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Bill 20-Of Blunder and Thunder


The workload of General Practitioners will now be adjusted according to their years of practice and a “patient classification system” to determine the number of patients that they will be following.

Healthcare minister Gaetan Barette has decreed that in the scope of the proposed Law 20, imposition of ‘patient quotas’ on our ‘Family Doctors’ shall be deemed obligatory.

The magic number is said to be 1512 patients.

GPs that follow a clientele of elderly, frail, pregnant, depressed, or those receiving palliative or home care will not have to follow the suggested number of patients or rather ‘the 1512 quota’.

Instead, a type of equivalency system could be applied to calculate the type of ‘care’ required and shall correspond to a numerical ‘value’ to the type of patients they consult.

For example:

Patients in palliative care / care at home = 25 patients

Person with complex needs or severe loss of autonomy /home based environment = 12 patients

Patient with depressive disorders, chronic pain, HIV, Hepatitis C etc… = 2 patients

Patient with misc. specific issue = 1 patient

Routine non complicated patient = 0.8 patient

Other patient related factors will also be taken in consideration and used to weigh the actual number patients that the GP’s will be obliged to consult and in turn, follow.

They are also being told that they have to be more ‘accessible’ to their present patient load. The proposed Bill 20 also states the goal of ensuring an “adherence rate” of 80 per cent — this means that at least 80 per cent of a patient’s visits in Québec should be to their own GP, instead of an Emergency room, walk-in clinic or a hospital.

GPs who do not meet some of these proposed conditions shall risk having their pay reduced, with penalties ranging up to 30% of their salary. Their pay may also be docked if their patients seek consultation in an emergency room or other clinic.

Their work load and in hospital consultations shall also be determined based upon on their years of active practice.

The CLSC Chateauguay has an active waiting list for non complicated patients of 2 – 3 years according to personnel.

Most other clinics in Chateauguay are simply not ‘taking new patients’ yet will deal with emergent situations in the walk in clinics.

Only time will tell how this” new vision” of Health Care will affect the general population in terms of the increasing privatization and pay for service option. General Practitioners will have to assume more patients and this will likely lead to longer waiting times for appointments and accessibility to expedient care in time of need. Those who have the ‘means’ will almost most certainly opt for the ever emerging ‘private clinics’ where an annual fee is collected to facilitate access to a doctor or testing.

How much time will the GP’s also have to spend ‘protocoling’ the next day’s appointments based upon urgent requests for care and those seeking annual checkups or minor consultations?

All of these issues combined shall simply lead to longer wait times for everyone else on the request for service lists.

Perhaps the establishment of 24 hour Super Clinics staffed with GP’s, Nurse practitioners, in addition to diverse professionals with onsite testing facilities should be used conjointly to become first line partners in care.

You can read the proposed Bill 20 with this link.

ChateauguayCitizen.com

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