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CBC
30-05-2025
- Business
- CBC
Quebec doctors say new bill will drive them away, threaten patient access
Doctors at a medical clinic in Kingsey Falls, a town in central Quebec, say they're contemplating closing their clinic and pivoting out of family practice — or Quebec altogether — if a bill allowing the province to regulate how physicians are paid is adopted as it is written. Bill 106, tabled earlier this month, would link up to 25 per cent of physicians' pay to their performance in an effort to get them to take on more patients. But in a statement posted to their social media, doctors at the Kingsey Falls medical clinic said the new rules would impose unattainable performance targets on them and reduce their ability to deliver quality care to patients. "We can't take on more patients if we don't have more resources or a system that's more efficient and productive to be able to take good care of them," said Dr. Isabelle Lemieux, who works at the clinic. As legislative hearings on the bill run their course, the clinic and others in the province are warning their patients that they risk losing their family doctor — despite Article 4 of the bill suggesting otherwise — and are asking them to write to their local MNA. The clinic has since deleted its statement and letter templates from its Facebook page. Quebec's College of Physicians (CMQ) has condemned these types of communications after being confronted about them by Health Minister Christian Dubé during Tuesday's hearing. "They transmit false information," wrote the college's president Mauril Gaudreault in a statement to Facebook. In the halls of the National Assembly Thursday morning, Dubé said the college did the right thing by adding that "what is important are the interests of the patients." But the debate rages on as doctors continue to voice their concerns, some echoed by the CMQ, about the bill's impact. WATCH | Why doctors are upset: Why Quebec doctors are upset with the government's proposed changes to their salaries 2 days ago Duration 2:46 Gaudreault argues the bill and its title — An Act mainly to establish the collective responsibility and the accountability of physicians with respect to improvement of access to medical services — make explicit the government's attempt to place the burden of a well-functioning health-care system squarely on the shoulders of doctors. What the bill changes — and what its blind spots may be The bill proposes a mixed model of remuneration for family doctors: capitation payments (an annual flat rate per patient based on their level of vulnerability), an hourly rate for time spent with patients and a fee-for-service. Part of their pay would also be tied to their collective performance based on targets set at the provincial and local levels. Those targets aren't specified in the bill but could look like reducing waiting times and absenteeism rates as well as increasing quality of care, said Dubé at Tuesday's hearing, adding the targets would need to be discussed. The president of the Fédération des médecins omnipraticiens du Québec (FMOQ), which represents family doctors, called the bill "catastrophic," warning that it will negatively affect accessibility to doctors. "We need to stop evaluating the work of family doctors solely based on their clinical appointments because we're neglecting a whole lesser-known section of their work," said Dr. Marc-André Amyot. He addressed the committee with a pair of family doctors who said the new rules would penalize the doctors whose colleagues chose to take on less work for mental health reasons or whose workload is underrepresented by Quebec's health insurance board's (RAMQ) compensation system. "I work full-time all year, but the RAMQ thinks I work for barely four months," Dr. Benoît Heppell told the committee studying Bill 106, explaining that the hours spent training, doing administrative work or teaching aren't taken into account. Heppell said the government's targets need to be tied to a promise of more resources. Currently, there are 1.5 million Quebecers who don't have a family doctor, according to Dubé. "It's not about working harder, it's about working differently," he told the FMOQ. For Roxane Borgès Da Silva, a professor at Université de Montréal's school of public health, the shift to capitation pay is good news. She says it encourages more collaboration and delegation between doctors and other health-care professionals and takes away the incentive for doctors to reach a high volume of appointments. For example, under the proposed model, a physician wouldn't lose compensation for an appointment if a patient registered to them is treated by a nurse or physiotherapist instead. Setting performance targets could help counter the shift away from productivity, said Da Silva, but they need to be the "right" ones and should be for all health-care personnel and not just doctors as the bill proposes.
CBC
28-04-2025
- Politics
- CBC
Western Quebec mayor resigns over 'intimate remarks'
A Western Quebec mayor and warden has resigned after Quebec's municipal commission sought to bar him from office over "intimate remarks" he allegedly made to municipal employees. Benoit Lauzon announced on Monday that he was vacating his roles as the mayor of Thurso and warden of the regional municipality of the MRC of Papineau. "I am officially retiring," he wrote on Facebook. His announcement follows Quebec's municipal commission (CMQ) applying to the Superior Court of Quebec on April 23 seeking to disqualify Lauzon from holding municipal office for five years. 'Intimate remarks' The CMQ alleged Lauzon had abused his position of authority over municipal staff by making "intimate remarks" over the Messenger app and in text messages to at least seven employees. Lauzon did not contest the application. "After discussing the alleged breach of the code of ethics for elected officials with the municipal commission, I told them there was no need to waste time debating the alleged misconduct or reducing the period of disqualification, given my decision to retire without plans to return," he posted on Facebook, writing in French. The CMQ application did not provide details on the remarks in question but found that Lauzon's conduct "seriously depart[ed] from the standard that should be expected of a person serving as warden of an MRC and mayor of a municipality." His conduct had undermined his municipal office and public trust in municipal institutions, the CMQ wrote. "Sometimes during discussions, we say things, we use words, we put emojis in messages without considering their impact but in ways which can affect people," Lauzon wrote in his Facebook post. "I am sorry for that." He continued: "This is why I am leaving before the end of my term, in order to ensure that this issue does not become a distraction and so that the work of elected officials and staff in the town and MRC continues to live up to their standards of professionalism and commitment to the well-being of the community." Lauzon did not respond to requests for comment from Radio-Canada. Lauzon had served as the mayor of Thurso since 2013 and warden of the MRC of Papineau since 2017. He also chairs the Outaouais warden's conference. Thurso is a town of about 3,000 residents located on the Ottawa River about 40 kilometres northeast of Ottawa. In January, Lauzon announced he would not seek re-election as mayor of Thurso, saying that the MRC of Papineau had introduced new rules preventing him from serving as mayor and warden concurrently. On Friday, the MRC of Papineau announced that Danie Tassé, mayor of Montpellier, Que., would assume the role of deputy warden following the departure of Lauzon.
