Whenever it meets with physicians in their environment, the QMA has observed that many of its members are committed to improving care and services on a daily basis. Great initiatives are taking shape everywhere. Some of them should even be implemented or adapted elsewhere, but for this to happen, we need to know that they exist!
If you have set up a project that deserves more visibility or if you know of members colleagues who have done so, feel free to contact QMA. We would be pleased to showcase your achievements.
Doctors need to promote successful models
Like many QMA members, Montréal-based family doctor George Michaels believes we need to rethink things if we want to meet the population’s health needs.
Backed by a strong conviction that health care and services should revolve around the patient, Dr. Michaels has always advocated for this type of model, both at St. Mary’s Hospital, where he used to practice and teach, and at Clinic MDCM, a family medicine group (FMG) in Montréal’s Centre-Ouest district, which he currently owns and operates.
Dr. George Michaels invited QMA president Dr. Hugo Viens to Clinic MDCM
to discuss the importance of doctors rallying together.
“I managed to convince my former colleagues that a teaching hospital could become a patient‑centred environment, and I’m convinced the same goes for an FMG,” Dr. Michaels explained. For Dr. Michaels, continuity of care and services is essential, and an FMG is an organization that is particularly well suited to treating a population, provided all healthcare professionals—specialists and family doctors included—abandon their silos and work together.
Tear down the silos, focus care on the patients
Clinic MDCM became an FMG in November 2016. With its 33 family doctors, it treats more than 37,000 registered patients with an attendance rate of nearly 82%. The clinic also has specialists on staff. Dr. Michaels believes that family doctors and specialists need to collaborate when it comes to patient follow-up: “They need to communicate. A family doctor needs to be able to call a specialist to refer a patient or ask a question, but a specialist also needs to be able to refer patients back to a family doctor.” When Dr. Michaels was practising at St. Mary’s Hospital, 20 to 30 years ago, everyone worked alone, and the wall between specialists and family doctors had to be broken down. Today, the same thing has to be done in FMGs between doctors and other healthcare professionals.
Clinic MDCM, a level 9 FMG, also employs nurse clinicians and nurse practitioners, social workers, a nutritionist, and a pharmacist. In bringing all these professionals together, “we really emphasized teamwork and trust,” pointed out Dr. Michaels, who feels strongly that success breeds success.
Doctors standing together to be heard
In Dr. Michaels’ opinion, doctors need to band together if they want their practice to change for the better. He believes doctors need to convince managers and the population that the FMG model, which is still not very well known, is capable of meeting the health needs of a population. The 14 FMGs in the CIUSSS that encompasses Clinic MDCM have some 265,000 registered patients out of a total population of 320,000—more than two-thirds of the territory’s population. According to discussions by the round table of FMGs in this CIUSSS, if each doctor took on 33 more patients, they could empty out the waiting list for the Québec Family Doctor Finder (GAMF).
The high attendance rates of several FMGs in the CIUSSS Centre-Ouest-de-l’Île-de-Montréal also show that it’s possible to meet the needs of this population, including those of the most vulnerable patients, patients with complex needs, or patients with decreasing autonomy who require home care.
While nearly 80% of Quebecers now have a family doctor, it’s obvious to Dr. Michaels that high attendance rates and physicians’ ability to work through the waiting lists for family doctors are priority front-line issues, which is why he believes that FMGs need to join forces in order to make themselves better heard by decision-makers at the CISSSs, CIUSSSs, and the Ministère de la Santé et des Services sociaux. In fact, FMGs have the potential to become service outlets responsible for the treatment and follow-up of entire populations within a district, provided they are given the necessary regional medical staffing plans (PREMs).