Bill 20: Volume Trumps Quality… Where Is the Logic?

MONTRÉAL, Dec. 9, 2014 /CNW Telbec/ - The Québec Medical Association (QMA) is concerned that Bill 20 forces physicians to practise volume-based care to the detriment of quality care. If the government obliges physicians to see more patients in the same amount of time so that they meet the imposed quotas, physicians may well just decide to increase the number of medical analyses and tests instead of conducting a more complete physical exam.

This is precisely the type of practice that the QMA has been seeking to eliminate through its efforts to tackle overdiagnosis during the past 18 months, advocating for quality medicine and reducing procedures that do not add value. Overdiagnosis greatly impacts the cost, quality, effectiveness, efficiency and accessibility of the health care offered to patients, and as a consequence, the efficiency of the entire health care system. Doing more is not always better. Bill 20 risks sending the opposite message to the population.

The problem of access to primary care, which is more acute in Québec, is being resolved to varying degrees in most of Canada's provinces, because solutions are being developed and implemented through a collaborative effort between members of the medical profession and the governments. Thanks to efficient information systems and the introduction of an interdisciplinary approach based on collaboration, these health care systems offer the accessible, quality health care that taxpayers have a right to expect. The results of the 2014 National Physician Survey released on December 2 show that Québec is at the very bottom of the list when it comes to computerization of the health care network. The Québec Health Record project, promised for 2011 at a cost of $543 million is, according to the Health Minister himself, a resounding failure. He recently stated that the Québec government plans to deliver this project in 2021 at a cost of $1.6 million, but added that he was not sure that the money would be available to do so. The physicians are not the ones who are responsible for this delay and wasteful use of public funds. On the contrary, they want to make full use of the benefits of computerized records that will help to increase accessibility to care while also encouraging better discussions with their patients.

Furthermore, there is a fundamental contradiction with the efforts that the Québec government has made over the last few years to recognize the value of family physicians and encourage medical students to choose this specialty. The message of coercion that the government is sending with this Bill threatens to undo all the work to motivate students to choose family practice and to discourage them from working in primary care.

"The QMA is aware that physicians can improve their efficiency, but in order to do so, the medical profession must be part of the solution and have the proper tools," stated Dr. Laurent Marcoux, President of the Québec Medical Association. "By encouraging a spirit of collaboration, we can transform the health care system. Productive discussions between members of the medical professions and governments in Canada's other provinces were able to produce solutions. All stakeholders in Québec's health care system must put their shoulder to the wheel to review the ways of doing things. The QMA has already expressed its desire to the Health Minister to collaborate. But instead, he is imposing his method, unilaterally and forcefully, just as he did with Bill 10. The government must restore the dialogue and spirit of collaboration with the medical profession. Medical leadership needs to be exercised in transforming the health care system."

About the QMA

The Québec Medical Association is made up of close to 10,000 general practitioners, specialists, residents and medical students. Its mission is to bring together members of the Québec medical community in a context that promotes reflection and action in the best interests of the health of Quebecers.

SOURCE: Quebec Medical Association

Denise Pelletier, Communications Coordinator, Québec Medical Association, Tel.: [phone], E-mail: [email protected]