Why more Quebec family doctors are leaving the public health system

From The Globe and Mail

For years, large numbers of Quebeckers didn’t have timely access to doctors, creating a pool of potential clients, matched by a pool of unhappy doctors itching to leave the public system. Meanwhile, a significant court case led to the normalization of a competing system outside of medicare.

Quebec has some of the worst indicators for access to primary care. According to Statistics Canada, in 2021, one in five Quebeckers (21.6 per cent) didn’t have a regular health care provider, compared with 10.3 per cent in Ontario and 14.5 per cent nationally.

Those numbers mirror a poll of 9,000 Canadians conducted last fall for OurCare, a countrywide initiative looking at the future of primary care. The survey found that 31 per cent of Quebec respondents didn’t have a family doctor or nurse practitioner they could see regularly, compared with 22 per cent nationally.

Of those without a regular primary-care provider, 37 per cent in Quebec said they have had to pay a fee for non-urgent care, compared with 21 per cent across Canada.

OurCare’s lead investigator, Tara Kiran, said the poll doesn’t differentiate whether respondents paid a doctor or other professionals, such as nurses or pharmacists.

“People who didn’t have access … are turning to all sorts of places to try and get care that’s not urgent but worrisome. And in many cases, they have to pay out of pocket,” said Dr. Kiran, a family physician and scientist at St. Michael’s Hospital and the University of Toronto.

The migration of GPs out of RAMQ is “a crisis for us right now,” said Nebojsa Kovacina, a researcher for OurCare in Quebec.

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