Quebec's Bill 20 is forcing family doctors to work more. Mais non!

Bill 20 in Quebec is going to force family doctors in that province to have a minimum of 1,000 patients in their rosters and work 12 hours per week in a hospital. Doctors can lose 30% of their income if they don't. Can you imagine this legislation for any other professional? Lawyers would fight it to the Supreme Court.The Quebec government says that family doctors there have an average of slightly more than 500 patients in their practice and see 13 patients per day—half of what Ontario FPs see.But the Quebec government forgets that doctors there do much more hospital work than we do in Ontario. Also, the legislation includes doctors who are teaching students and residents (which slows them down), as well as part-time physicians and those who work in medical administration. Also, a lot of family doctors are women, who have a whole other full-time job to go to at home after seeing patients.I think it is wrong to force any doctor to do anything. You will end up with low morale and an exodus to the rest of Canada or the U.S. The U.S. is starved for family doctors now that Obamare is funding tens of millions of patients for the first time. Patients there used to rely on “free” care in ERs but are now be able to afford family doctors.Quebec doctors have some of the lowest fee schedules in Canada. I think the Quebec ministry of health should try a carrot, not a stick.In larger centres in Ontario physicians are not forced to do any hospital work. We have hospitalists who can spend eight hours with patients—not the 10 minutes we as family doctors can afford.Ontario has retired doctors assisting at surgery, and enjoying it. We have full-time emergency physicians who have much more skill in running the ERs than family physicians (I know, I was one for 20 years). We have obstetricians and midwives with much more training and time and funding than FPs.The nice thing is we can do all these things but are not forced to, so we get people doing them who want to and are good at it. It also leaves family phsicians to concentrate on our offices.Ontario FPs can see 30 patients a day comfortably without hospital interruptions. Many of us have government-funded nurses and/or nurse practitioners and/or social workers who can help us with the load.I as an old FP of 67, I see 30 patients per day and have for 42 years. My roster is 1,500 patients and I work 9 to 5, with an hour off for lunch and Wednesday afternoons off. I get eight weeks of paid vacation per year, which costs the taxpayers nothing as I am covered for free by two fellow physicians, and I reciprocate.Our call group is one-in-24 on call. So I have been able to give fast service to my patients and not burn out over 42 years. We offer after-hours instant service to our patients from 5 p.m. to 8 p.m. weekdays and 9 a.m. to noon on Saturdays, as well as and nurse and doctor phone advice 24/7/365.I suggest the Quebec ministry of health sit down with its family doctors and some outside consultants from the rest of Canada who have happy, productive family doctors and try to work out a way to encourage Quebec physicians to increase availability to their patients, and have a good lifestyle as well. They can find a win-win-win for all.Comment below or email me your thoughts at drjohncrosby@rogers.com.Dr. John Crosby is a family physician in Cambridge, Ont.

Quebec's Bill 20 is forcing family doctors to work more. Mais non!

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