2023-07-06 04:00:00
No less than 150 medical specialists have left the public network temporarily to treat patients in the private sector, at great expense, for a year. More popular than ever, this profitable strategy shocks patients and colleagues.
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“It’s frustrating to walk into a doctor’s office and be told: ‘If you come to private, in two weeks you’ll be operated on!'” deplores Sylvie Hébert, a patient from Shawinigan who has been waiting for arm surgery since 2018.
Recently, a nurse in the public network was even offered by her employer to pay the costs to have her injury treated more quickly in the private sector.
“I know that it’s faster in the private sector and that we want to get the world back at work, but it’s a bit absurd”, she denounces on condition of anonymity for fear of reprisals from her employer. .
Private shift
There are many stories of patients navigating a two-speed medicine in Quebec.
For the past year, 150 medical specialists have disaffiliated from the Régie de l’assurance- maladie du Québec (RAMQ) at least once before returning to it, compiled The newspaper.
The phenomenon has been gaining momentum in recent years, with the rise of private clinics. In 2015, the first time The newspaper did the exercise, only nine medical specialists had made the leap to the private sector.
Disaffiliated doctors
2015: 9 2016: 19 2017: 40 March 2020- summer 2021: 71 May 2022-April 2023: 150
Legal, the strategy makes it possible to go to work for a week or more in the private network, and to treat there patients ready to pay the high price (up to $20,000 for surgery).
Typically, the patient is operated on within weeks, rather than months (or even years) of waiting in public. For people who have the financial means, this avenue can be interesting to regain health quickly. Doctors of all kinds of specialties go back and forth.
However, according to many, this scheme allows the recruitment of patients from the public for profit.
“We become traders, admits a specialist who deplores this way of operating. There is a drift in Quebec.”
“It’s obvious that waiting in the public network allows some doctors to play a little on patients’ feelings of anxiety and urgency to go to the private sector,” also believes an orthopedist.
The Quebec Orthopedic Association (AOQ) also hears these stories of doctors who offer their own clients to pay for private surgery.
Photo provided by the CHUM
Veronique Godbout
President of the Quebec Orthopedic Association
“We don’t endorse that at all, and that worries us,” reacts Dr. Véronique Godbout, president of the AOQ.
Indeed, a doctor cannot place himself in a conflict of interest and must be transparent by offering all possible options, confirms the College of Physicians of Quebec. For example, a specialist cannot inflate his waiting list or refer his patient to his own private clinic.
Significant fact: 40 orthopedists have withdrawn at least once over the past year, ie 10% of them. In 2017, there were only three.
“We do not encourage our members to disaffiliate to go private. Except that at the same time, the hospitals are not able to give operating time”, nuance Dre Godbout.
Currently, 36,507 patients are waiting for orthopedic surgery, including 4,584 for over a year. This is the longest wait in Quebec.
wait or pay
According to the Quebec Doctors group for a public plan, this growth confirms the drift towards two-tier medicine.
Photo courtesy
Isabelle Leblanc
Spokesperson, Quebec Doctors group for the public system
“The patients are very angry and resigned. They wait or they pay”, summarizes Dr. Isabelle Leblanc, spokesperson.
“This is the pinnacle of two-tier medicine. If people can pay $15,000, $20,000, $30,000, they will come before those who need it more,” she adds.
By email, the Federation of Medical Specialists of Quebec writes that the priority is to treat the public, and does not encourage doctors to refer patients to the private sector.
The rules need to be tightened
Disaffiliation rules must be tightened to put an end to two-tier medicine, asks the College of Physicians of Quebec.
“The rules allowing the alternation between the public and private plans must be strengthened to prevent a doctor from being able to offer the same service almost simultaneously to the public and the private sector, and thus create situations of two-speed medicine”, writes the College. in a brief recently tabled in the National Assembly.
Indeed, the current rules allow specialists to withdraw several times a year, ie every 30 days as many times as they wish.
Disaffiliate, child’s play:
1. A doctor completes a RAMQ form online, which takes effect after 30 days.
2. After 30 days, the doctor begins to work privately for a minimum of eight days.
3. When he wishes to return to the public, the doctor sends a new notice to the RAMQ and returns to the public eight days later.
According to many, this back and forth could be completely eradicated simply by increasing the minimum disaffiliation period to three or six months.
“It would be easy to solve this problem, believes a medical specialist. People would choose their camp, and we could not play in both flowerbeds at the same time.
In its brief, the College of Physicians also deplores that this system is detrimental to the resources available in hospitals. A concern shared by the Quebec Orthopedic Association.
“If half of the service withdraws, covering hospital activities becomes complicated, admits Dr. Véronique Godbout, president. If the wandering continues, it could become an issue.
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