Ce qui m'etonne,moi,c'est de voir que des gens puissent s'etonner d'une pareille nouvelle.
Les effets pervers des lois qui tentent de gerer la penurie comme s'il s'agissait d'un surplus...Trop de lois,et qui se succedent trop rapidement... Qui peut etre assez naif pour penser que les PREM seront la solution?Ils le seront sans doute,d'ici 15-20,quand les baby-boomers se mettront a mourir(sans etre remplaces en termes de nombre) et que les MD en formation gradueront des ecoles ou on les a admis avec 10-15 ans de retard.Mais en attendant... L'itinerance geree intelligemment,avec formation d'equipes motivees (et qu'on laisse habiter ou elles veulent...)m'est toujours apparue comme un element de solution beaucoup plus prometteur que la coercition.SURTOUT en periode de penurie relative (et absolue)des effectifs.Faut juste changer de mentalite,et realiser que la continuite des soins peut se realiser de diverses manieres. Un pneumologue qui va passer une semaine par mois pendant dix ans en region eloignee devient beaucoup plus un MD- associe-qui-habite-loin qu'un "depanneur".Idem pour des equipes d'hospitalisateurs itinerants qui se relaient pendant des annees et s'attachent a une region.Qui a dit que ce n'etait qu'une solution "pis-aller"??? Faut lacher nos bons gros vieux prejuges sur l'organisation "ideale" de la pratique et faire preuve d'un peu d'imagination. Et enfin comprendre qu'on ne gere pas la penurie comme on gere le surplus.Les decideurs politiques les plus motives se retrouvent malheureusement trop rapidement pris dans la spirale des decisions...politiques,justement. M'enfin. C. > > From: "Martin Loranger" <[EMAIL PROTECTED]> > Date: 2005/02/21 Mon PM 06:18:48 EST > To: [email protected] > Subject: URG-L: Article Gazette > >
| AARON DERFEL | |
| The Gazette |
February 21, 2005
Quebec has been losing nearly half of its new general practitioners to other provinces since a government policy came into effect requiring them to start their careers in regions outside of Montreal.
The province had expected to recruit 216 GPs last year, but only 145 stayed on to practise in Quebec, according to the latest government figures. This means that 71 doctors who were trained in Quebec - many at McGill University - decided to start their careers elsewhere.
The trend has coincided with a policy designed to steer more doctors to remote regions like the North Shore and Gaspesie.
Those doctors who choose to stay in Montreal are docked 30 per cent of their pay. Before they can regain their full salary, they must first work for three years in an outlying region.
"The thought was to redistribute doctors in the province of Quebec. It has really redistributed doctors into other provinces," said Dr. Mark Roper, director of the division of primary care at the McGill University Health Centre.
"It's a shortsighted policy. We don't live in a black box in which we can shuffle doctors around in the province. The law of unexpected consequences is taking place here."
Under the policy, doctors in their final year of residency (hospital training) must apply for a work permit in a given region. Montreal, where most doctors want to start practising, has set aside only 34 positions.
Those who miss out on Montreal must then apply to other regions that are more remote until they get a permit.
Dr. Saul Oberman, a resident at St. Mary's Hospital, contends the policy is based on flawed data. He cited numbers that show Montreal is more in need of family doctors than many regions.
The North Shore has one doctor for every 826 residents, while Montreal's ratio is one to 1,061.
"Right from the get-go, the raison d'etre for the program was poorly formulated," said Oberman. "The rest of the country has incentive-based programs to attract doctors, whereas here in Quebec it's coercive."
Dr. Sara Parniani, a first-year resident at St. Mary's, described the policy as "completely crazy."
"It's like calling into a radio station to win a contest - that's how the permit policy works," she said. "You've worked a decade to get to where you are - and everything is decided on a first-come, first-served basis."
Not only were some medical residents turned down to work in Montreal, Parniani noted, many failed to get permits in their second- and third-choice regions as well.
Health Minister Philippe Couillard could not be reached for comment yesterday.
Quebec currently has a shortage of 800 full-time GPs. More than 300,000 Montrealers don't have access to a doctor
