Latest news with #Bill106
CTV News
3 days ago
- Health
- CTV News
Quebec pediatricians sounding alarm over Bill 106
Quebec pediatricians say that children are being forgotten in Health Minister Christian Dube's Bill 106.
Montreal Gazette
6 days ago
- Politics
- Montreal Gazette
Letters: Health care isn't an assembly line
I think we should be very concerned that Bill 106 proposes to link up to 25 per cent of a doctor's pay to various performance objectives. As a student, I worked on an engine assembly line. The salary was indirectly tied to the number of engines produced. That measure seems reasonable for industrial production. However, I become nervous as a patient when a doctor, in analyzing our health issues, is pressured by performance objectives. Humans are different, and symptoms and conditions are not the same for all. Our daughter graduated almost 10 years ago as a doctor specializing in anesthesiology. Quebec had no residency available for her, but she was offered one in Alberta. She preferred to work instead of waiting another year and hoping for an opening here, so off she went out west. She could come home to Quebec, but would earn less than in Alberta, be chided by politicians to work more, and have no work-life balance. Why should she consider it? Ragnar Radtke, Beaconsfield Democracy in decline under CAQ Re: ' Dubé's bill could push physicians out, doctors warn ' and ' French-language sign rules kick in June 1, and non-compliance penalties are stiff ' (The Gazette, May 28) I wonder just when it was that our governments — and the Coalition Avenir Québec in particular — decided it was their responsibility to arbitrarily impose legislation and regulations onto the backs of taxpayers they purportedly have been elected to represent and serve. Aren't our doctors and retailers significant enough stakeholders in society to be encouraged rather than punished by the province? Unfortunately, under Premier François Legault, Quebec seems to have adopted an Orwellian 'Big Brother knows best' authoritarian mode of government with its unilateral implementation of whatever the CAQ decides is in the best interest of Quebecers. As a result, democracy — famously defined by Abraham Lincoln as 'government of the people, by the people, for the people' — appears to be rapidly disappearing in Quebec. One can only hope that next year's provincial election may help remedy the situation. Eric Bender, Kirkland Grand adventure in art of listening Re: ' N.S. man embarks on 'listening tour' across Canada ' (The Gazette, May 20) As a former oncology social worker at a major teaching hospital in Montreal, I can well appreciate the value of compassionate listening and how it can bring untold benefits to the heart, mind and spirit of someone who desperately needs to be heard. The art of listening is a gift. Too often, people and patients who earnestly wish to express deeply held emotions are cut off by those being spoken to with the offer of deceptive comfort — 'don't worry, everything is going to be all right.' Retired social worker Paul Jenkinson has embarked upon a 'listening tour' across Canada. He creates a safe space and listens to those who need to speak their mind, providing a most meaningful example of catharsis. The Dalai Lama effectively sums up Jenkinson's 'grand adventure' with his quote: 'Love and kindness are not a luxury, but a source of health and happiness for others and ourselves.' Brahms E. Silver, Côte-St-Luc Submitting a letter to the editor Letters should be sent by email to letters@ We prioritize letters that respond to, or are inspired by, articles published by The Gazette. If you are responding to a specific article, let us know which one. Letters should be sent uniquely to us. The shorter they are — ideally, fewer than 200 words — the greater the chance of publication. Timing, clarity, factual accuracy and tone are all important, as is whether the writer has something new to add to the conversation. We reserve the right to edit and condense all letters. Care is taken to preserve the core of the writer's argument. Our policy is not to publish anonymous letters, those with pseudonyms or 'open letters' addressed to third parties. Letters are published with the author's full name and city or neighbourhood/borough of residence. Include a phone number and address to help verify identity; these will not be published. We will not indicate to you whether your letter will be published. If it has not been published within 10 days or so, it is not likely to be.
Montreal Gazette
29-05-2025
- Health
- Montreal Gazette
Bill 106 will not boost productivity of doctors: health policy expert
By There is scant evidence that the Quebec government's proposed bill to tie doctors' pay to their performance will lead to more patients being treated, argues a prominent health policy expert. Damien Contandriopoulos, a professor of public health at the University of Victoria who had previously taught at the Université de Montréal, is highly critical of Bill 106, which proposes linking up to 25 per cent of a doctor's pay to performance targets as an incentive for them to take on more patients. 'It's a government that likes the notion of direct control, top-down, all the way from the ministry to the worker,' Contandriopoulos said in an interview Wednesday after he testified on Bill 106 at a National Assembly hearing. 'Centralized systems, data collection, heavy monitoring, and this kind of top-down, direct-control approach is generally not a great fit for super complex, extremely large systems like the health-care system,' he added. Bill 106 has sparked an intense backlash in the medical community, with physicians charging that the legislation would drive some doctors away from the profession or the province — and worsen patient care. The bill follows Health Minister Christian Dubé's creation of Santé Québec in December to run the province's $65.5-billion-a-year public system. Despite opposition to Bill 106, Premier François Legault has said the Coalition Avenir Québec government intends to have the legislation adopted. Dubé tabled the bill on May 8 amid contract negotiations with two Quebec federations representing physicians. The 25-per-cent pay figure tied to performance targets was calculated in a mathematical formula that Contandriopoulos described as 'complete nonsense.' Even if the performance targets aren't met, doctors would still receive 10 per cent, according to the formula written in the bill. In Contandriopoulos's report on Bill 106, he wrote similar past incentives in Quebec have not notably increased doctors' capitation — which is the term used for the number of patients a physician has on their roster, and the new rules would only make it harder for them to do their jobs. He illustrates that financial incentive systems are prone to 'gaming,' meaning doctors will try to exploit the system's flaws to their advantage. He cited a recent initiative in Quebec, the 'Guichet d'accès pour la clientele orpheline,' which tied a payment incentive to the registration of new patients. Because of a flaw in the system, he suggested many doctors retroactively enrolled patients who had already been treated. This gave physicians the financial benefit despite the fact they didn't take on additional patients. He also suggested that with Bill 106, doctors may be less motivated to take on complex cases that require extra attention and expertise if their remuneration were based largely on the number of patients they see. As a result, doctors may flood their schedules with patients who could be treated by nurses, social workers or other health professionals on their team as a way to maximize their patient load and increase their remuneration, Contandriopoulos said. If a doctor delegated their straightforward patients to nurses and social workers, 'then they would be stuck with demanding, challenging, long visits,' he explained, adding that this approach would be effectively penalized under Bill 106. 'They would go bankrupt because the system doesn't reward them to do so. So if we want physicians to really focus on the work that they are the best trained to do and where the benefit for society is the highest, we need to incentivize them to really focus on (these complex cases), which we do not.' Dubé said during a scrum Tuesday afternoon that Bill 106 won't be adopted this session of the National Assembly and he would like for discussions to continue. Amid the hearings on Bill 106, Dubé reiterated he wants 100 per cent of Quebecers to have access to a health professional by the summer of 2026.
Montreal Gazette
29-05-2025
- Health
- Montreal Gazette
Don't send letters about Bill 106 to patients, Quebec's college of physicians tells doctors
Quebec Politics By Quebec's college of physicians is demanding an end to any communications sent to patients about proposed legislation that could change how doctors are paid. The Collège des médecins issued a statement on social media platforms late Wednesday afternoon after reports of patients receiving letters from their doctors or clinics about Bill 106. It also notes its invesgations department is aware of the situation. 'The professional order responsible for protecting the public strongly condemns these publications, which focus on limited access to one's physician or abandoning part of its clientele,' said the order's president, Mauril Gaudreault. 'They convey false information and use personal information intended solely for the provision of health care.' Some patients were reportedly told access to their family physician could be compromised if Bill 106 — which is the subject of committee hearings at the National Assembly — becomes law. Under the plan, 25 per cent of a doctor's salary could be tied to various performance objectives in an effort to see them take on more patients. The Collège des médecins is among the organizations that have spoken out against the bill, saying it 'strongly disagrees' with the proposed renumeration model. It is also concerned doctors will spend less time with patients if they have to meet quotas. Earlier Wednesday, Health Minister Christian Dubé and opposition parties roundly criticized the move by some doctors and clinics. 'Honestly, sending letters to your patients, I find it skirts the ethical border,' Liberal health critic André Fortin said.
Montreal Gazette
29-05-2025
- Health
- Montreal Gazette
Opinion: Our family clinic might not survive Quebec's latest health reform
Op Eds I'm a family doctor in the West Island and have been serving my community for over 30 years. I am also the lead physician in our GMF (Groupe de médecine de famille), teach family medicine residents at the Jewish General Hospital, and work in long-term care. Like many family doctors in Quebec, I wear multiple hats — not because I'm 'lazy,' as some government rhetoric might suggest, but because the system demands it. I entered medicine understanding the long hours and sacrifices required. What I didn't anticipate was the persistent erosion of professional autonomy and the vilification of physicians with every new wave of health care reform. Policies like the '70 per cent rule' — when GPs choosing to work on Montreal Island were paid 70 per cent of their billings in the first three years — AMPs (Activités médicales particulières.) and PREMs (Plans régionaux d'effectifs médicaux) have historically penalized physicians rather than supporting them, pushing many to leave Quebec or exit public practice altogether. Despite these challenges, I stayed. I joined a small practice in Pierrefonds in 2000, and in 2008, helped transform it into a GMF. We've since built a high-functioning, multidisciplinary team including nurses, nurse practitioners, a dietitian, a pharmacist and a social worker. We're proud of our 94 per cent fidelity rate — meaning nearly all our patients get their front-line care from us — and of the fact we offer advanced access (appointments within 24–48 hours) and stay open 68 hours a week. We've achieved all this even as most of our doctors also work in other areas like palliative care, teaching, long-term care and so on. But now, Bill 106 threatens to undo everything we've worked for. I fear that this time, my clinic may not survive. The bill proposes a sweeping reorganization of how doctors are paid and how patients are assigned. Bureaucrats with no clinical training will assign patients using a simplistic 'colour code' system, removing the ability of doctors to manage their patient rosters based on actual capacity and clinical complexity. It's a superficial fix that does nothing to address the true crisis: Quebec is short 2,000 family doctors, and a quarter of those still practising are nearing retirement age. This bill also fails to invest in the support systems we need. There's no funding for additional psychologists, physiotherapists or dietitians. There's no plan to improve access to imaging or specialist consultations. Instead, Bill 106 focuses on shifting names on lists and monitoring 'stats' that don't reflect patient realities. Perhaps the most dangerous component is the so-called '25 per cent supplement.' In reality, it's a punitive measure that withholds a quarter of doctors' pay until we meet government-imposed collective performance targets. These targets are often impossible to meet because they rely on systemic factors outside our control— like the availability of specialists or support staff. In a clinic like ours, if some doctors meet them but others don't, we all lose that income. Since clinics are funded through a portion of physician income, this effectively puts our clinic's financial viability at risk. If passed, I expect this bill will accelerate retirements and drive more physicians out of the public system. It will not improve access to care — it will worsen it. My colleagues and I are exhausted by constant restructuring that ignores the realities on the ground. We are ready and willing to collaborate on real solutions. But collaboration requires listening, not legislating by force. The people of Quebec deserve better. They deserve a health system that values front-line providers, supports multidisciplinary care and invests in sustainable access. Bill 106 is not that solution. If it passes, the cost won't just be felt by physicians — it will be borne by every patient who loses their family doctor and every community that loses a clinic like mine. Orly Hermon is a family doctor and lead physician at the Medistat medical clinic in Pierrefonds.
