#1 Assiduité (92.1%), #1 Lowest % ER visits (1.7%) in CIUSSS Centre-Ouest de L'île-de-Montreal (2023-2024)

Bill 20


Bill 20 – will adversely affect Cote Saint Luc’s only GMF Clinic


Dear Mr. Birnbaum,

As the Medical Director of Cote Saint Luc’s only GMF clinic, I must express my concerns regarding the proposed Bill 20.

GMF Sante Kildare serves almost 20 000 registered patients in our community.  We are a group of 25 family physicians – offering medical services 365 days per year, including evenings, weekends and holidays.

We have an open, daily walk-in clinic for any patient (even “orphaned persons”).  We provide services to local Foster Homes, collaborate with McGill, coordinate with CSSS Cavendish, conduct research studies – all in an effort to provide the best, comprehensive and timely care to all persons.

We started with two physicians in October 2011 – and now pride ourselves on exceptional growth with a stellar and superb team of 25 committed doctors, nurses, and other health care professionals.

Of the 17 family doctors based at my location, 14 are female.  In fact, most are young doctors who recently completed their Family Medicine Residencies.  They were attracted to Sante Kildare for many reasons: our inclusive philosophy, teamwork, supportive network, flexibility and GMF status.

And this is my point – GMF works.  The incentives offered by previous Ministers of Health were working.  We actively remove orphaned patients from the CLSC Guichet list.  We keep doctors in our territory.  We offer extended hours.  We keep patients out of the ERs.  We cover young female doctors during maternity leaves.  We cover patient practices when doctors are away fulfilling their AMPs.

Group GMF coverage is the only solution.  80% of Family Medicine graduates are female!  While I personally work 70 hours each week, most doctors don’t.  It is ridiculous, unrealistic and unreasonable to demand young, female doctors to work 36+ hours/week.  They have made sacrifices to continue schooling to serve and heal others.  They should not be penalized for striving to balance home and work.

But this Bill punishes everyone.  Why should I be fined (or docked pay) if my patient sees another physician – even if I am open and available?  If you live in Quebec City and your family doctor works in Cote Saint Luc, should he/she be penalized if you seek urgent or semi-urgent attention locally?  What if someone lives in Dollard and works downtown?  What about chest pain at 3 am?  In all scenerios, it’s the family doctor who pays.

I care about quality.  I book 30 minutes per physical.  The RAMQ agrees that a check-up requires more time.  Am I to work 15 hours each day to meet the Minister’s quota of 30 patients?
Should I tell patients to book multiple appointments to “get through their list of problems?”

We need a system that rewards productivity – not a plan that punishes.  We need a Bill that recognizes the reality of our workforce – not an outdated, punitive vision that frowns upon families.  We need an open dialogue – not a demagogue.  Quality and commitment should be recognized and embraced – not attacked.  The family physician is the backbone of the health care system – the quarterback – the human face.  We only succeed by developing and nurturing the doctor-patient relationship – not timing it.

Family Medicine is not radiology.  We see patients – not their films.  We talk to patients – teach, advise, advocate, heal.

Please, please, please.  I urge you to visit our clinic and see how this Bill will devastate us.

Leadership should not be achieved through bullying.  We desperately need collaboration, discussion, vision.

Thank you.

Dr. Michael Kalin