Decline in the productivity of doctors: the government minimizes the results of the report

File Photo, Simon Clark
The minister of Health, Gaétan Barrette

Patrick Bellerose

Wednesday, march 7, 2018 14:11

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Wednesday, march 7, 2018 14:15

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The government Couillard and the federation of family physicians have minimised choir on Wednesday that the decline in productivity of doctors from 2006 to 2015, despite a significant increase in their remuneration.

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“It is an observation préréforme, said the minister of Health, Gaétan Barrette, on the sidelines of a press conference in Montreal. And what is unfortunate, is that the study does not go far enough to show us to what point the changes give the results today.”

In effect, the period covered by the report ends shortly after the arrival in power of the government Couillard in the spring of 2014. Since then, the government has adopted laws 20 and 130, which provide penalties for physicians who do not reach certain targets of productivity, although their application is temporarily suspended.

The minister Barrette was responding to a study commissioned by the Commissioner of the health and well-being, since abolished, and made public on Wednesday, which demonstrates that the compensation of doctors has doubled from 2006 to 2015. However, the number of visits per family doctor has fallen by 17% during the years studied; for specialists, the reduction is 12 %. The number of days worked follows the same downward trend.

The compensation act

From Paris, where he headed an economic mission, the prime minister Philippe Couillard has acknowledged that it “still has a challenge of productivity in the medical profession”, while lauding the measures put in place by the minister Barrette.

No question, however, to replace fee-for-service physicians for the salaried in the health institutions, one of the main recommendations of the report. “The payment from the act, despite all its faults, makes it so that people has an interest to see more patients, maintains Philippe Couillard. Then, if we change the mode of compensation to remove an incentive to see more patients, it will exacerbate the phenomenon that you just talk to me.”

In addition, he stressed that the mode of payment of doctors is “mixed” and not just based on the medical acts.

Bad indicators

For his part, the president of the Fédération des médecins omnipraticiens du Québec says that the study uses the wrong indicators of productivity. “To judge the productivity just with the number of acts, or the number of visits, it does not take into account the way in which the work of doctors has changed in recent years,” says Dr. Louis Godin.

The creation of family medicine groups (GMF) and the increased collaboration with the nurses changed the game, ” he continues. The doctors are now focusing on the follow-up of the heaviest cases. “Then, as a result, I’m going to do less actions and less visits,” says Dr. Louis Godin.

In addition, family physicians have supported a million additional patients in the two years since, he argued.

For its part, the Fédération des médecins spécialistes du Québec, also referred to by the report, did not wish to comment on. Its president, Diane Francoeur, was in a meeting all day Wednesday and Thursday, according to its communications department.

– With the collaboration of Charles Lecavalier