Last month, in an interview on Radio-Canada, host Annie Desrochers asked the president of Médecins québécois pour un plan public (MQRP) this question: “What do we really want: l access to a doctor or access to care? »A question that exposes the importance of clearly identifying the main issue before wanting to respond to electoral commitments.
The systemic problems of the health network are the source of difficult challenges for anyone wishing to reform the complex machine, regardless of their political stripe. Since cause and effect links are often not immediately apparent, it therefore becomes essential to draw on diverse perspectives to offer lasting solutions.
Does every Quebecer really need a family doctor? Does this solution offer efficient and equitable access to health care? In a society where demographers are projecting ever-aging pyramids, can we hope that this accounting ratio will hold up in the coming decades? Several experts think not, and as the journalist Philippe Mercure headlined in Press, the time has come to free doctors from their role as network gatekeepers.
When we talk about the right care at the right time, it means consulting the right person in the right place, without necessarily seeing the doctor first. This premise involves exploring all the possibilities in the already existing service structure. Needs have changed, and at the same time, the health professions have undergone great transformations, with more in-depth clinical and scientific training, giving them the necessary tools to play a better role in the system.
Pilot projects reporting the benefits of making appointments in the front line with interprofessional teams have already proven their worth in family medicine groups (FMGs) across Quebec. The time has now come to make judicious use of the number of visits with doctors by democratizing adapted access, as proposed by the MQRP. From our point of view, this optimization of all the actors and actresses in the FMGs must be done by the sharing of tasks and certain reserved rights, such as the prescription of short-term work stoppage or even certain examinations.
Throughout its history, medicine has been dependent on the conceptions of its time reflecting a perception of the world specific to each era. Faced with the difficulties we are experiencing, the question we must collectively answer is: what is our vision of health in the XXIe century? Does it rest only on the shoulders of the doctors? By stating the problem in this way, we will be able to redefine the social function that the expertise of all professionals in the current network must play. This is, in our opinion, one of the keys to unlocking access to health services in the public network.
* Texte also written by Axel Sessler, physiotherapist in GMF / GMFU; Marie-Eve Toutant, physiotherapist in GMFU and clinical professor at Laval University; Philippe Ouellet, physiotherapist in a rehabilitation center and clinical lecturer at Laval University and Marjorie Gingras, fellow physiotherapist in FMG with expertise in advanced neuro-musculosqueletti physiotherapythat
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