The organization of care, it needs to be discussed and that is what we are doing

QMA info march2018

Hugo viensMore and more physicians are realizing that professionalism offers a way forward for improving the health care system. Even while they are still studying medicine, some also want to learn more about this topic, as I was able to observe recently by talking to about 50 of our future colleagues at a training session organized by the QMA’s students committee. Like many of their practising peers, in addition to wanting to develop their medical skills, these young people feel that physicians have a collective social responsibility and are already asking themselves how they can get involved with their profession. It is inspiring. 

Like the current debate on the organization of health care in Québec, which brings us to the QMA’s primary mission and the reason we are here: professionalism. It is exciting to see the results of several years of work helping to move the debate forward.

Since 2013, the QMA has given a lot of consideration to the health care issues that led it to identify numerous challenges faced by the health care system, whether they were related to organization, appropriateness or medical leadership. By focusing on optimizing clinical practice, the QMA found that reducing overdiagnosis made it possible to free up human and economic resources in order to offer better quality care and greater access to this care. In 2015, we started a consultation on the social contract, which revealed that the credibility of our profession was being increasingly called into question and that we had to show leadership if we wanted to keep our professional autonomy.

We thus came to the conclusion in 2016 that it was necessary to convey a new medical leadership that was more receptive to integrated interprofessional collaboration and clinical governance in which managers and physicians shared responsibilities. It is now time to move up a gear, and to get out of the stranglehold of negotiation. Fees and compensation are negotiated and that is the role of the federations. Organizational changes are discussed, and to do this, the QMA must be at the discussion table with the other players in the health care system. The medical profession knows what patients need and has the tools to improve the organization of services, namely through the intervention of physician executives. 

Far from confrontation, the QMA has already proven that it can make positive changes, on the appropriateness of care, when it comes to medical leadership, and also by joining with more or less natural partners (15 solutions movement with the CSN, ACSSSS and Alliance des patients) to present constructive solutions that will benefit both physicians and the population.

The debate has been started among physicians and the public. It is up to us to keep it going through our actions and our professionalism.

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