At the Fleurimont Hospital of the University Hospital Center of Sherbrooke (CHUS), I had a year of waiting to do breath tests […] And I wanted answers right away
exclaims Ms. Tardif.
During our visit to the Laval clinic a few days ago, specialist doctor Jad Hobeika had some good news for him.
<q data-attributes=""lang":"value":"fr","label":"Français","value":"html":"On a éliminé pas mal d’affaires dans votre cas: no asthma, no chronic obstructive pulmonary disease, no anemia, you are not deconditioned”,”text”:”We eliminated a lot of cases in your case: no asthma, no chronic obstructive pulmonary disease, no anemia, you are not deconditioned””>We eliminated a lot of cases in your case: no asthma, no chronic obstructive pulmonary disease, no anemia, you are not deconditionedhe explained to her.
Ms. Tardif drove more than seven hours and paid a few hundred dollars for her two appointments. She does not regret her choice. I attach more importance to my health than before
confides Ms. Tardif.
A record 784,000 pending requests
Obtaining an appointment with a specialist doctor in the public network requires unprecedented patience in recent years.
According to the latest data from the Ministry of Health and Social Services (MSSS), there were 784,000 pending requests for all specialties in August, up 60% since September 2020.
The average time to get an appointment went from 267 to 381 days.
In respirology alone, more than 27,000 requests were pending in Quebec with an average delay of 322 days (46 weeks).
A situation at odds with what the Laval clinic says it is living.
Currently, I have a deadline of one to two weeks for a first appointment
says pulmonologist Jad Hobeika.
A graduate in internal medicine and pulmonology since 2016, he joined the Lacroix Medical Group in January 2022 after spending a few years in the public sector, where he was notably head of the pulmonology department in a CISSS in Greater Montreal.
To the public, we saw patients with cancers and urgent cases within a few weeks. Otherwise, for the others, we were talking about months or years of waiting […] I was not comfortable with the amount of patients on the waiting list
he explains.
According to Dr. Hobeika, there is an accessibility issue in the system that the private sector allows me to fill in a little […] We are adding an offer for patients who can come see us without a referral, to get a second opinion, who have access to quick appointments, get diagnostic tests quickly
.
Jad Hobeika, Pulmonologist, Lacroix Medical Group
Photo : Radio-Canada / Davide Gentile
As the administrative director of the Lacroix Medical Group, Jean-Nicolas Chagnon, points out, the demand is there […] Growth is exponential every year
.
People need services quickly and we provide accessibility, a complement to the public network
he adds.
A nurse practitioner specializing in mental health joined the group at the beginning of the summer, alongside a general practitioner.
Both appreciate the professional freedom that their employer gives them and also deconstruct the myth that the private sector is frequented only by rich people.
On the contrary, we see everything, even patients on social assistance who have saved up to come and see
underlines Émie Gervais, general practitioner in the private sector since obtaining her diploma six years ago.
After modest beginnings in the Quebec region, the Lacroix Medical Group now has 90 doctors in ten clinics across Quebec, two operating rooms, a private laboratory and nearly a hundred employees.
555 doctors bill without going through the RAMQ
Physicians who are making the leap to the private sector are more and more numerous in Quebec. Sometimes to practice there full time, if not alternately with their practice in the public network.
According to the most recent data from the Régie de l’assurance maladie du Québec (RAMQ), the number of medical specialists who have made the jump to the private sector over the past five years has increased by 55%, to 178 doctors.
There are notably dermatologists, plastic surgeons, but also anesthesiologists, gynecologists, radiologists, psychiatrists and a handful of pulmonologists, such as Dr. Hobeika.
Family physicians are also more likely to make the leap to the private sector.
Over the past five years, their number has increased by 27%, to 377 doctors.
In total, the percentage of doctors who practice outside the health insurance scheme is heading towards 3%, whereas they were less than 2% in the mid-2010s.
There are more than 21,000 physicians in Quebec.
A doctor who decides to work in the private sector as a doctor non participant
must, in particular, inform the RAMQ, notify his patients that they must fully assume the fees and post the rates in the office waiting room.
According to data from the MSSS, there are 22 specialized medical centers where non-participating physicians practice exclusively.
reactions
In March 2022, the group Médecins québécois pour le régime public published a press release recalling their concern about the ambitions of the private sector.
« Each healthcare professional working in the private sector is one less healthcare professional in the public network. »
A doctor working both in the public and private sectors can refer his own patients seen in the public sector to provide care in the private sector and increase his income. […] It raises important ethical issues through the blatant conflict of interest that it engenders
he wrote.
At the Montreal Economic Institute, we are instead promoting the liberalization of the health care system, in particular by lifting of the ban on duplicate health insurance
as well as that of restrictions on mixed practice of health professionals
.
In 2005, the Supreme Court of Canada ruled in the Chaoulli decision that, when Quebecers do not have access to public health care within a reasonable time, they should be able to take out private insurance.
The Health Insurance Act was later amended to allow private insurance, but only for knee, hip or cataract surgeries.
Party positions
Since the start of the election campaign, most political parties spoke to increase or reduce the outsourcing of surgeries to the private sector using the health insurance card. A phenomenon that has reached around 15% of the volume since the start of the pandemic.
The Conservative Party of Quebec (PCQ), in particular, would gradually explore
the possibility of giving Quebecers the free choice to subscribe to complementary private insurance to obtain health care already covered by the health insurance plan.