Quebec physician organizations divided on Bill 83

Health Minister’s Christian Dubé’s Bill 83, which aims to stem the exodus of doctors to the private sector, is creating a divide within organizations. On the one hand, The Collège des médecins du Québec (CMQ)  would like to see the status of physicians not participating in the public system abolished altogether; on the other, the Fédération des médecins de pratique privée du Québec (FQPQ) and the Fédération des médecins spécialistes (FMS) do not believe that Bill 83 will improve access to care. 

Last week, Dubé presented several amendments to Bill 83. Among other things, he proposed that doctors obtain prior authorization from Santé Québec to disaffiliate from the Régie de l’assurance maladie du Québec (RAMQ). 

Dubé states that approximately 150 doctors are currently switching between the private and public sectors simply by informing the RAMQ of their intention. The minister would like Santé Québec to assess the relevance of each request according to certain criteria. For example, that there is no shortage of doctors in public institutions in the region of the doctor requesting to disaffiliate. CMQ finds this insufficient, it calls for “more rigorous professional and legal oversight” of the private sector, given that more than 800 doctors work in the private sector in Quebec compared to a few dozen in the rest of Canada.

“We would have liked the government to go further and prohibit the movement of doctors between the public and private sectors, as this contributes to the staff shortage in the public network,” the CMQ wrote on Bluesky last week. 

The Quebec Federation of Medical Specialists (FMSQ) takes a completely different view. It commented on Bluesky that Bill 83 seemed to have been “written on the corner of a table” and that it “completely missed the mark.” 

On Tuesday, it was the turn of the Fédération des médecins de pratique privée du Québec (FMPPQ) to criticize. According to the FMPPQ, the evaluation criteria for authorizing disaffiliation from the RAMQ are “administrative and subjective.” It also believes that this infringes on the professional freedom of physicians and the freedom of patients to choose. “Ultimately, it is the patients who will suffer the consequences, notably by having less access to care and having their surgery postponed, at least in the short term,” the FMPPQ stated in a press release. 

Dubé suggests that the private sector must complement the public network. He emphasized that agreements have been reached with private clinics to ensure that patients continue to receive treatment more quickly and free of charge. 

—The Canadian Press’s health content is funded through a partnership with the Canadian Medical Association. Editorial choices are solely those of The Canadian Press.

–This report by La Presse Canadienne was translated by CityNews