Orphan patient has been looking for a family doctor for years

Denis Gagné still has it on his heart: he had to go to a private clinic to renew the prescription for his blood pressure medication. The 72-year-old does not have a family doctor and he cannot get a “walk-in” consultation. “I worked until the age of 65, we paid our taxes to pay for a health system, and it revolted me to be forced to pay again to see a doctor in a private practice”, he said.

Denis Gagné registered three years ago at the one-stop-shop for access to a family doctor. He was then living in Saint-Hyacinthe, in Montérégie. In December 2020, he moved with his wife to Quebec and updated his file online. “When I registered at the ticket office in June 2018, I was at 471 days [d’attente]. I’m still 471 days old, ”he says.

He is not at the end of his sentences: his prescription for hypertension medication expires on November 27. This time he plans to go to a “walk-in” clinic in Quebec. Unless he gets a call from a family doctor by then. “Every time the phone rings, I think maybe …”

Testimonies of the kind, The duty has been receiving them constantly since the publication on Tuesday of his article on access to family physicians in Quebec.

In the province, the average waiting time at the access counter is about one year and three months (451 days) for patients deemed to have priority (aged 70 years and over, suffering from cancer or infected with the HIV, for example) and one year and eight months (602 days) for non-priority patients (people who consider themselves to be “in poor health” or who claim to be in “good health”), according to data provided by the Ministry of Health and Social Services (MSSS), which date July 31.

However, these figures are average times: many of the patients interviewed by The duty have been waiting a lot longer.

When I registered at the ticket office in June 2018, I was at 471 days [d’attente]. I am still at 471 days.

Marcelle Thiffault, 67, registered at the access counter in 2018. She claims to have lived an “obstacle course” to renew her prescription for vitamin D which aims to prevent osteoporosis. Every day for three weeks, she contacted two clinics in her region early in the morning to obtain a “walk-in” consultation. No place. She complained twice to the MSSS. She was finally able to see a doctor who renewed her prescription for two years.

Nothing to reassure this citizen of Saint-Charles-Borromée, near Joliette. “I told myself, when my doctor retired, that I wasn’t worried, that I would go to a walk-in clinic,” says Mr.me Thiffault. But I realize that I don’t even have walk-in access! “

Pierre Larocque, who lives in Quebec, believes that one should not count on the counter to find a doctor. “I signed up in December 2019 and was 432 days away,” says the 68-year-old diabetic man. Six months later, another 432 days. A joke. “

He decided to take the lead and used his “medical contacts” to find a doctor. “It took not even two months,” he says. In his view, the average waiting times provided by the MSSS are “bogus”, since patients registered at the counter who find doctors on their own are lowering the average.

False hopes

At the MSSS, it is reported that patients try to find a family doctor themselves by contacting clinics. The fact remains that the care is mainly done through the access window to a family doctor (GAMF).

“In 2018, less than 60% of patients were supported through the GAMF, and since the start of 2021, it is 71%”, we wrote in an email. The Ministry also specifies that financial incentives are planned to encourage physicians to take charge of clients from GAMF.

But how can we explain waiting times of several years? The MSSS replies that the delay may vary depending on “the patient’s state of health, the availability of physicians in the region and the number of registrations on the territory’s waiting list”.

“The pandemic has put pressure on the entire health network, including the first line, which may have led to an increase in the time taken for treatment,” it also says.

Quebec adds that it is working to increase the number of family doctors and to set up a first-line access point, intended for orphan patients. It is also focusing on interdisciplinary practice by making greater use of specialist nurse practitioners (NPPs).

The deputy of Solidarity Quebec Sol Zanetti urges the Legault government to act. In the Capitale-Nationale region, the number of patients registered at the counter doubled between 2018 and 2021, in particular due to the many retirements of doctors. “It was part of their electoral commitments of the [Coalition avenir Québec] to say that people will have a family doctor or IPS, he says. Except that it is not in this direction that they are going: they did not devote any energy to this objective, and there, we are paying the price. “

The first line must be “more efficient” if it is to offer better access to patients, thinks Dr.r Simon-Pierre Landry, co-owner of a family medicine group in Mont-Tremblant. According to him, doctors must “stop doing things that have little added value” or “that can be done by other health professionals”.

The Dr Landry also deplores that the waiting period announced at the access desk creates false hopes. “The data is unreliable,” he says. He compares the entry counter to a constantly growing queue of restaurants in which overtaking is permitted. “The people in the front are the older or sicker people, and they’re served first,” he says. The wait can therefore be prolonged …

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