Quebec scraps annual physical exams for healthy patients over 5 years old

Annual medical checkups for healthy Quebecers over the age of five are being scrapped under new medical fee guidelines being implemented by Quebec's government starting in June.

Healthy Quebecers will still be able to see the doctor once a year, but under a different category of visit called a "follow-up visit." 

Such a visit would be less comprehensive than an annual checkup, and that has some family doctors worried about the long-term impact on the health of Quebecers.

Gaétan Barrette, the province's health minister, says most patients in good health don't require annual appointments and that Quebec is joining other jurisdictions in abolishing them.

"What does an annual visit prevent? Nothing," Barrette said. "Prevention is about habits, about way of life. It's about eating well, it's about exercise, it's about caution; it's about that sort of thing."

The move comes after a recommendation by the Quebec Federation of General Practitioners, or FMOQ.

The new fee structure will favour children under five and patients with chronic health concerns, who will now have an easier time booking appointments to see their family doctors.

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"Those who need visits, those who need access, they don't have access because those appointments are taken by those who do not need them," Barrette said.

"It's not important for young people to go to an annual checkup every year," he said. 

New system 'detrimental' to children's health, says family MD

That view is disputed by Leslie Solomon, a family physician at Club Tiny Tots in Montreal's Côte-Saint-Luc borough, who called the new fee structure "worrisome."

Eliminating annual checkups for children over the age of five runs the risk of missing diagnoses.

"I don't think it's good for continuity of care for patients," she said. "It's going to be very detrimental."

Family doctors won't be able to fit the full scope of exams formerly conducted in an annual checkup into a shorter follow-up appointment, she said.

"It's absolutely impossible — things will get missed. It's calling for a disaster, I believe," she said.

This view is at the heart of a letter published by 25 pediatricians and doctors.

According to the letter, "the majority of heath care expenditures are spent on conditions that are largely preventable," naming conditions like diabetes, hypertension and heart disease, among others.

Investments in complete annual checkups will yield significant savings to Quebec's health care system in the long run, the letter argues. 

"The penny-wise, pound-foolish approach by this Government is not only short-sighted as far as the health of the population of Quebec is concerned, but will ultimately fail to meet its objectives of cost savings."