Accessory Fees and Ultrasounds : The FMSQ Announces Agreement in Principle

Speech given by Dr Diane Francœur, President of the Fédération des médecins spécialistes du Québec, at a conference called to update the press on ongoing negotiations regarding the issues of abolishing accessory fees and the public coverage of ultrasounds.

When we were in the process of inviting you to this press conference, we prepared two texts as we didn't know which one we would be presenting. In the meantime, we maintained our positions which we believed to be fair. We refused what we considered unacceptable requests, even abusive demands, by the Minister of Health, that were communicated to us last evening and again this morning, when we were close to agreement.

I wish to announce that, barely a few minutes ago at the end of an accelerated round of negotiations with representatives of the Ministère de la Santé et des Services sociaux, we concluded two agreements in principle, one dealing with the abolition of accessory fees associated with the provision of insured services and the other on the public coverage of ultrasounds in external radiology clinics. For the Federation, these two issues were linked and we insisted they be treated and settled together. In both cases, access to specialized care was at the centre of the stakes for the public.

We insisted on a serious and frank negotiation; these agreements are the results of our efforts. We worked conscientiously as we took into account the range of treatments and services that are offered to patients by the various medical specialties. This was not simple… not at all ! Our Federation represents 59 different specialties under the umbrella of 35 medical associations.

In broad strokes, here is the summary of what will be included in the agreements in principle that remain to be validated by our Federation's decision-making entities. To start with, I wish to apologize to my colleagues, who are Presidents of these associations and who are being informed of these agreements at the same time as you are.

The FMSQ has always said it would do its part and we have kept our word. We will be attributing an amount of close to $45 million to cover both agreements.

In particular, insofar as new services are concerned :

  • We will create new billing codes for the small, medium and large instrument trays that will allow medical clinics to perform diagnostic and minor surgical acts, including the famous vasectomy.
  • We have also settled in large part the issue of procedures in physiatry as an additional room will be added at the CHUM and technical platforms will now be available in physiatrist offices to facilitate the most frequent procedures.
  • We have asked the Association des médecins ophtalmologistes du Québec to revise its rates and to include drops and instrument trays to allow them also to perform diagnostic and therapeutic procedures.

As for the issue of ultrasounds, the Association des radiologistes du Québec will need to present the details of the agreement in principle and hope its general assembly will confirm the proposal.

There will still be a lot of confusion in the network as much for patients as for physicians. We will send the details of the agreements and the information needed by physicians to clarify expectations on both sides as soon as the final agreements are signed.

It is very important for the population to be informed that these agreements will not settle all the problems of accessory fees. We managed to salvage something in the short delay granted in order to reduce cuts in services to patients.

Once again, I repeat that even if we are satisfied with these two agreements in principle, they do not solve all the problems resulting from the two regulations imposed by Minister Barrette. There is still a lot of confusion in the field, because the distinction between what is allowed and what is forbidden is far from clear. We continue to deplore this state of affairs for patients who are the ones directly affected and for physicians and other healthcare professionals who have to go through an Nth reorganization.

Our aim has always been to maintain access in outside clinics because they are an essential component of the public healthcare system. Obviously, there is still work to be done to tie up the last details of these agreements in principle. It's said "the devil is in the details" and we are going to make sure nothing is left to chance.

The Federation will also continue to concentrate its efforts on the other issues that concern us because of their impact on patients and on the practice of specialized medicine. You can rest assured we will not be taking it easy.