Free membership for all residents!

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Free membership for all residents!

As of January 1, 2019, membership in the Québec Medical Association will be free for all residents. Being a member means supporting the only professional association that serves as a voice for the entire medical profession.

As students do, residents can take advantage of all QMA and Canadian Medical Association services. The QMA is proud to provide support for its members throughout their studies.

The QMA is also developing exclusive projects for member residents, including training events to help them enhance their leadership skills.

To renew your membership, log in to your member section at www.amq.ca/en.

 

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Choosing Wisely Canada National Meeting: update on overuse

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Choosing Wisely Canada National Meeting: update on overuse

The next Choosing Wisely Canada National Meeting, organized in conjunction with the Canadian Medical Association, and co-hosted by the Québec Medical Association, will be held in Montréal on May 27, 2019.

Stakeholders at the 2019 National Meeting will have the opportunity to discuss the need for reducing the overuse of medical services. To register, click here.

You have until January 31, 2019, to submit your abstracts, which must address one of the following five topics:

  • Quality improvement
  • Measurement and evaluation
  • Deprescribing
  • Medical education
  • Patient engagement

Choosing Wisely Canada has set itself a mission to reduce the amount of unnecessary medical tests and treatments that patients undergo. This campaign was launched in Canada on April 2, 2014, as part of a global movement that originated in the United States in 2012, and which has now taken hold in 20 countries on five continents. The QMA has been involved in the French-language component of the campaign since the outset.

Unnecessary medical tests, treatments and procedures are those that are done without adding any value to the patient’s care. While they can provide useful information or confirmations, they can also expose the patient to risks. In fact, they can lead to more tests to rule out false positive results, contributing to the stress felt by patients and their relatives. They also have harmful consequences on access to care in that they are a waste of time and resources.

Choosing Wisely Canada encourages healthcare professionals to step up as leaders in the reduction of unnecessary tests, treatments and procedures by giving them resources and easy-to-use tools to help them make wise choices. It also works with patients to educate and inform them about this issue.

As a delegate at the 2019 National Meeting, you will have the opportunity to: 

  • interact with the Choosing Wisely Canada community and participate in stimulating discussions about overuse;
  • acquire the skills needed to reduce overuse in medical practice;
  • share concrete strategies for reducing overuse and measuring its effects.

ACTION nationalmeeting graphic

 

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Post-election issues

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Post-election issues

While it’s true that the new government is creating opportunities, let’s be honest—all our problems aren’t going to disappear overnight. We’re going to keep facing the same issues. The good news is that we can tackle them head-on with a new outlook and new approaches.

The new government needs to improve access to services while ensuring that public funds are used appropriately. More good news: The CAQ’s election promises and the willingness shown by the new trio in the health portfolio, Minister of Health and Social Services, Danielle McCann, Junior Minister for Health and Social Services, Lionel Carmant, and Minister Responsible for Seniors and Informal Caregivers, Marguerite Blais, are on the right track. Their goal is to address the root causes of several critical issues.

At the QMA, we’ve been analyzing these issues for a few years now, and we’ve come up with a number of solutions based on professionalism, the fight against overdiagnosis, the organization of care, and innovative ideas.

Closer ties between decision-makers

We at the QMA believe that physician executives and institution managers need to work together to implement and reinforce clinical governance rules in the field. These stakeholders have the ability and the expertise needed to introduce effective measures suited to their environment.

Relevance

Since 2013, the QMA has been working to educate doctors, decision-makers and patients about the issues of overdiagnosis, overtreatment and overmedicalization. The tests, procedures and treatments administered aren’t always relevant, a fact that’s jeopardizing the sustainability of our public health system.

The care trajectory within larger teams

In recent years, the QMA has analyzed several care models in place in other Canadian provinces or U.S. states. Optimal patient management hinges on making care trajectories more efficient. This means patients need to be managed by larger teams, with a collective responsibility for access and outcomes, and of course with the appropriate funding. These new approaches result in the patient being seen by the right professional, in the right place, at the right time, not to mention that they also improve teamwork.

Refocusing care on the patient

Over time, the health system has become overly focused on the needs of healthcare professionals, and on the way in which they divide up their work and patient services. The time has come to refocus medical care on the patient’s needs, by taking a population-based approach to these needs and by adjusting our practice to give more priority to shared decision-making.

Health funding

What’s needed is a service funding structure that identifies the needs of the population and addresses them through specially tailored structures and teams with collective accountability. In order to truly rethink the care trajectory within larger teams, the funding needs to be refocused on the patients. In other words, the money needs to follow the patient.

Review of compensation mechanisms

In order to encourage true interdisciplinarity and allow healthcare professionals to work together in a way that complements each other, what’s needed is an in-depth review of physician compensation mechanisms. And to do this properly, we need to change our outlook on the debate. The question isn’t so much the amount physicians are paid as how the compensation package is divided up. And it’s up to physicians to take charge on this issue.

Innovation

New ways are emerging of dispensing patient care, such as teleconsultations and virtual clinics, but beyond being the stuff of new technologies, innovation has a lot to do with organization and communication. If we want to improve care trajectories and be able to work together in bigger teams, we also need to come up with new tools to better share information between care teams and patients.

Now is the time for us to show that physicians are motivated to work alongside the ministers in the health portfolio and on the Conseil du trésor. The major issues facing our profession are the same as those that concern the government and the general population. We all want a better healthcare system. Are you ready for it? I know I am!

Dr. Hugo Viens, B.Sc., M.D., FRCSC 
President, Québec Medical Association

 

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Rules of Moderation for Comments Submitted to QMA-Info

Wishing to promote quality discussions among its members, the QMA welcomes your opinions and invites you to comment on its articles. But first, we would like to lay down a few rules to ensure a tone of moderation in members’ comments.
To begin with, your comments will be read before they are published—not to censure the content, but rather to ensure a friendly forum for discussion.  
So, in order for your comments to be published, we ask you to abide by the following rules:

• Do not overuse capital letters: putting everything you want to say in capital letters is akin to shouting;
• Avoid making discriminatory statements: obviously, statements that may be construed as racist or sexist will not be tolerated;
• Refrain from making aggressive or violent statements: you are free to disagree with something you’ve read, but avoid overreacting;
• Do not insult people: As physicians, we must foster collegiality in our communications with one other.

Our goal, of course, is to promote good discussions.
Thank you for your understanding.

 

 

To comment on this article or view the other comments, click here.
Comments in both languages are grouped in the French version.

Are you ready for your CaRMS interviews?

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Are you ready for your CaRMS interviews?

If you are a student and preparing for your residency applications, you can improve your interview techniques through the exclusive CaRMS preparation program offered by the Canadian Medical Association in collaboration with the Québec Medical Association. This mock interview service is provided free of charge to active members.

During these meetings, medical residents who have been through the interview process will ask you typical questions, provide feedback on answers, and lead discussions in a group setting. They will give you advice and information to help you approach your interviews with confidence.

These meetings will be held on the following dates:

  • Université de Sherbrooke – Saturday, December 8
  • McGill University – Sunday, December 9
  • Université Laval – Sunday, December 9

Are you interested? Here’s how to register:

  • Tell us your preferred location, date and time;
  • Click here and log in to CMA.ca using your CMA ID: 
    If you have not yet registered your CMA ID, go to cma.ca/register to create your username and password;
  • Review and if necessary update your contact information to ensure that everything is accurate;
  • Select the date and location that is most convenient for you:
    *You may only participate once;
  • After selecting a city, indicate your top five choices of sessions and times by dragging and dropping them into the specified area;
  • Submit your request — we will confirm your spot within seven business days.

Remember: You may only submit your choices once, so please make sure you review your selections prior to submitting them.

If your schedule does not allow you to participate at any of the locations or if you have any questions, please contact CMAmembership@cma.ca.

Note: This offer is only for students preparing for medical residency.

 

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Introduction to medical practice management: Understanding and fulfilling your role in the organization

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Introduction to medical practice management: Understanding and fulfilling your role in the organization

Do you want to equip your team to manage organizational priorities more effectively and understand your institution’s funding mechanisms?

Would you like to promote greater awareness of the duties, responsibilities and obligations of various players in your organization?

Physician executives play a strategic role in the organization, but most often without having management training. However, it is vitally important that they have basic knowledge to more effectively take on their managerial role and more easily carry out their assigned responsibilities.

To help public healthcare institutions provide their physician executives with all of the necessary tools, the Québec Medical Association has set up a comprehensive training course covering basic knowledge of practice management. This program entitled Introduction à la gestion médicale : Comprendre et assumer son rôle dans l’organisation covers the following topics:

  • useful legal instruments for management;
  • budget principles;
  • strategic planning;
  • steps to follow to complete a project;
  • interrelationships between various institutional authorities;
  • winning conditions for effective partnerships between medical practitioners and administrators.

For each organization, this certified training will be tailored to the institution in which it will be given.

To learn more, go to www.amq.ca/medecins-gestionnaires/offre-de-service (In French only).

 

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The story of Dr. Ak'ingabe Guyon and her two million patients

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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.

The story of Dr. Ak'ingabe Guyon and her two million patients

Akingabe Guyon photoQMA member Dr. Ak'ingabe Guyon was recently awarded the Public Health Physicians of Canada’s President’s Award, in recognition partly for her public health advocacy work. In 2015, she didn’t hesitate to take her protest straight to the National Assembly when the government slashed the budgets of regional public health teams by 33%.

As an assistant clinical professor at Université de Montréal’s École de santé publique and a consulting physician at the Direction de santé publique de Montréal, where she has worked since 2013, Dr. Guyon was unwilling to stand by and watch as the teams that keep the public health system running were dealt a crippling blow. “We don’t have any big machines, scanners or expensive drugs—our treatments depend on the partnerships and relationships we make and on the influence we have on people,” she explained. If we start sabotaging these multidisciplinary teams of doctors, epidemiologists, nutritionists, sociologists, demographers, etc., then we’ll be less well armed to win the battles that, 10 or 15 years down the line, have the potential to turn into resounding victories in the form of spectacular health outcomes.

The work done by the Centers for Disease Control and Prevention in the United States shows that 25 of the 30 years of life expectancy gained in the past 100 years are attributable to prevention, compared to only five years gained through curative treatments! “These staggering effects make prevention non-negotiable,” Dr. Guyon said, both for her personally, which is why she chose it as her speciality, but also on a population level, because of the tremendous difference it makes on people’s health.

Building up Quebec’s public health capacity

Dr. Guyon remains convinced that the 2015 cuts will continue to have negative effects for years to come. “The situation can be compared to having one-third of your body amputated. The rest of the body might continue to function and slowly heal, but it’s not without its consequences.” In her opinion, there’s no doubt that Quebec needs to start playing catch-up with the other provinces in order to build up its public health capacity.

According to the Commissaire à la santé et au bien-être, Quebec currently contributes 2.8% in funding to its public health system, compared to the Canadian average of 5.5%— far from the shining example of public health that the province once was and making it impossible to be as efficient as we should be. “We have recognized, proven solutions and interventions that actually reduce preventable deaths and diseases. But given all the cuts and disinvestment since 2011, the teams are no longer capable of delivering the dose, the dose being the team itself,” explained Dr. Guyon. In short, we have a pretty good idea of what can be done, what needs to be done, or what needs to keep being done, but it’s impossible to do it well enough.

Quebec was once the envy of the rest of Canada for its public health capacity and interventions, which were considered the most innovative in the country. However, Dr. Guyon is optimistic and hopes that in the next few years, “we’ll be able to make up ground again, to everyone’s benefit.” She was very encouraged by this fall’s election campaign. “This is a government that recognizes the benefits of public health and prevention initiatives,” she said. She also keeps several quotes from François Legault handy in case the new government starts backsliding on its public health promises.

Battling the effects of climate change and social inequality

Obviously, the need for prevention isn’t going away anytime soon. And the worst is yet to come, given the growing issues of climate change and social inequality, two issues with harmful effects on health because they cause “preventable deaths and diseases.”

Hence the importance of doctors continuing to defend health in general and public health in particular. It’s obvious to Dr. Guyon that physicians are “excellent messengers of the problems they see in their patients every day. Physicians are healers, but they’re also witnesses to the things they see on a larger scale.” This means they can attest to their patients’ problems; they’re also justified in explaining that the reason why some of their patients are sick is because what should have been done up to that point wasn’t actually done. Physicians need to commit to defending health in general—not just individual patients, but all patients—and to fight, if need be, for what their patients should be entitled to in order to improve their health. Dr. Guyon admits that physicians are tired and overworked; nevertheless, she is calling on them to speak out on this issue with democratic institutions, such as the Protecteur du Citoyen, the Auditor General, or users’ committees.

The healthcare system needs to create health, not just provide care

With two million patients on the island of Montréal, there’s nothing stopping Dr. Guyon from taking her campaign for prevention public! But how, exactly? By reminding people that they have the right to “demand that the healthcare system keep them healthy.” Treating a disease is one thing, but the healthcare network, in conjunction with all its partners in the municipal government, community organizations and society in general, should also be able to “generate health.” She also thinks it’s crucial that we showcase “the incredible successes” we can achieve through prevention, not to mention “honour the clinical prevention work done by physicians, nurses, midwives, respiratory therapists, etc.”

Public health may not be glamorous, but it works, and for it to work even better, the healthcare system needs to help healthcare professionals deliver clinical prevention, “meaning counselling, immunization, screening, and the evidence-based initiatives that generate health. It’s important for me to reinforce what my clinician colleagues are already doing in terms of clinical prevention work, and to say out loud that if they want to keep doing what they’re doing, the healthcare system needs to support them.”

 
What is clinical prevention?
According to the Canadian Task Force on Preventive Health Care, clinical prevention is based on four areas: immunization, screening tests, counselling, and preventive treatments, for example, prophylactic chemotherapy or treatment prescribed to the partner of someone with a sexually transmitted infection.
 

 

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Rules of Moderation for Comments Submitted to QMA-Info

Wishing to promote quality discussions among its members, the QMA welcomes your opinions and invites you to comment on its articles. But first, we would like to lay down a few rules to ensure a tone of moderation in members’ comments.
To begin with, your comments will be read before they are published—not to censure the content, but rather to ensure a friendly forum for discussion.  
So, in order for your comments to be published, we ask you to abide by the following rules:

• Do not overuse capital letters: putting everything you want to say in capital letters is akin to shouting;
• Avoid making discriminatory statements: obviously, statements that may be construed as racist or sexist will not be tolerated;
• Refrain from making aggressive or violent statements: you are free to disagree with something you’ve read, but avoid overreacting;
• Do not insult people: As physicians, we must foster collegiality in our communications with one other.

Our goal, of course, is to promote good discussions.
Thank you for your understanding.

 

 

To comment on this article or view the other comments, click here.
Comments in both languages are grouped in the French version.

Twitter and Facebook messages of the month

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Are you interested in the latest medical news, the future of the medical profession and health issues? Then join our community in the social media, where the opinion leaders express their views! Our communities are growing. Follow us and connect with us!

twitter @amquebec

facebook www.facebook.com/AMQ.QUEBEC

 

Messages on Twitter

 

 

 

 

 

 

 

 

 

Messages on Facebook

 

 

 

 

 

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Lionel Carmant launches his early screening strategy for children

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Lionel Carmant launches his early screening strategy for children

In an interview with a journalist from Le Soleil, Junior Minister for Health and Social Services Lionel Carmant unveiled his early screening program for developmental and learning disorders in babies and children aged 0 to 5, a promise he made during the election campaign.

He plans to introduce throughout Québec an approach that he tested at Montréal’s Hôpital Sainte-Justine while working there as a neurologist prior to being elected.

Under this new strategy, parents will no longer need a doctor’s diagnosis to get therapy for their child. Instead, they will have to fill out an online questionnaire on the A.I.D.E. platform (Approche interactive au développement de l’enfant) to determine whether their child has a developmental delay.

Children screened through the platform will then be treated at the CLSCs by teams of early childhood experts. Once this project is up and running, each CISSS or CIUSSS will have two teams of 10 people available to follow patients: two physiotherapists, one occupational therapist, one psychologist, two speech language pathologists, one psychoeducator, one nutritionist, one social worker, and one coordinator. 

The CAQ believes that addressing issues earlier on in childhood will lead to a higher high school graduation rate among young Quebecers.

The strategy, set to launch in early 2019, will be in place across the province by 2020. Mr. Carmant estimates its cost at $40 million per year.

 

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The QMA at work for patients

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The QMA at work for patients

CAAP Image 2On November 6, at the invitation of the Centre d’assistance et d’accompagnement aux plaintes (CAAP) - Montérégie, Dr. Hugo Viens spoke about the QMA’s opinion on the healthcare system’s responsibility for placing the patient at the centre of the decision-making process.

Dr. Viens reminded the audience of some one hundred people about the importance of the QMA’s mission and its willingness to support physicians who are committed to improving the system and, by extension, patient care.

“At the QMA, we believe that, in addition to their individual responsibility toward their patients, physicians have a collective responsibility to make sure the healthcare system works better and that we improve the health of the population,” stated Dr. Viens.

The president spoke to audience members about several concrete solutions that the QMA is helping to implement. Reducing the incidence of over-diagnosis and over-medicalization has effects on the access to and quality of care that patients receive. Dr. Viens also explained that, while physicians and patients can certainly do their share to reduce the scope of over-diagnosis and over-treatment, there are also systemic and cultural factors at play in these issues.

Physicians and patients would therefore benefit from investigating tools such as Choosing Wisely Canada, which promotes informed joint decision-making.

“To make sure medical care is more relevant, the system absolutely needs to be more focused on the patient’s needs,” Dr. Viens continued, explaining why it’s essential that we start rethinking the care trajectory within larger teams. All healthcare professionals on a team have their own role to play, but we need to give them the means to work together. It’s a waste of time if they’re all doing the same thing, just in a different way. Of course, there’s still a lot of work to be done to improve this, but we’re already seeing a change in culture within our organizations.

And if we want healthcare professionals to work with patients as a team, the service structures and financing mechanisms will have to be adapted accordingly. This means we will need to refocus financing and care on the patients. “The only way to effect change is to address the problems with the system,” explained Dr. Viens. “And, of course, physicians have an important role to play in all this through their leadership positions.”

The president then touched on the importance of innovation, reminding audience members that if we want to improve population health, we need to think outside the box and be open to new ways of doing things. This could mean adapted access at the organizational level, or new tools such as the Québec Health Booklet, the CRDS, and electronic medical records.

In conclusion, what patients need is a system that allows them to be treated by a team, in which the healthcare professionals caring for them have the tools they need to provide a continuum of care—care that’s necessary and appropriate to the patients’ personal situation and that they have chosen themselves, in consultation with their physician and healthcare team, as part of a joint decision-making process.

 

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Extension of the registration period for the QMA’s 2019 Regional Members Forum

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Extension of the registration period for the CMA’s 2019 Regional Members Forum

If you would like to participate in the CMA’s 2019 Regional Members Forum to be held in Montreal on January 28, but you haven’t had the time to register before the registration cut-off date on Friday, November 23,  don’t worry! The date has been postponed to Monday, December 3.

The Regional Members Forums are held to mobilize members and gather their ideas on how to make best use of the CMA’s advocacy activities and resources to effect change. In 2019, four forums will be held in Canada, including one in Montreal.

These forums will focus on two pressing issues raised by members:

  • Physician health and wellness; and
  • Adapting healthcare systems and human resources strategies to the changing physician workforce.

To ensure broad and equitable participation across each region, the CMA will cover travel costs for participating CMA members.

Fairmont Queen Elizabeth Hotel, Monday, January 28, 2019

8:00 am to 4:30 pm

To find out more or to register, click here.

 

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Physicians sought for workshops on potentially inappropriate medication use

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Physicians sought for workshops on potentially inappropriate medication use

The Quebec Strategy for Patient Oriented Research Support Unit is looking for front-line physicians who will agree to participate in a workshop to raise public awareness of the problem of potentially inappropriate medication use (as defined in the Beers criteria). Participants would assess the impact of workshops (held in public libraries) focusing on a health issue.  

This workshop will be given a number of times in Quebec City and Montreal in April and/or May 2019. After a preparatory meeting, the physicians who agree to participate in this event will be invited to have a 45-minute discussion with the facilitator, followed by a discussion lasting a maximum of 45 minutes with the public. They will have documents provided by the research team and will be paid for their participation.

In 2016, during a first edition of the workshop focusing on the use of antibiotic therapy for acute respiratory tract infections, the Library Project demonstrated the very promising potential of this knowledge-sharing method. According to the study conducted at the time, 94.4% of the people who attended a workshop found the experience to be very relevant and worthwhile, and 98.9% found the information provided to be very clearly presented.

Library Project 2 will be conducted by the Quebec Strategy for Patient Oriented Research Support Unit, in collaboration with the Canada Research Chair in Shared Decision Making and Knowledge Translation, the Centre d’excellence Déclic sur le dialogue entre les scientifiques et le public, founded by journalist Valérie Borde, and the Montreal and Quebec City libraries.

Click here for additional information about the project. To propose your services, pleased write to José Massougbodji at composante.ciussscn@ssss.gouv.qc.ca.

 

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Recruitment of candidates for Chair of the CMA Board of Directors

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Recruitment of candidates for Chair of the CMA Board of Directors

The Canadian Medical Association is seeking a new physician Chair of its Board of Directors. This is a unique governance opportunity for a CMA member to work with an exceptional team and a national Board during an exciting and unprecedented period of transformation and growth.

To learn more, consult the recruitment notice.

 

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