Quebec’s doctor shortage slowly improving
Doctor shortage most acute in greater Montreal area, Outaouais
After several years on waiting lists and cold-calling doctors’ offices, Stacey Tenenbaum was fed up not having a family doctor. So when she attended a Christmas party hosted by an emergency room doctor, she hatched a plan.
"I told my husband, ‘Hey, there’s going to be lots of doctors at this party. I’m going to find myself a doctor tonight.'"
"I sort of just sidled over to this guy who looked sort of prosperous and older and doctor-ly and said, ‘Hey, are you a doctor?’ And he said, ‘As a matter of fact, I am.'"
"I don’t think it’s a method that everyone can use," admits Tenenbaum.
New numbers obtained by CBC suggest the province is catching up with the demand for family doctors. But the greater Montreal area still lags behind other regions when it comes to accessing primary care.
Acute shortages
The data comes from a 2015 plan, compiled by the COGEM — a joint committee of Quebec’s federation of family physicians and the Quebec health ministry. The plan still has to be approved by Health Minister Gaétan Barrette.
According to the committee’s calculations, Montreal would need another 183.5 full time positions to meet the population’s needs. The city is projected to gain only 29 full-time positions next year.
The most acute shortages by population are:
- James Bay (7.8 positions).
- Outaouais (92.2 positions).
- Montérégie (204.4 positions).
- Lanaudière (93.4 positions).
- Laurentians (113.2 positions).
- Laval (75.7 positions).
Quebec City bucks the trend, with 38 more doctors than are needed for the size of the population.
“It’s a big challenge for us…to be fair, for all of the regions,” says Dr. Serge Dulude, director of regional planning for the federation of family physicians.
Dulude says the committee must take several factors into account when planning how many doctors each region should be allowed to recruit.
Those include how many doctors are retiring in each region and how many have moved between regions or out of province. The committee also considers population demographics, such as age and income, in deciding which regions have the greatest need.
Montreal 'particularly punished'
But some doctors are critical of the way regional needs are calculated, saying it fails to account for how many patients live in one region, but have a doctor in another region.
“People may have a doctor across the street, but they can`t access them, because [doctors are] busy seeing commuters from off-island or other regions, “ says Dr. Mark Roper, head of primary care at the McGill University Health Centre.
“I think Montreal is particularly punished by the set up that is in place right now,” he says. “And when we`re trying to convince the other regions of our situation, we get little sympathy.”
According to a 2012 health ministry study, 24 per cent of all patients seen by Montreal doctors were from off-island. The same study showed 42 per cent of patients in Laval were from outside that region.
But Dulude says that situation has likely improved because 220,000 Montrealers have found a family doctor in the past three years.
He believes the province can help solve Montreal’s doctor shortage by dealing with the shortage in the regions around the city.
“It’s not a message of saying, ‘OK, doctors in Montreal, you have to clear out your clientele coming from outside.' That`s not the point. It’s having the doctors from the 450 [area code] being available.”
Dulude points to a study conducted by the federation of family physicians that shows more than 80 per cent of Quebecers would prefer to have a doctor near where they live, rather than near their workplace.
Stacey Tenenbaum says she understands why people are looking for a doctor wherever they can get one.
“I’m not about to say that someone shouldn’t be coming into Montreal to get a qualified doctor,” she said.
“Everybody needs health care.”
Our CBC Quebec series, Hacking the system: Making our system work for you, looks at some of the lengths Quebecers go to navigating the health care system.