Fed up with combative Gaétan Barrette, medical specialists want new bargaining partner

When it comes to the delicate art of negotiating, Quebec Health Minister Gaétan Barrette often resembles a bull in a china shop.

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Currently in talks with Ottawa for a new health accord, Barrette has accused the federal government of holding Quebecers "hostage" and has threatened to walk away from the bargaining table.

He regularly calls out his federal counterpart, Jane Philpott, on Twitter. 

Barrette isn't any gentler when dealing with Quebec doctors. He's pressed ahead with a promise to eliminate auxiliary fees charged by some medical specialists, forcing private imaging clinics to offer ultrasounds at no extra cost to patients — and without any formal agreement on how those clinics are to be reimbursed.

Beginning next week, medical specialists will be unable to charge many of the fees that have become important sources of revenue for their practices.

But now Quebec's federation of medical specialists, the FMSQ, is pushing back.

Less Barrette, more Moreau, say doctors

The FMSQ says Barrette unilaterally imposed the new rules, and that in negotiations with the association, he has done little to address concerns about how doctors operating freestanding clinics will be compensated for their lost revenue. 

Faced with uncertainty over payment, several radiologists are turning away patients. Other specialists have threatened to drop out of the provincial health insurance system.

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"The information diffused by the Health Ministry is incomplete and raises a lot of questions without providing answers, either for patients or doctors," said Diane Francoeur, president of the FMSQ.

"What is being allowed is uncertainty, and uncertainty can't be allowed."

The FMSQ wants Barrette gone from the negotiating table. They called on the government to replace him with Treasury Board President Pierre Moreau.

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"He seems in a totally different mindset, happy to discuss and evaluate, as every negotiation should be," Francoeur said of Moreau, who recently returned to politics following a serious illness.  

"You have to respect both people and find an agreement that fits both," Francoeur said.

The medical specialists are also hoping to strengthen their bargaining position by hiring former premier Lucien Bouchard to represent them in possible legal actions against the government. 

Barrette unfazed

Barrette, for his part, appears unfazed by the FMSQ's latest moves. In characteristic fashion, he accused the federation of holding patients "hostage" and chalked up their demands for compensation to greediness. 

"The issue here is, above all, monetary," Barrette told Radio-Canada on Thursday. "There are groups that always want more. I think the public is listening to us and knows what we're talking about."

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His position is getting some support from a patients' rights group in Quebec that is seeking to launch a class-action lawsuit against radiologists who are cancelling or refusing to take appointments.  

"Medical specialists can't refuse or neglect to offer care to patients for whom they will nevertheless be compensated following a ministerial decision," said Paul Brunet, who chairs the Quebec Council for the Protection of Patients, the group behind the lawsuit. 

Announcing his intention to end auxiliary fees last fall, Barrette said the only extra fee that doctors will be allowed to charge will be for the transport of biological samples from a private clinic or specialist. 

There is a $15 limit for blood samples, and $5 maximum fee for transporting all other kinds of samples.

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