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.
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.
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.
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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