‘It’s going to be chaos’: Montreal clinics warn Bill 2 closures will put patients at risk

Note on the above video: While the clinic previously told CityNews it was slated to close April 1, its the medical director and co-owner has since clarified that it could close at some point in 2026 if nothing changes with Bill 2.

---

A family medicine clinic in Montreal is anticipating it will be shutting its doors due to Bill 2 – one of roughly 40 clinics across Quebec that have chosen that route, citing financial pressures.

The Santé Mont-Royal family health clinic could close at some point next year if nothing changes with Bill 2 – with its owners forecasting a 45 per cent loss in revenue once it fully takes effect in the new year.

Bill 2, introduced in October, ties part of doctors’ salary to meeting performance targets — a change critics say penalizes clinics already stretched thin.

“This entire new law that was non-negotiated, that was falsely conceived and thought out, is going to have a significant impact on us being able to provide care in a clinic,” said Dr. Mark Buch, the medical director and co-owner of Santé Mont-Royal.

“The financial model changes on April 1 therefore, there is a risk of closure by the summer,” added Dr. Buch in a clarification email to CityNews on Thursday.

---

And that clinic is far from alone. According to a survey by the Journal de Montréal, roughly 40 clinics across the province say they may also shut down in the wake of Bill 2.

Dr. Buch says performance targets, including asking general practitioners to collectively deliver 17.5 million appointments per year, are unattainable, putting clinics like his at risk.

“These performance objectives are quantity based,” Buch said. “They’re not quality based. They make no sense. And eventually patients suffer.

“It’s counterintuitive to the heart and soul of what family medicine is,” he said.

Buch says pressures placed by Bill 2 stack onto what family doctors already shoulder.

Family doctors in Quebec are already required to perform mandatory government-assigned jobs outside their clinics, like ER shifts.

Buch says with Bill 2, doctors are stretched thinner than ever, which means the over 24,000 patients his clinic serves will feel the impact when physicians can’t keep up.

“I’ve developed a deep relationship with some of these patients. This entire model puts that at risk,” the doctor said.

And the pressure isn’t isolated to family medicine.

La Licorne in Ville-Marie, which primarily provides STI screenings, says it stands to lose up to 80 per cent of its revenue under Bill 2.

“The government wants to cut this amount from $75 to $5 a patient,” said Dr. Robert Pilarski, the clinic’s medical director and general practitioner. “So unfortunately with this amount, I mean, there’s no way I can make the ends meet.

“If prep doesn’t exist, people will not have access to the treatment to the STI screening. We’re going to have STIs going up. We’re going to have new infections of HIV going up.”

Patients’ rights advocate Paul Brunet warns the closure of 40 clinics – in an already strained system – could have devastating effects and risk patients slipping through the cracks.

“You’re talking about more or less 100,000 more patients left out,” said Brunet, the Chair of the Montreal Council for the Protection of Patients.

“If the threats of so many doctors, so many clinics are put in reality, it’s going to be chaos, totally, in Quebec.”