Quebec's two major physicians' unions have endorsed a controversial April 2 proposal from the opposition ADQ party that would allow doctors in that province to work in the private sector after they've fulfilled a minimum number of hours in the public system.
ADQ health critic Éric Caire introduced the legislation, Bill 392, last week.
Dr Louis Godin, the president of the Fédération des médecins omnipraticiens (general practitioners) du Québec, announced a few days later, "The Federation believes that free choice should be offered to physicians. The conditions and rules around mixed practice should be established in consultation with physicians."
"The idea of mixed practice is very interesting and should be considered seriously," said Dr Gaétan Barrette, the president of the Fédération des médecins spécialistes du Québec. "This bill seems to satisfy the objective of maintaining and protecting the public system as well as implementing some of the recommendations of the Castonguay report."
(For more on the Castonguay report and the Liberal government's uncertain response to its recommendations on reform, read my article from last month's NRM.)
In the National Assembly on April 8, Mr Caire confronted Liberal Health Minister Philippe Couillard about his equivocation on Bill 392. Dr Couillard said, in essence, that he's in agreement with the ADQ on the philosophy behind the legislation but that he's unwilling to introduced mixed practice during a time when Quebec is suffering from a doctor shortage. That prompted a sarcastic response from Mr Caire, calling Dr Couillard out for his initial dismissal of Bill 392 and his gradual warming-up to it: "Monsieur le Président, I'm happy to see the Minister of Health is preparing for a career in comedy after his career in politics." In a press release, in a press release, Mr Caire also called Dr Couillard the "champion of inaction" and scolded him for supposedly letting his pride get in the way of coming to a consensus with the ADQ on healthcare reform.
Without the support of Dr Couillard, the bill is unlikely to become law; the Parti Québecois, which could conceivably help the ADQ to outvote the Liberal minority government on this, is typically the most left-wing of the three parties when it comes to healthcare privitization.
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Friday, 11 April, 2008
Quebec MDs endorse proposal to allow mixed public-private practices
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As we move toward a reinterpretation of what constitues "medical " care and how it is costed....GP's should be astute in the following areas:
ReplyDelete1. their rights in a democracy to equip/express their vocation as they choose.... keeping in mind that the move to collaborative, interprofessional and muilti-disciplinary practice has three key features related to marketplace value (on public contract or private payor):i.e.
+these teams will eventually develop matrix models that are "branded" and that reputation is what makes their practice lucrative ( e.g. Mayo clinic)
+maturity matrix models could be developed and privately owned, thus earning from "reputation"and ?franchise
+ services development related to "needs-based, wants-based ,and access-based service.... must be developed ( read Regina Herzlinger)"
2. Primary care may be redefined where the GP "lead" is not essential. As part of an interprofessional group may be the "only" context in which fees are paid.
With respect to that possible eventuality they should be as active as possible in redefining how primary, secondary, tertiary and quaternary care are costed and inclusive ( a possible broadening of their skillbase).
The search for "continuity" in the continuum of care is over 50 years old. It has always been a "top-down search" and the time has now come where a "bottom-up" perspective should be reviewed.... for it is there where the "real" earnings grow exponentially through coordination , as well as through client ( payor and user) satisfaction.