Province preps project to get patients without family doctor quicker access to care

Like tens of thousands of Quebecers, Claude Viau is registered on the province's waiting list for a family doctor.

The 67-year-old has been on the list for more than 1,270 days, or three and a half years. 

"With my taxes, I contribute to the public health system, and that's fine with me," said Viau. "But to make that contribution for a service I don't have access to because I don't have a family doctor, it's a situation that, for me, is very frustrating."

The Quebec government is hoping to put an end to Viau and others' frustration in the coming months, by implementing a one-stop resource for people without family doctors who need access to primary care, known in French as Le Guichet d'accès aux soins de première ligne (GAP). 

According to Radio-Canada's La Facture, Quebecers will be able to call a phone number, which will vary by region, and speak with a health professional who will evaluate their needs before directing them to a physician, nurse or pharmacist at a nearby clinic or pharmacy.

The service is expected to be up and running by March 31, 2022.

It's not the only initiative from the province that aims to make it easier for people without a family doctor to get access to care. 

On Nov. 11, the Coalition Avenir Québec government tabled a bill that would make doctors enter their work schedule in a new appointment booking system. The idea is to get a sense of doctors' workloads and see if there is room to take on more patients.

Eventually, the province's goal is to help the estimated 1.5 million Quebecers without a family doctor to be able to find one.

The GAP system is different, however, in that it does not necessarily refer a patient to a physician.

"A patient can think that they need a doctor, but there are also a lot of pharmacists that can fix [many] situations," said Maryse Proulx, one of the first nurses to enroll in the GAP in the Montérégie-West region.

"The doctor isn't always the first resource to fix a problem that a patient has."

The GAP project is rolling out across Quebec, after a pilot project in the Lower Saint-Lawrence region.

About 8,900 calls were received in that region. Half of the callers were referred to a physician, and 10 per cent of the callers ultimately found a family doctor.

No family doctor, no services

According to Radio-Canada, patients without family doctors have been struggling to access services, partly due to the fact that general practitioners were pressured by the previous Liberal government to see more of their registered patients. 

That left many Quebecers feeling as if their only options were the private sector or the hospital emergency rooms.

Martin Forgues, who helps oversee access to proximity services for the province's Health Ministry, says the GAP system will help level the playing field for those who don't have a family physician.

"Fundamentally, there's an equity problem between those who have a family doctor and those who don't," said Forgues.

"So we had to find a concept, a mechanism, that could help and give medical services to the [part] of the population that doesn't have a family doctor."

Concerns about workload

As part of the GAP project, the province's Health Ministry will ask physicians to free up about 10 per cent of their schedule for patients who don't have family doctors.

Dr. Anne-Isabelle Dionne, a physician in Saint-Mathieu-de-Beloeil, a municipality located 40 minutes east of Montreal, says she is worried that doctors' workloads are already too heavy. She also wonders if taking on more patients will lead to shorter appointments.

But overall, she's optimistic about the project. 

"We'll be able to redirect people that need psychologists or nutritionists, a nurse or a pharmacist that will be able to prescribe medication without going through a doctor's office," she said. 

According to the Health Ministry, the province's ongoing efforts to recruit more nurses into the public system are an important part of the project.