Two young ER doctors quit Montreal jobs, blaming Quebec's broken health-care system and Bill 96
Two young emergency room doctors, raised and trained in Montreal, are leaving their jobs after only two years to move back to Toronto – and they say the Quebec health-care model and Bill 96 are to blame.
The doctors, who work at the Jewish General Hospital, are headed back to Ontario, a move they've made before – but this time, they say they don't expect to return home anytime soon.
The married couple says they can't see a way forward in Quebec for themselves and their two boys, aged three and one.
So two different Toronto emergency rooms are preparing for their arrival, with jobs waiting for them.
"It was a really tough decision," said Dr. Daria Denissova, 34. Her husband, Dr. Philip Stasiak, 37, said they made it "with a heavy heart."
"I love Montreal. It's the city I grew up in, and to leave it again for the second time, it's disappointing," Stasiak said.
They are leaving at a time when the Quebec health-care system has been heavily criticized for being fragile.
Montreal alone is short 18,399 health-care workers, according to the government's July 4 health-care system dashboard.
But after all their agonizing, it became clear to the doctors that compared to the hospital system they remember in Toronto, Montreal's working conditions, which they consider to be tough and inflexible, are incompatible with raising a healthy family. They say those conditions are a natural consequence of government rules limiting hiring.
And if they still had doubts about the move, Quebec's new language law, commonly known as Bill 96, sealed the deal for them.
The doctors have no trouble communicating with patients in French or English. They're trilingual: Denissova also speaks Russian, Stasiak speaks Polish.
But they're somewhat concerned that the law aimed at protecting the French language could affect patient care and make an already fraught workplace all the more burdensome.
"It's very fuzzy. What are going to be the true implications of this? Is it political posturing? How are the laws going to be applied?" Stasiak said. "No one really knows."
He expects at the English-designated hospital he works at, he'd be able to continue to use his better judgment, but the unknowns still rankle.
Will it be felt in "my interactions with patients, is it my interactions with my colleagues, when I speak to a consultant or a nurse or someone else from an allied health profession? What about my charting?" he said.
"We're perfectly bilingual, but the thing is, there are so many acronyms in medicine... and to describe that to someone else who needs to have that information transmitted… wouldn't it be better to continue it that way?" Stasiak said.
"I don't like it, as a principle, that you should dictate as to who I should speak to in English or in French," Denissova said, when what matters most is communicating effectively with patients.
"It's infuriating that this is even a conversation to have," she added. "Are people going to have to show their eligibility certificates when you go to the hospital for care?"
They aren't alone in their concerns. Other medical groups, namely Quebec's College of Physicians, have been sounding the alarm about Bill 96 for months.
In an email to CTV News on Monday, Quebec's College of Physicians reiterated that the organization "will remain vigilant" regarding Bill 96 as "the reform could have an impact on the doctor-patient relationship."
"I just didn't want to live in a place where I didn't feel, anymore, was representing my views and values," said Denissova.
THREE PRIORITIES: FAMILY, FRENCH FLUENCY AND FREEDOM OF CHOICE
The much larger issue looming over the young parents, however, is how Bill 96 might limit their children's academic choices when they get to CEGEP age, and after they'd attended French elementary and high schools, as their parents did when they were kids.
"We would want them to have the freedom to choose between, 'You know what? I want to go to an English CEGEP or a French CEGEP,' which is the choice that we had made," said Stasiak.
But they fear changes in the language law might make that impossible.
Bill 96 caps enrolment levels at English-language CEGEPs, and it's expected to make the colleges more and more difficult for francophone and allophone students to get into as their growth will be halted at 2019 levels.
Given the restrictions, the pair wants to ensure their children don't spend all their younger years studying in French in a province that might, later on, slam the door on their future success.
"They're freezing English CEGEP enrolment, and they're prioritizing students coming from English schools – and this is now," said Denissova. "What is it going to be in 10 to 15 years?"
The only possible solution would be to send the boys to private English schools in Montreal that offer a grade 12 option, so they could bypass CEGEP altogether and graduate with an Ontario Secondary School diploma.
But then, their French fluency could take a hit, the pair noted. They say they're in a catch-22 unless they leave Quebec.
"I think the biggest irony is that now we're going to be going back to Toronto, we're going to be sending them to a private French school," Denissova said.
"We want them to be perfectly fluent in French... but not at the expense of their future freedom and future choices and career opportunities," she said.
EMERGENCY ROOM COLLEAGUES ARE 'UNDERSTANDING'
The couple says it's hard to believe they've come full circle and are leaving home again.
They left for Ontario the first time because they could not get permits to practice in Montreal after they completed their residencies at McGill University teaching hospitals.
The government determines how many doctors a region or hospital can hire, using a permit distribution system known as PREMs/PEMs (Plan régional d'effectifs médicaux) – and there weren't any available to them.
So for five years, they worked in emergency rooms in Toronto.
"Then, once we had our first child, we decided, you know, it would be really nice to go back. I miss the French. I miss Montreal as a city. We're going to be closer to our parents," Stasiak said.
Those Montreal elements were great for them: the grandparents, the house, the neighbourhood. After about a year, however, reality set in, they said.
"It hit me that, oh my goodness, this is such a rougher work environment and also there was Bill 96 that was all over the news, so all of these things started dawning on me," Denissova said.
She wondered if they could sustain the workload -- many shifts, and shifts 30 to 50 per cent longer than in Toronto, she calculated -- and remain healthy over the next 20-plus years if they continued on the same course.
The environment, they said, has nothing to do with the way their particular hospital is managed, something Denissova observed when she picked up a few ER shifts at a different Montreal hospital to help her understand the issues she was up against.
Both young doctors believe the "onerous" workload has much to do with the province's permit system.
"Because of the PREM system, the work conditions are a lot more difficult. The work is a lot less flexible in terms of hours, in terms of shifts," Denissova said.
When it comes to that assessment, she has an ally in a veteran Montreal GP who has just taken the health ministry to court over the PREM system and the way it's being used to distribute – or not distribute – family doctors in Montreal.
"It doesn't make any sense that we have restrictions on recruitment," Dr. Mark Roper said, "when we have such a lack of personnel, a lack of emergency doctors. That doesn't make sense, right?"
He believes having more family doctors in Montreal would relieve pressure on swamped emergency rooms because the family doctors would see more patients in their offices and do ER rotations.
"We would for sure welcome and benefit from more physicians," Denissova said. She added that she's discouraged to see that doctors decades her senior are still over-working just as much as she and her husband are.
Nor does she envision they will ever have a flexible work schedule that would allow them to provide better care for their children and get them to and from daycare and school – unless various aspects of the system change dramatically.
"This is true," said Roper. "The PREM system and the PEM system, which is more the manpower controls for hospitals, force the heads of departments only to use full-time doctors, and the part-timers have a very difficult time."
They're so short-staffed, said Denissova, that it would put too much pressure on the rest of the team if she were permitted to scale back her hours for a few years – something she will now be able to do in Toronto.
"Pretty much as soon as I spoke to the department in Toronto where I worked before, they said 'Yeah, of course, we'll take you happily, however many shifts you want to work.'"
The hospital told her that "'if you want to work less hard for a few years of your life because you have younger kids, we can accommodate whatever you want,' she said. "So the contrast was striking."
Telling colleagues in the Jewish General ER about their decision was "tough," said Stasiak.
"These are people that we trained with, that we know, that are our friends -- I feel like we're in a way even maybe letting them down a bit, and they're also disappointed," he said.
"But everyone is very understanding. They get it because they see the conditions," he said.
"We need to do what's best for us, for our family," even if that means leaving others behind.
CTVNews.ca Top Stories
While problem gambling affects a minority of the Canadian population, more than 300,000 are at “severe” or “moderate risk” for gambling-related problems, according to a Statistics Canada study of gambling behaviour.
Anne Heche is on life support after suffering a brain injury in a fiery crash a week ago and her survival isn't expected, according to a statement from a representative.
Cabinet heard of potential 'breakthrough' with 'Freedom Convoy' protesters before Emergencies Act was invoked: documents
The night before the federal government invoked the Emergencies Act in response to the 'Freedom Convoy' protests, the prime minister’s national security adviser told him there was 'a potential for a breakthrough' in Ottawa, court documents show.
Rising over beaches, buildings and statues, the last supermoon of the year created ample viewing and photo opportunities around the world Thursday night.
The City of Toronto is investigating a power outage that left a large swath of the downtown core including office buildings, a major mall and a university campus without electricity yesterday.
Health Canada has recalled Crescent brand sliced pastrami and Tuscan turkey breast sold in Ontario over Listeria concerns.
A federal judge was to decide as soon as Friday whether to grant the Department of Justice's request to unseal the warrant that authorized the FBI to search former U.S. President Donald Trump's Florida estate. Attorney General Merrick Garland declared there was 'substantial public interest in this matter,' and Trump backed the warrant's 'immediate' release.
Scientists are keeping an eye on the Langya virus, a new pathogen that appears to have been transmitted from animals to humans in China and causes symptoms similar to COVID-19 or the flu.
Doug Ford's live news conference on Friday was unexpectedly interrupted after the premier swallowed and choked on a bee.
Two sisters adopted into separate families have found each other after 35 years of separation.
Police in Peel Region have issued a public safety alert regarding the 'heightened risks' associated with visiting a Mississauga strip club.
A plaque commemorating Viola Desmond was revealed Friday by the federal agency at the former Roseland Theatre in New Glasgow, N.S., where she was forcibly arrested while watching a movie on Nov. 8, 1946.
Officials say the wildfire situation in central Newfoundland is improving and the risk of evacuation is now low for nearby communities.
Halifax police say a city park that has been used as an encampment for homeless people has been cleared out and fenced off.
'I own this': London police chief apologizes for officers dead naming transgender activist and commits to update training
London police Chief Steve Williams says he understands the distress that can be caused to a transgender person when their ‘dead name’ (birth name) or incorrect gender is used during an interaction with his officers, and commits to make the necessary changes to internal databases and training.
A helicopter made an emergency landing in front of a home on Bluewater Highway, just north of Grand Bend, Ont., around 9:30 p.m. Thursday.
A London woman is $1 million richer.
In the age of doorstep deliveries, porch pirates who steal items from front doors have become common, but one North Bay mom says she was scared by a recent encounter with one.
A wellness check on a person living on Churchill Avenue in Wawa last month led to the discovery that the victim was being forcibly confined in their home by three people.
There has been another crash on Highway 69/400 north of Parry Sound that has closed the road Friday morning following a fatal collision earlier this week.
Calgary firefighters were called to the Bonavista Church at around 3:20 a.m. on Friday.
Lethbridge police are investigating after a woman walking home from work on Tuesday night was assaulted by a group of men.
After a series of interest rate hikes implemented by the Bank of Canada, housing markets are now facing a 'significant' correction. CTVNews.ca spoke to Canadians who are now struggling to make the goal of purchasing a home, or selling one, a reality.
Wellington-Dufferin-Guelph public health says one person was bit and another was exposed after a rabid bat was found in the Melancthon area just north of Shelburne.
The Region of Waterloo's roadmap toward a population of nearly one million has been updated.
Three community organizations will receive a combined total of $550,000 from the federal government to raise awareness and reduce stigma about monkeypox.
A major thunderstorm hit parts of B.C.'s Interior Thursday night, even causing flash flooding in some areas.
From overall safety to getting back to work in person, a new survey is revealing how Canadians feel about returning to their city's downtown cores.
About 90 Edmonton-based soldiers took off from the Edmonton International Airport on Friday morning for a training mission with the Ukrainian army.
Drew Dilkens will be seeking a third term as mayor of Windsor.
Windsor police have arrested two people after seizing a “large quantity of illicit drugs,” officers said Friday.
The Ouellette Car Cruise is almost ready to roll.
The suspect at the centre of Saskatchewan's recent Amber Alert was arrested in South Dakota for a possible illegal border crossing and kidnapping, according to U.S. Customs and Border Protection.
A memorandum of understanding (MOU) was signed by Premier Scott Moe on Friday that will see more humanitarian flights with displaced Ukrainians land in Saskatchewan.
It’s been seven days since 74-year-old Lois Chartrand went missing while mushroom picking in the forest north of Smeaton, Sask.
One person is dead after a head-on crash on a ramp from the Highway 401 to Highway 416 south of Ottawa.
All eastbound and westbound lanes of Hwy. 417 are closed between Metcalfe Street and Carling/Kirkwood Avenues for the replacement of the Booth Street Bridge. The closure will continue until Monday at 6 a.m.