premiere ligne,' or GAPs: five front-line services hubs that will be operated by the CIUSSS in each of Montreal's five health territories.

ONE PHONE NUMBER, ONE CALL

It might sound a little confusing, so to make it simple for people to use, there will be just one number to call for any non-emergency issue, like "an earache for example, or a vision problem,” Belanger said.

"We don't want it to be complicated. People don't always know which CIUSSS is in their territory so for the population there will be one unique phone number,” Belanger said, that will be publicized at a later date.

A nurse will answer the call, gather some basic information and will then transfer the person to the GAP in their area.

"There at the access point, there will be an evaluation with a professional on the phone. They can sign up for a family doctor and they can ask for help if they need it,” Belanger said.

WHAT KINDS OF HEALTH SERVICES WILL BE AVAILABLE?

"Depending on the person's needs and priority we can give access within 48 hours to a health professional,” said Belanger.

She said the referral would be "either to a doctor - but if there's no doctor then, depending on the situation, they can have access to a nurse practitioner, a nurse, a social worker or even a pharmacist.”

Frequently she said, people just need to renew a prescription, but without a family doctor to turn to they don't know how to go about it.

"Pharmacists in many circumstances could renew,” Belanger said.

It will take time before they'll be able to integrate other professionals and services into the mix, like psychologists or physiotherapists, support that GPs say they need if they're to take on new patients.

Still, GPs will be called upon she said to help make the new system work.

"All the GMF's [family medicine groups] will have an obligation to have an appointment system,” that will be connected to the new GAPs.

"The doctors…will have to take the people who are on the list, it's very important,” she said. 

“It’s a big challenge, a big, big challenge. We’re missing many nurses now also."

The hope is that those who have been working in hospitals and vaccination centres over the last two years will return to help.

“We’ll continue to recruit. We need them, it’s clear,” said Belanger.