For his health system recovery plan, Minister Christian Dubé has lifted one of the most important commitments of the CAQ. Unfortunately, as promised in 2018, offering a family doctor to all Quebecers by the end of his first mandate is no longer an option.
Instead, the minister proposes setting up a first-line access counter (GAP) for the almost one million so-called orphan patients. Someone somewhere has to refer them to the “right specialist” by phone or internet.
So it doesn’t necessarily have to be a family doctor. At first glance, the idea seems plausible. As long as you don’t have access to a family doctor, many will say, you can take whatever is possible. At least if the GAP works for a big city like Montreal one day.
However, the proposal is problematic. Politically, the government is giving up in the face of a glaring and normal need in an advanced and aging society.
Above all, it forgets the true nature of family medicine. who makes it so important. Why ? The role of the general practitioner is complex and varied. First and foremost, he is the leader of his patients’ well-being.
Guarantor of the rights of his patients
The general practitioner is also the guarantor of the rights of his patients. Rights that are becoming increasingly difficult to exercise in this immense and dysfunctional network.
When care is reputable and official, every GP sees, hears and treats every patient as a whole as a whole person.
He doesn’t see him as a simple patient passing through, reduced to small spare parts that a switch sends separately to this and that specialist without the family doctor monitoring everything.
Having your own family doctor also eliminates the need to consult different doctors in walk-in clinics. Which, as we know, does little follow-up.
On the contrary, GPs are able to develop genuine trust, listening and attention to their patients over time.
Through observation, testing, or screening, GPs will spot problems or deficiencies before they become serious and much more difficult to treat.
I think what does prevention mean? Including even in mental health. Because quick access to psychologists and psychiatrists in Quebec has become a mission impossible.
A vital pillar
When a health problem requires a specialist, GPs also know how to open the right doors for their patients.
For all of these reasons – and many more – it would be risky to try to reinvent the wheel of family medicine. It is an important pillar of the health of people of all ages and social status. Let’s not forget that.
However, if we send orphan patients here and there without this valuable leader being able to draw the overall picture and provide the appropriate follow-up care, how can we know whether the care and services are of high quality or not?
So why give up the promise—and, of course, the challenge—of offering every Quebecer GP care? Quebec has all the necessary resources to deliver this long-awaited commodity.
Quebecers deserve better, says Minister Dubé’s action plan. In force. Doesn’t this “better” start with access to real primary care?
Anyone who is lucky enough to be able to count on their family doctor knows that – or is unlucky enough to remain on a waiting list as an orphan patient. And this isn’t an April Fool’s joke…