Quebec studying reassigning family doctors based on person's health

The François Legault government could withdraw no fewer than 1.5 million medical appointments from people who have family doctors and redistribute them to people who do not.

This is one of the options proposed by the Institut national d'excellence en santé et en services sociaux (INESSS) in a study on primary care published this week.

Under this option, only the most vulnerable people with health problems would be assigned to a family doctor, to the disadvantage of healthy people. The Coalition avenir Québec (CAQ) had originally promised access to a family doctor for every patient.

During question period on Thursday, Health Minister Christian Dubé referred to new "vulnerability criteria" for care that had been defined by INESSS.

"Doctors have asked us to revise the criteria for patient vulnerability. It's not done like that, by shouting with scissors," he said.

"We will present this list of new criteria to my colleague [Treasury Board President Sonia LeBel] who is negotiating with the doctors, and we will be able to find solutions so that doctors ... are obliged to take on vulnerable patients."

These scenarios are part of the negotiations to renew the agreement with the Fédération des médecins omnipraticiens (FMOQ).

According to the study, there are currently 2.1 million people not registered with a family doctor.

On average, people registered with a family doctor consult between two and six times more clinics than those not registered, depending on their health profile. Conversely, people who are not registered with a family doctor consult emergency departments more often, particularly for non-urgent problems.

For 2022-2023, 4.9 million people considered to be in good health accounted for 7.1 million visits made out of 17.6 million consultations in doctors' offices, specialist nurse practitioners or emergency departments.

Healthy people registered with a doctor would lose 640,000 appointments, while those not registered would gain 780,000.

The second category is people with minor chronic conditions, who account for 1.4 million visits: those registered would lose 170,000 appointments, and those not registered would gain 90,000.

The third category is people with moderate conditions, who account for 5.5 million visits. Registered patients would lose 570,000 visits, while non-registered patients would gain 340,000.

Finally, for those with major medical conditions, patients would lose 140,000 appointments, while non-patients would gain 330,000.

In all, the redistribution of appointments from registrants to non-registrants would total 1.5 million.

This report by The Canadian Press was first published in French on Oct. 10, 2024.