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Current version of Bill 20 not supported

Published: 27 February 2015

Proposed Bill would compromise training of future doctors and growth in the number of family doctors

The faculties of medicine of Universit茅 Laval, Universit茅 de Montr茅al, 69热视频 and Universit茅 de Sherbrooke support the intent of the government to optimize resources in Quebec鈥檚 health care system to improve access to family physicians and specialists. However, the faculties today voiced deep concerns to the Commission de la sant茅 et des services sociaux about the expected negative impact on the training of future physicians and the number of family physicians in the province.

鈥淎s written, Bill 20 seriously compromises the activities that are at the heart of our mission,鈥 said Dr. David Eidelman, president of the Conf茅rence des doyens des facult茅s de m茅decine du Qu茅bec and dean of the Faculty of Medicine at 69热视频. 鈥淭he Bill does not recognize the major role physicians play in training the next generation of family doctors, specialists, nurses and other professionals who provide health care to Quebecers. It also does not consider the clinical research conducted by many.鈥

Recognizing the role of the teaching physician

Under Bill 20, doctors would be subject to annual patient quotas that do not fully recognize the additional teaching and research responsibilities of professionals practicing in hospitals and other health care institutions with an educational mission, such as Family Medicine Units (FMUs). These physician teachers are responsible for receiving, supervising, training and evaluating the growing number of cohorts of students and residents in their institutions.

According to the faculties, the impact would be three-fold:

鈻燘ill 20 would make it very difficult for physicians to fulfill their teaching responsibilities, which would undermine quality, make it difficult to train the number of family physicians envisioned by the Ministry and discourage those who wish to become physician teachers.
鈻燜amily medicine as a career choice would become increasingly less attractive; over time, this would reduce the number of family physicians in Quebec.
鈻燫esearch activities would be similarly compromised.

鈥淏ill 20 must contain specific terms so that physician teachers can perform both their teaching and their clinical tasks,鈥 said Dr. Renald Bergeron, dean of the Faculty of Medicine at Universit茅 de Laval. 鈥淚n its current form, Bill 20 would negatively impact the quality of care provided to patients, as well as the number and the quality of future family practitioners trained by Quebec鈥檚 medical faculties.鈥

Family medicine under threat

In the field of family medicine, given the shortage of family physicians, there has been a concerted multi-year effort by all stakeholders, including the Minist猫re de la Sant茅 et des Services sociaux (MSSS), to promote and position this specialty to make it more attractive and to encourage generalism in medical training.

鈥淎t the heart of these initiatives, family physicians have worked rigorously in all areas of medical training. They have taken on this mission and done a brilliant job,鈥 said Dr. H茅l猫ne Boisjoly, dean of the Faculty of Medicine at Universit茅 de Montr茅al. 鈥淏ased on current projections, the annual number of family medicine residency positions, which has doubled over the last ten years, will continue to grow, peaking at 514 in 2017, but Bill 20, in its current form, would seriously compromise our ability to meet this target.鈥

Six principles that must be guaranteed

In its brief to the Commission de la sant茅 et des services sociaux, the Conf茅rence des doyens des facult茅s de m茅decine du Qu茅bec set out six principles that must be guaranteed for the faculties to consider supporting Bill 20:

鈻燩rinciple 1 鈥 Recognition of the crucial importance of formal, ongoing collaboration between the Minist猫re de la Sant茅 et des Services sociaux, the Minist猫re de l鈥橢nseignement sup茅rieur, de la Recherche et de la Science and the faculties of medicine in the transformation of the network
鈻燩rinciple 2 鈥 Recognition of the status of the family physician teacher and the family physician researcher, and adaptation of clinical demands to academic requirements
鈻燩rinciple 3 鈥 Recognition of the status of the specialist physician teacher and specialist physician researcher, and adaptation of clinical demands to academic requirements
鈻燩rinciple 4 鈥 Recognition of a collective and interdisciplinary practice of family medicine in teaching environments
鈻燩rinciple 5 鈥 Recognition that clinical settings, and particularly FMUs, have variable configurations and require resources that are adapted to the populations they serve and teaching needs
鈻燩rinciple 6 鈥 Recognition that specific material conditions are essential to ensure accessibility and quality of teaching

鈥淓veryone鈥檚 contribution is needed to achieve excellence in medical teaching and research,鈥 said Dr. Pierre Cossette, dean of the Faculty of Medicine at Universit茅 de Sherbrooke. 鈥淲e believe we all have a crucial role to play in ensuring high-quality health care is accessible to Quebecers, and teaching by our physicians is at the heart of the solution. We therefore invite the MSSS to an open, constructive dialogue, and ensure the government of our cooperation.鈥

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