The proposed super clinics Health Minister, Gaétan Barrette, does not arouse enthusiasm among family physicians in Quebec. So far, twenty clinics have contacted the Ministry of Health for details on obtaining this status, but none is still officially committed to the process. And at least three major polyclinics, who were approached candidates to become super clinics refuse for the moment to embark on the project, arguing that the requirements are too great, learned.
What is a super-clinic?
On 25 April, Minister Barrette presented the framework for managing 50 new super clinics he wishes to place in Quebec by 2018. The super-clinics will be family medicine groups (GMF), which will offer more services and in return receive more funding.
Some requirements of super-clinics:
Opened 12 hours a day, 7 days 7
Give a minimum of 20 000 visits per year
Enable decision appointments each day until three hours before closing
Provide more coverage during the annual flu episodes
Provide access to levies and public ultrasounds
“Accept is shooting themselves in the foot”
Medical Polyclinic Pierre-Le Gardeur in Repentigny has the ideal profile to become a super-clinic. It already treats 35,000 patients annually, is open daily until 16 pm on weekends, and offers access to laboratory and radiology services. Nevertheless, the establishment does not want to become a super-clinic. “There is no real benefits. Accept is shooting ourselves in the foot, “claims co-director of the clinic, Dr. Luc LaSalle.
“Barrette attacks only the first trios”
Dr. LaSalle is not against reforms minister Barrette. He says 40% of the province’s family doctors have fewer than 500 patients in care, which is “unacceptable.” But the super-clinical management framework is as unfair to him. “Doctors, we are like a hockey team. We are privileged in society. And we have the first and fourth trios. But part of super-clinical management only attack the first trios … It does not make sense, “he said. “Instead of installing four super-clinics in Lanaudière, why do not require all existing FMG to offer more hours? “He asks.
“Not all urgent cases”
Dr. LaSalle added that many of the patients who visit the service without appointment of its polyclinic are “not urgent cases”. “If they have not been seen before 16 pm on weekends, these cases can wait until Monday,” he said. Dr. LaSalle emphasizes that when the weather is fine or, for example, the Montreal Canadiens play the waiting room of his clinic is empty. “The demand, it is not necessarily there,” he notes.
“The super-clinics, we will fulfill them, said Barrette”
“I ask the doctors to start, and then we will adjust the shooting. The public expects that. The super-clinics, we will fulfill them, “replies the minister Barrette, accusing doctors of sulk his project because they do not want to work weekends. If too few patients presented in super-clinics on weekends, doctors could take the opportunity to enroll appointments, he said. Hospital emergency rooms could also refer less urgent cases in the super-clinics. Convinced that the super-clinics are “the main solution to emergency overcrowding problem,” the minister said Barrette not rule out the possibility to “take appropriate measures” to encourage clinics to participate.
“He hits the best”
“Over 5000 practitioners already working in the evenings and on weekends! Several guards are in hospital, obstetrics … To say that our doctors do not want to work evenings and weekends because they want dinner at the restaurant, it’s insulting, “tonne President of the Federation of Physicians General practitioners of Québec (FMOQ), Dr. Louis Godin. Director of the Medical Polyclinic Pierre-Le Gardeur, Fabienne Dionne, agree with him. “The atmosphere is already tense now. They accuse doctors of not doing enough. Yet our doctors are working very hard. But patients are increasingly aggressive. It’s sad, “she said. Ms. Dionne said reforms include Barrette minister, “but it hits on the best.”
Dr. Godin explains that the FMOQ had already proposed to Quebec to create a network of 70 clinics open 76 hours a week until 16 pm on weekends. With its super-clinics, the Minister Barrette wants rather to establish a 50 clinic network, open 84 hours per week until 20 pm on weekends. According to Dr. Godin, the Polyclinic Concorde in Laval has been open 12 hours a day. “But they finally dropped those hours because it did not meet the needs of the population. I’m willing to convince my board members. But nobody is demonstrating the need for that, “he said. The Association of Medical Clinics Quebec (CEQM), which held last week a special meeting with several GMF-network in the province to discuss the project, the opening hours are not “the main issue.” “There are concerns rather like the problem of access to radiology services on the weekend,” says the General Manager, Isabelle Girard.
No enthusiasm in Laval
In Laval, the 25 doctors of Concord Medical Polyclinic have not yet ruled definitively in the super-clinical folder. “But there is no great enthusiasm. There are more doctors are against it now, “says Dr. Patrick Parise from the polyclinic Concorde. At least one other GMF-network Laval is in the same situation. If the GMF-network refuse to become super clinics, they will “fall back on their mission GMF” notes Dr. Godin, who believes that without a family doctor patients will then be less well served. “We will stop clinics that work, just because we do not meet the standards imposed upon us … It does not make sense,” says Dr. LaSalle.