Young doctors worry Bill 106 will make more early-career physicians leave

Montreal Gazette

6 days ago

News
The Quebec government's bill to change how doctors are compensated fails to address serious flaws in the health system and could make it even harder to retain young professionals, according to early-career physicians and medical students.
The president of the Association des jeunes médecins du Québec, which represents young doctors, characterized the Health Ministry's goal to strengthen access to health care as 'noble.'
'The problem that we're noting is that this isn't the best approach from our perspective as practitioners,' Dr. Chakib Setti said Tuesday night during committee hearings into Bill 106.
Health Minister Christian Dubé's bill proposes tying up to 25 per cent of a doctor's salary to various performance objectives in an effort to see them take on more patients. About 1.5 million Quebecers do not have a family doctor or regular health-care professional.
While Dubé and Premier François Legault have staunchly defended the plan, several medical federations and doctors argue the bill could push physicians out and leave patients behind.
Quebec was already facing a problem before the latest legislation, according to Setti. He said up to 50 per cent of young doctors are currently considering settling elsewhere.
'We think there are a lot of young doctors at risk of leaving, unfortunately. Not leaving the public system, but the province,' he said.
In the hours after Bill 106 was tabled, four colleagues said they had had enough and will be leaving the province, Setti said in an interview with The Gazette earlier this month. That came after 28 physicians told him they planned to leave due to Bill 83 requiring new doctors trained in Quebec to practice for five years in the public system or face fines.
The AJMQ and the Fédération médicale étudiante du Québec, which represents medical students, both worry Bill 106 won't fix some of the long-standing issues in the health system.
They pointed to a shortage of other health professionals — a problem one family doctor previously testified falls on his shoulders. In one example, Setti said some patients have no choice but to turn to doctors instead of psychologists because they can't afford the fees.
Maxence Pelletier-Lebrun, president of the FMEQ, said if the bill goes ahead as is, more Quebecers may have access to a family doctor 'but only on paper.'
'They won't be able to see a doctor when they need it because their doctor will be crushed under the number of patients that largely exceeds their environment's capacity,' he said.
Fewer clinical services even as docs 'work a lot'
Economist and HEC Montréal professor Pierre-Carl Michaud and his team were asked by the Health Ministry to look at doctors' compensation and medical services.
The report, tabled this month, concluded a 'sustained growth in compensation, accompanied by stagnation or even a decline in the availability of medical services' after analyzing figures from 2010 to 2023.
'We can find that, at once, doctors work a lot, which was found in the report. But at the same time, they are doing fewer medical services than before,' Michaud said during the hearings Wednesday. The brief submitted was also titled what roughly translates to: 'Physician compensation in Quebec: The status quo is no longer an option.'
The report highlighted how both family doctors and specialists reported working an average of 46 weeks in 2021. But RAMQ data from the same period showed family doctors reached a 'minimum billing threshold' during 37 weeks on average and 32 weeks for specialists.
'This implies that about one in four weeks worked was not dedicated to fee-for-service medical care,' the report said.
'Physicians likely engage in significant non-clinical activities, as the number of weeks reported in the censuses far exceeds the number of weeks with clinical (fee-for-service) activity recorded in RAMQ data.'
Michaud and his team found the trend in the supply of medical services 'is likely insufficient to meet the growing needs of the population.'
Calls for calm amid letters to patients
Earlier Wednesday, opposition politicians addressed reports that some doctors and clinics reached out to patients directly. Some patients were reportedly told access to their family physician could be 'compromised' if Bill 106 becomes law.
'Honestly, sending letters to your patients, I find it skirts the ethical border,' Liberal health critic André Fortin told reporters, but he said concerned doctors have 'worthwhile arguments' that deserve to be heard.
Dubé, for his part, said he didn't like threats. He has asked the Collège des médecins to investigate if clinics were co-ordinating efforts.
The timing of the bill has also come under scrutiny as it was tabled during ongoing contract negotiations with two of Quebec's federations representing doctors. Dubé recently hadn't ruled out invoking closure, but he said during a scrum Tuesday afternoon that Bill 106 won't be adopted this session and he would like for discussions to continue.
Parti Québécois MNA Pascal Paradis said Wednesday that the tone 'needs to be lowered' and there should be a 'frank discussion' about the bill.
'It's time to listen and engage in dialogue to find the best solutions for Quebecers.'
This story was originally published May 28, 2025 at 4:11 PM.