Retirements of family doctors are accelerating in Quebec. About 275 general practitioners treating patients told the Régie de assurance maladie du Québec in 2021 that they would leave the practice or would do so within two years. An almost double number compared to 2017, according to data obtained by The duty with the RAMQ.
“The phenomenon will worsen in the next few years, estimates the Dr Marc-André Amyot, president of the Quebec Federation of General Practitioners (FMOQ). 25% of family doctors are over 60 years old. “
According to RAMQ, Montreal GPs who announced immediate or imminent retirement in 2021 are 68 years old on average. The average age is 65 in the Capital-Nationale and in Montérégie. She is 62 years old in Estrie.
These upcoming departures are increasing the number of people registered at the family doctor access desk (GAMF). Of the roughly 990,000 Quebecs listed, more than 136,000 are in attendance as their GP will retire within the next 24 months. Until then, they remain followed by their doctor.
Gaëlle Lebreton, has lost hers. She accidentally learned that her family doctor would be discharging at the end of December. “My partner had an appointment with her and overheard the two secretaries talking about her retirement in a month,” she says.
The 41-year-old from Montreal, a GAMF member, recently got a taste of her new reality as an orphan patient. Getting a Pap smear was “tricky”. “I had to find an appointment [médical] in a “walk-in” just to take the card [la requête] see a gynecologist, because the doctor didn’t do the Pap smear, “he says.
Hélène Rochette fears that her 95-year-old mother – a member of the GAMF since September – will suffer the same fate. “She doesn’t move easily,” she says. Often the family doctor consulted her on her phone to avoid having to bring him. “
Hélène Rochette believes that the Frontline Access Window (GAP), a measure targeting orphan patients at the heart of Minister Christian Dubé’s health reform, is not suitable for older people like her mother, who have rows of “thick” medical products . “They can’t be ‘barouetted’ from one professional to another,” thinks this Quebec citizen. They must, he believes, be treated by a doctor.
Lack of succession
Bridging retirement is far from simple. According to the FMOQ, there is already a shortage of 1,000 general practitioners in Quebec. A fact that the Ministry of Health and Social Services (MSSS) does not claim to be able to confirm.
“There are indeed several early retirements currently among doctors, writes the MSSS in an email. However, it is difficult to quantify the “number of missing doctors” because a doctor does not necessarily work full time. Their activity level varies throughout their career. “
The MSSS points out that medical hospitalizations are increasing (969 in 2022-2023, compared to 915 in 2021-2022). Minister Dubé’s reform also plans to promote family medicine to persuade young people to adopt the profession.
Medical graduates avoid family medicine. “Last year, 75 graduate posts in family medicine were not filled,” recalls Dr.r Amiota. Since 2013, 400 positions have not been filled. “
To meet the needs of orphaned patients, the Montreal Association of General Practitioners (AMOM) believes that the number of places for new doctors in the city needs to be increased. About a third of Montreal family doctors are over 60.
The vice president of AMOM, Dref. Odile Kowalski, denounces the “interference” of the Minister of Health, Christian Dubé, who intervened last summer to reduce the number of posts in Montreal – from 102 to 72 – in favor of 450.
His clinic has suffered the consequences of these changes to the regional medical personnel plans (PREM). Two doctors from his GMF have retired and a third has moved to another region as “pre-retirement”. “But I didn’t have any recruits,” the D saidref. Kowalsky. There has been a reduction in positions in my RLS [réseau local de services]. Last year there were nine PREMs, this year four. Candidates who wished to practice at your clinic did not get one of these positions.
Nil Lefrançois, 75, left his family medicine practice on January 2. He followed 3,000 patients at Beauport Medical Center, a neighborhood clinic he founded in 1977. He was unable to transfer his clientele to a colleague, apart from “a few very heavy patients”.
His “little GMF” is struggling to recruit doctors. Shifts on call most often occur in a clinic with few general practitioners. Remember that an FMG must comply with the obligations imposed by the MSSS, such as “being open 68 or 72 hours per week, going without an appointment from 8:00 to 20:00 and on working weekends”. “When there are 25 or 30 doctors, your shift comes much slower,” he says. For this reason, according to him, superclinics seem more attractive than small medical centers.
Nil Lefrançois indicates that PREMs have also thwarted Beauport Medical Center’s hiring plans in the past. She pleaded her case with Quebec and got a waiver from the PREM in 2019 so that a doctor would join his team.