See a medical specialist in Quebec: 10 days private, 381 days public

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See a medical specialist in Quebec: 10 days in private, 381 days in public

For five years, the number of doctors practicing outside the Quebec health insurance plan has increased by 35%.

The premises of the Lacroix Medical Group in Boucherville

When she went to the private clinic of the Lacroix medical group in Laval, at the beginning of the summer, Sophie Tardif could not get an appointment with a pulmonologist in the Sherbrooke region.

< p class="e-p">At the Fleurimont Hospital of the University Hospital Center of Sherbrooke (CHUS), I had a year of waiting to do breath tests […] And I wanted answers right away suite, exclaims Mrs. Tardif.

During our visit to the Laval clinic a few days ago, specialist doctor Jad Hobeika had good news for him.

We eliminated a lot of cases in your case: no asthma, no chronic obstructive pulmonary disease, no anemia, you're not deconditioned, he explained to her.

Ms. Tardif drove more than seven hours and paid a few hundred dollars for her two appointments. She does not regret her choice. I attach more importance to my health than before, says Ms. Tardif.

The patient Sophie Tardif meets a pulmonologist from the Lacroix Medical Group.

Getting an appointment with a medical specialist in the public network requires unprecedented patience in recent years.

According to the latest data from the Ministry of Health and Social Services (MSSS), there were 784,000 requests pending for all specialties in August, up 60% since September 2020.

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The average time to get an appointment went from 267 to 381 days.

In respirology alone, more than 27,000 requests were pending in Quebec with an average delay of 322 days (46 weeks).

A situation at odds with what the Laval clinic says it is living.

Currently, I have a lead time of one to two weeks for a first appointment, says pulmonologist Jad Hobeika.

< p class="sc-1wicwa1-0 gfWqyy">Totally private medicine is growing in Quebec. Exasperated patients pay out of pocket for faults in the public. 555 doctors are disaffiliated from the public network, an increase of 35 per cent in 5 years. And it's not just cosmetic surgery anymore. Report by Davide Gentile.

A graduate in internal medicine and pneumology since 2016, the latter joined the Lacroix Medical Group in January 2022 after spending a few years in the public, where he was notably head of the pneumology department in a CISSS in Greater Montreal.

To the public, we saw patients with cancers and urgent cases within a few weeks. Otherwise, for the others, we were talking about months or years of waiting […] I was not comfortable with the number of patients on the waiting list, he explains.

According to Dr. Hobeika, there is an accessibility issue in the system that the private sector allows me to fill in a little […] We are adding an offer for patients who can come to see us without a referral, to obtain a second opinion , who have access to quick appointments, get diagnostic tests quickly.

Jad Hobeika, Pulmonologist, Lacroix Medical Group

As underlined by administrative director of the Lacroix Medical Group, Jean-Nicolas Chagnon, the demand is there […] The growth is exponential each year.

People need services quickly and we offer accessibility, a complement to the public network, he adds.

A nurse practitioner specializing in mental health has joined the group at the beginning of the summer, alongside a general practitioner.

Both of them appreciate the professional freedom that their employer gives them and also deconstruct the myth that the private is frequented only by rich people.

On the contrary, we see everything, even patients on social assistance who have saved up to come and consult, underlines Émie Gervais, general practitioner in the private sector since obtaining her diploma six years ago.

After modest beginnings in the Quebec City region, the Lacroix Medical Group now has 90 doctors in ten clinics across Quebec, two operating rooms, a private laboratory and nearly a hundred employees.

Physicians who are making the leap to the private sector are more and more numerous in Quebec. Sometimes to practice full-time, if not alternately with their practice in the public network.

According to the most recent data from the Régie de l'assurance maladie du Québec (RAMQ) , the number of medical specialists who have made the leap to the private sector over the past five years has increased by 55%, to 178 doctors.

There are notably dermatologists, plastic surgeons, but also anesthesiologists, gynecologists, radiologists, psychiatrists and a handful of pulmonologists, such as Dr. Hobeika.

Family doctors are also more likely to make the leap to the private sector.

Over the past five years, their number has increased by 27%, to 377 doctors.

In total, the percentage of physicians who practice outside the health insurance system is heading towards 3%, whereas it was less than 2% in the mid-2010s.

There are more than 21,000 physicians in Quebec.

A physician who decides to work in the private sector as a non-participating physician must, in particular, inform the RAMQ, notify his patients that they must fully assume fees and display rates in the office waiting room.

According to MSSS data, there are 22 specialized medical centers where non-participating physicians practice exclusively.

In March 2022, the group Médecins québécois pour le régime public published a press release recalling their concern about the ambitions of the private sector.

“Each health professional working in the private sector is one health professional less in the public network. »

— Quebec doctors for the public plan, March 2022

A doctor working both in the public and in the private sector can refer his own patients seen in the public sector to provide care in the private sector and increase his income […] This raises important ethical issues because of the blatant conflict of interest that this engenders , he wrote.

At the Montreal Economic Institute, we rather promote the liberalization of the health care system, in particular by lifting the ban on the duplicate health insurance as well as restrictions on the mixed practice of health professionals.

In 2005, the Supreme Court of Canada ruled in the Chaoulli decision that, when Quebecers do not have access to public health care within a reasonable time, they should be able to take out private insurance.

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The Health Insurance Act was later amended to allow private insurance, but only for knee, hip or cataract surgeries.

Since the start of the election campaign, most political parties have spoken out in favor of increasing or reducing the outsourcing of surgeries to the private sector using the health insurance card. A phenomenon that has reached about 15% of the volume since the start of the pandemic.

The Conservative Party of Quebec (PCQ), in particular, would gradually explore the possibility of giving free choice to Quebecers to subscribe to private supplementary insurance to obtain health care already covered by the health insurance plan.

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