Myths and realities of dual medical practising

A major issue: the Québec Medical Association sheds new light

The leaders of the Québec medical community were gathered in Montréal on October 24, 2008, for an exclusive symposium organized by the Québec Medical Association (QMA) in order to shed more light on the issues, impacts and implementation conditions of dual medical practising.

Because dual medical practising is a major issue at the heart of current reality, the QMA had already asked Caroline Cambourieu, who has a master’s degree in science, to conduct a study on this topic in England and Australia. The results of this study provided the fodder around which the symposium could unfold.

Report on dual medical practising in England and Australia (by Caroline Cambourieu, for the QMA) (In French only)

In short, dual medical practising...

Dual medical practising is a compensation model that allows a physician to practise in both the public and private sectors. For instance, a physician can practise three days a week in a public hospital and then offer the same services to private patients who pay the physician directly. Currently, most OECD countries have opened their health care systems to dual medical practising with the goal of slowing their health care costs and reducing waiting lists for a range of elective surgeries and specialized tests.

A look at experiences abroad

The QMA also welcomed two renowned experts in dual medical practising who shared their experience with the 70 participants at the event: Dr. Christoph Lees, an obstetrician and founding member of England’s Doctors for Reform (British experience) and Dr. Michael Wooldridge, a former Minister for Health and Family Services in Australia (Australian experience).

The presentations given by these two physicians helped to better define the parameters of dual medical practising. Dr. Lees explained how adopting dual medical practising had increased the offer of medical services, but that the movement to private services had been accompanied by the introduction of several regulatory mechanisms by the UK government. Dr. Michael Wooldridge gave an overview of the steps that led the Australian government to introduce dual medical practising.

Taking it further

A discussion panel in the afternoon brought together six different points of view (from an advocate of private services, orthopedist Nicolas Duval, to the president of the Conseil pour la protection des malades, Paul G. Brunet) that nevertheless converged on the fact that any change to the Québec health care system had to be for the benefit of patients.

QMA Board Chairman Dr. Jean-Bernard Trudeau concluded this day of information sharing and reflection by reminding everyone that, for the Association, although the public health care system was not perfect, it had to remain the primary player in the health care sector and that the private sector had to be limited to a complementary role. “As for dual medical practising, this had to be analysed through the prism of medical professionalism. Further reflection was necessary by studying it as a tool in a basket of initiatives to improve medical practising and the health of the population. It was necessary to be prudent. The impacts, such as cost, quality, fairness and accessibility, are not always well known and must be brought to light before introducing a public policy,” he stated.

The entire event is available to enrich and foster your reflection. Enjoy.

Myths and realities of dual medical practicing

Conference videos

Opening remarks

Claudette Duclos
Executive Director, Québec Medical Association


Flash movie (5'48")

Comparative analysis of dual medical practising

Caroline Cambourieu
Researcher, Université de Montréal


Flash movie (44'05")

The British experience

Christoph Lees, M.D., MRCOG
Obstetrician, National Health Service

Founding member of Doctors for Reform


Flash movie (1'01'21")

The Australian experience

Hon. Michael R.L. Wooldridge, M.D.
Former Minister for Health and Family Services
President of Michael Wooldridge and Associates


Flash movie (36'01")

Discussion panel: Can dual medical practising have a positive impact on our health care system?