Quebec doctors try to sell Gaétan Barrette on Bill 20 alternatives

General practitioners in Quebec who don't want Bill 20 have offered up a dozen alternatives they say would address the same accessibility problems the government is hoping to solve with a bill the doctors say nobody wants.

Abolishing mandatory hospital work, finally coming through on EMRs and keeping seniors home on wish list

Quebec general practitioners met in Montreal this weekend to discuss what alternatives to Bill 20 would work best. (CBC)

Hundreds of doctors from across Quebec opposed to the government's Bill 20 attended a weekend summit in Montreal to outline alternatives to the controversial bill.

A collective of general practitioners known by the French acronym ROME held a colloquium to discuss other options to Bill 20 which, among other things, would impose a quota on the number of patients family physicians must take on.

​Health Minister Gaétan Barrette has said forcing family doctors to treat a minimum number of patients in their clinics will help more Quebecers get a family doctor.

Quebec Health Minister Gaétan Barrette first introduced Bill 20 in November 2014. (Jacques Boissinot/Canadian Press)

Barrette said it's a better option than the current set-up, which he said encourages people to visit hospital ERs instead of a doctor's office.

But many of the province's doctors fear the proposed Bill 20 will only push more doctors away.

"Imposing quotas to physicians is going to make physicians decide to maybe go to private care, or actually leave the province," said Dr. Tony Assouline.

That, he continued, would end up making it harder for Quebecers to find a family doctor.

Suggested alternatives to Bill 20

Those who attended the ROME conference put together a letter outlining a dozen suggestions for making the health-care system more accessible. 

I can see a greater number of patients if I am not wasting my time over the course of the day trying to get results, trying to get information back that I've asked for.- Dr. Robin Coombs

"We are asking the government to not impose a reform that the majority of health-care professions are against. We are asking the government to rescind Bill 20 and put in place a series of solutions that would respond to the same accessibility goals," the letter reads in French.

The list of suggestions includes better policies for keeping seniors at home for as long as possible, abolish the requirement that doctors perform specific medical activities (which forces them to work outside of their clinics) and push the province to make good on its promise to use electronic medical records (EMRs).

However, Barrette on Sunday said he found the list of 12 recommendations surprising because, according to him, 10 of them are already in the works. He didn't explain which 10 were underway.

He said the doctors he's spoken to have largely agreed that abolishing the mandatory hospital service is not a good option. He also said that doctors are responsible for bearing the brunt of the cost of implementing an EMR system, not the province.

Barrette continued, saying that nothing is stopping doctors from working more closely together with interdisciplinary staff like nurses, pharmacists and social workers.  

"The problem is starting with the doctors," Barrette said. "This bill will stimulate them."

Bill 20 may cause doctor exodus

Some doctors say they would be more productive is the entire health-care system was better organized to promote smoother communication.

Robin Coombs says she would only be able to take on more patients if the government offered better services to doctors, namely better communication of test results, referrals and such. (CBC)

"I am happy providing care for more patients, if I have access to the services I need to provide that care. I can see a greater number of patients if I am not wasting my time over the course of the day trying to get results, trying to get information back that I've asked for," said Dr. Robin Coombs, a family doctor at the Kildare clinic in Côte St-Luc.

Originally from Ontario, Coombs said she would consider returning to her home province if Bill 20 is implemented. She said her possible future decision will be influenced by whether she feels she can continue to provide high-quality care in this province.

"We need to be able to do our jobs — that's the commitment that we've made to our patients, and if we are in a situation where where we cannot provide the quality of care that we've committed to, we may have to make those decisions. So unfortunately, it is something that I have thought about and I know a good number of my colleagues, even native Quebecers have thought about, whether they will be moving to other provinces," Coombs said.

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