Montreal, victim of unfair medical distribution

Every year the injustice repeats itself. The citizens of Montreal are victims of a medical personnel allocation process with serious flaws and we expect similar results in the coming weeks.

The Regional Medical Workforce Plan (PREM) in family medicine, despite its intentions, generates blatant inequalities. It creates disparities in the short term as well as in the medium and long term, gaps in access to care which cause consternation and concern. The exasperation of the medical community, clinic managers, local and provincial elected officials is palpable, enough is enough!

The PREM is a resounding failure!

Created in 2004, the PREM aimed to guarantee equitable distribution of medical services across the province, by assigning family doctors to the most disadvantaged regions. Today, we are rather seeing its perverse effects. Barely 63% of Montrealers are registered with a family doctor (less than 55% in certain sectors of the island). The CAQ prides itself on being the government of the regions, but it does so at the expense of the population of the metropolis.

Are we second-class citizens for the current government?

Did you know that nearly 400,000 patients from other regions are registered with Montreal doctors? If these patients were Montrealers, our registration rate would increase to nearly 87%. As incredible as it may seem, the population area to be served is not taken into account when allocating PREMs.

Nearly 800,000 Islanders are without a family doctor, the equivalent of the population of Quebec or the regions of Estrie and Centre-du-Québec combined. Imagine telling them that no one has a doctor… It’s unimaginable!

We understand that the shortage of family doctors affects all of Quebec, but we consider that the method of calculating the distribution of PREMs greatly disadvantages Montreal.

Despite improvements announced each year, without serious study of the results, the PREM methodology still does not reflect the realities and specific needs of each region. The indicators used not only compromise access to care, but they devalue this profession. Indeed, medical students consider the PREM as one of the main obstacles to their decision to continue their studies in family medicine.

A unique metropolis of its kind

According to the Quebec Statistics Institute, the population of Montreal increased by 89,600 people in one year, which represents 44% of Quebec’s total growth. With its unique sociocultural and linguistic diversity, Montreal also welcomes the largest number of asylum seekers, students and foreign workers, consumers of care who are not considered by the PREM.

Our doctors adapt daily to this complex reality, exacerbated by an aging population and multiple health problems. The files are heavy and require continuous and rigorous monitoring, testing our resources and our ability to provide quality care. Not to mention that Montreal doctors train nearly half of Quebec residents, in addition to having two of the four universities where externs and students receive their training. A reality that seems far from the method.

These beautiful young people, the future of care in Quebec, find themselves exposed to an exhausted medical community… Our political decision-makers are then wondering why family medicine is being shunned!

Montreal doctors are also aging: nearly 30% are of retirement age and there is a shortage of between 300 and 400 doctors in Montreal. This is almost as many as doctors based in Laval or Chaudière-Appalaches.

Montreal urgently needs additional doctors now! It is crucial to completely review the PREM method with all relevant stakeholders. On July 4, we demand that an immediate moratorium be announced to find a fair and equitable solution! Political authorities must no longer intervene in the distribution of family doctors in Quebec.

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