If you don't have a family doctor, Quebec wants you to use this system before going to ER

With respiratory viruses spreading and emergency rooms buckling under pressure, the province is trying to get the word out about a new service for the 1.2 million Quebecers who do not have a family doctor.

This year, the province launched an online and phone service called the Primary Care Access Point. 

The service — which is known in French as the Guichet d'accès à la première ligne or the GAP —  aims to go further than the traditional 811 phone service by allowing people to speak with a nurse, get their symptoms assessed and, if necessary, book an appointment with a general practitioner.

"The bet we're making is that it will eventually have an effect on ERs for patients who aren't signed up [with a family doctor], as the service gets more and more known," said Martin Forgues, who is in charge of service access with the province's Health Ministry.

"I strongly encourage the population to use it and help us because [using] it will allow us to improve it constantly."

Accessing the GAP

Following a pilot project in the Lower St. Lawrence region, the service became available across Quebec in late September.

You need to meet these two criteria to be eligible for the GAP:

• You don't have a family doctor.
• You are signed up on the waiting list for a family doctor.

If you're sick or calling on behalf of someone who is, you can access the GAP by calling 811 and choosing Option 3.

You'll get to speak with a nurse who will ask you a series of questions to assess your condition and medical history — just like when you call the regular 811 service.

Once that is done, the nurse could either tell you to go to the ER, a pharmacy, refer you to a social worker or tell you to use basic remedies at home. They could also decide that you need to see a physician in a clinic. That's when they'll book the appointment for you.

The majority of the appointments booked through the GAP take place within 36 hours, Forgues said. 

A person can also use the GAP's online tool and go through a questionnaire instead of speaking with a nurse, but you won't be able to get a doctor's appointment doing that. Instead, the online GAP questionnaire will prompt you to contact its phone service if your situation warrants an appointment with a physician.

Through a deal with the Quebec government, general practitioners are freeing up time in their schedules to see patients who don't have family doctors.

Forgues said people who are on the waiting list for a family doctor have received an email or a letter in the mail to inform them that they are eligible to use the GAP and how to contact it.

If you sign up today, you will also be contacted and given that information.

Call wait times already a challenge

The Health Ministry says the volume of calls to the GAP has gradually increased since the service became available across Quebec. In one week in mid-October, there were 30,000 calls.

According to Forgues, 17,000 of those — slightly more than half — ended with doctor's appointments booked for the caller.

Forgues says the ministry is focused on making sure more people know about the service and reducing wait times for callers.

He said the waiting time could range anywhere from 15 minutes to two hours and the ministry wants to improve that up to make the GAP more attractive, especially if even more calls start flooding in.

Raising awareness about alternatives

The ability to get a doctor's appointment is the GAP's big draw, but the tool also serves to remind people that there are other health-care solutions besides going to the ER.

Health Minister Christian Dubé has said that about half the 10,000 Quebecers who visit ERs daily could be going elsewhere for their care.

"The GAP is certainly a good way to inform the population about what pharmacists can do," said Betrand Bolduc, the president of the Quebec Order of Pharmacists.

"They're going to realize that they could've gone to a pharmacist to get, most probably, their problem resolved — whether it's extending a prescription or treating a minor ailment."

The GAP also makes it easier for general practitioners to help patients when they see them, according to the vice-president of the Fédération des médecins omnipracticiens du Québec.

GAP nurses relay the information gathered about a patient to the physician who will meet with them, said Dr. Sylvain Dion.

"And just the fact that patients call [the GAP], are evaluated, so the patients that are in our office, it's pertinent for them to be there, that's a big step forward," said Dion.