June 2018 – The FMSQ's Mission
To defend and support medical specialists from its affiliated associations who work in the public healthcare system while contributing to the advancement of quality care and services for the people of Quebec.
During the Delegates' Assembly last March, we clarified our Federation's mission to include two aspects that were at the heart of our demands within the context of renewing our Agreement. Beyond the monetary issue, there is more, much more ! We have committed ourselves to defending the public healthcare system by negotiating that access to care (I refer here to scans and MRIs) must be provided via the financing of extended service up to 16 hours per day. This exercise (still in progress) allowed us to establish that maximum capacity is far from having been reached and that an all-inclusive spring cleaning must be undertaken to build service corridors, to prioritize examinations and to cancel non pertinent exams.
The other aspect of our specific mission is our role in society. In the Agreement, we specifically undertook to provide more services to the population and it is in this context that the pairing plan in anesthesiology became reality. This is not commonplace and we estimate that the current total of 4,500 replacement days will reach 7,000 at final deployment in 2 years. These 7,000 days do not include travel time nor do they reduce services in sponsoring centres.
Tangible results, if anything! Let those who took pleasure in striking out at us with their cheques for $480 million be advised: apart from the cheques imposed on us by the government for the year 2016-2017, the rest of the money, spread out for the third time, will be injected in services to the population. Our actions respect our word : we do not play politics, but we do practise medicine. I am anxious to see how energetically François Legault, if he's elected in October, will tear up this Agreement when the services will already have been implemented !
We have always played fair in our commitment to our patients and in the implementation of the 4 measures of accessibility to specialized care. We will continue to affirm our collaboration. An advisory group will review the targets of the 4 measures shortly. No one will be able to reproach us for not respecting the delays planned for the CRDSs, since the 3rd wave will not be able to start before January 2019 due to a lack of staff (the program has been in force since September 2015). Nor will anyone be able to reproach us for not operating on patients within desired deadlines, again because of a lack of staff, which even the Auditor General has conceded.
In this regard, patients have to be informed and conscious of the reality in which we find ourselves. Out of respect for their patients, the medical specialists concerned must conscientiously review their waiting lists in order to prioritize cases. Institutions experiencing "problems" must supply the administrative staff needed to update waiting lists and help to find free zones or service corridors in order to be able to operate elsewhere, if needed. We must also find a way of telling the truth to patients who need to be informed of their situation, and to claim in their names the deadlines that can have an effect on their prognosis. Get ready to defend your opinions before your Board of Directors : since Bill 130, they are now responsible for access to care.
Another ministerial drift which will have very short-term repercussions on our practices: the proportion of residency positions in specialized medicine has been reduced from 55 to 45%. How will we be able to maintain our training programs ? Teaching pyramids having disappeared, an adjustment has to be made without delay. At a time when medical specialists work more than ever (yes, it is in a less conflicted environment, but without a complete return to cooperation), we cannot accept that 68 positions will be left open by students who refuse to abandon their dreams and who decide to wait an extra year to obtain a residency position or to simply leave the province. We cannot force a student to opt for family medicine : if we do, the candidate may be tempted to choose a mini-specialty practice niche, which would counteract the Minister's patient-handling quotas.
The young people of today are the ones who will be caring for us tomorrow. I fervently wish that they feel the sacred flame like I do and that their passion remains alive. It is impossible to justify leaving the door open to foreign physicians trained elsewhere, while at the same time cutting positions for our young doctors who only dream of filling them. There is only one solution remaining for them: choosing the lottery of a residency in the rest of Canada and waiting for positions to become available. It is hard to believe that there is no underlying economic stake : would not training residents allow the government to save money, the same way that closing operating suites or clinics does? No care means no expenses ! Can waiting lists be profitable ?
We will be in the eye of the storm during the electoral campaign. Rest up this summer... I'll need you in the fall...