{"id":131523,"date":"2025-11-13T18:15:14","date_gmt":"2025-11-13T18:15:14","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/131523\/"},"modified":"2025-11-13T18:15:14","modified_gmt":"2025-11-13T18:15:14","slug":"inside-a-montreal-clinic-struggling-to-deal-with-quebecs-imposed-health-reforms","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/131523\/","title":{"rendered":"Inside a Montreal clinic struggling to deal with Quebec\u2019s imposed health reforms"},"content":{"rendered":"

As a family doctor, Hiromi Tissera prides herself on taking a compassionate approach to her patients.<\/p>\n

She says that will be more difficult because of the targets outlined in the Quebec government\u2019s new health reforms, known as Bill 2.<\/p>\n

\u201cWe are going to be penalized for spending extra time with patients because we are going to have to meet certain targets, and I don’t think that’s how it should be done,\u201d said Tissera, a family physician who works at District Medical, in Montreal\u2019s Ahuntsic neighbourhood.<\/p>\n

To provide the best care takes time, Tissera said. In her view, that means taking a moment to sit down with patients, make eye contact and ask, \u201cWhat can I do for you?\u201d<\/p>\n

\u201cThey’re exposing their most vulnerable moments to us, and to make them feel comfortable is extremely important,” said Tissera.<\/p>\n

Premier Fran\u00e7ois Legault has said the changes, which include tying part of doctors\u2019 pay to collective performance targets, will benefit the 1.5 million Quebecers who don’t have a family doctor.<\/p>\n

But doctors have been in an uproar over the reforms \u2014 which were forced through the National Assembly<\/a> last month, and many are threatening to leave the province.<\/p>\n

District Medical, one of the city\u2019s largest family medicine clinics, has lost nine of its 51 family physicians since the Coalition Avenir Qu\u00e9bec government first tabled its health reform legislation last spring. <\/p>\n

Some retired, others went back to school or transitioned to other positions and two moved elsewhere in Canada, according to its medical director, Dr. Georges Zaarour.<\/p>\n

Tissera is also considering leaving for Ontario. She is among more than 260 doctors<\/a> who recently applied to work in the neighbouring province.<\/p>\n

WATCH | Clinic struggles to replace doctors that left:\"\"<\/p>\n

Montreal family doctors warn new health reforms will make compassionate care harder<\/p>\n

One family medicine group in the city\u2019s Ahuntsic neighbourhood says it\u2019s lost nine physicians because of Bill 2, Quebec\u2019s controversial law that ties a part of doctors’ pay to performance indicators. As remaining staff try to absorb the patients of those doctors, they say the new law will make care more difficult.’We feel very, very disrespected’ <\/p>\n

District Medical is what\u2019s known as a GMF, the French acronym for family doctor group. GMFs are public-private partnerships, often owned by physicians.<\/p>\n

They are financed through a combination of provincial funding and a portion of the revenues generated by the physicians who operate them. <\/p>\n

Many of those physicians have voiced concerns about the reforms. Earlier this week, doctors at 18 GMFs in Montreal signed a letter denouncing Bill 2, first reported by the Montreal Gazette<\/a>. The letter said the reforms would put their financial model in jeopardy.<\/p>\n

Another Montreal GMF, Agora Clinic, said Wednesday it would close<\/a> by April 2026 if the changes under Bill 2 go into effect on Jan. 1, as expected. <\/p>\n

While not all District Medical\u2019s departures can be directly attributed to the government’s changes, Zaarour said apprehension about the changes hasn\u2019t helped. <\/p>\n

\u201cThe mood is very low. We’re insulted,\u201d he said. \u201cWe feel very, very disrespected coming out of the pandemic where everybody rolled up their sleeves.\u201d<\/p>\n

Zaarour’s clinic has grown quickly since being founded in 2020 with six physicians and one secretary.\u00a0The team now comprises 60 doctors and 60 support staff, and serves 55,000 patients. It offers a range of services including family medicine, pediatrics, physiotherapy and urgent care.<\/p>\n

\"PeopleDoctors jammed the Bell Centre on Sunday to protest against Bill 2. (Graham Hughes\/The Canadian Press)Stricter targets, at what cost?<\/p>\n

Zaarour said part of the reason for its success is because the clinic has made it easier for doctors to focus on medical care \u2014 while support staff handle administrative tasks. <\/p>\n

Now, the government is setting stricter targets for them.<\/p>\n

\u201cIt’s going to be, \u2018I used to see 20 patients, tomorrow, I have to see 40 patients in order to be able to hit those government targets,\u2019\u201d Zaarour said. That will put tremendous pressure on doctors, he said.<\/p>\n

The law also assigns patients to doctors according to their level of vulnerability. <\/p>\n

Family practitioners say this will make it difficult for healthy children to get access to care so doctors can spot a problem early on, before bigger problems develop.<\/p>\n

Another doctor, Dr. Sabrine Manoli, said this is a fundamental part of her job.<\/p>\n

\u201cWith kids, the truth is we spend so much time trying to prevent them developing pathologies,\u201d she said. <\/p>\n

\u201cKids are wonderful. If you help them early on, we might prevent all of this.\u201d<\/p>\n

Reforms meant to improve access, government says<\/p>\n

The Quebec government tried again Thursday<\/a> to ease tensions, saying it would not apply a portion of the law about inspections and that it hoped to find common ground.<\/p>\n

In a statement responding to specific concerns from GMFs like District Medical, Quebec\u2019s Health Ministry said the changes aren’t meant to force doctors to see more patients, but instead to improve access by matching care to people\u2019s clinical needs.\u00a0<\/p>\n

The new vulnerability classification will guide access and funding, but a ministry spokesperson said \u201cit is wrong to assume that people not classified as vulnerable will have less access to care.” <\/p>\n

\u201cAccess will always depend on clinical need, not on vulnerability status,\u201d Marie-Christine Patry said.<\/p>\n

\"manQuebec Health Minister Christian Dub\u00e9 is seen earlier this week at the National Assembly. The Health Ministry says the reforms are meant to improve health-care access for all Quebecers. (Jacques Boissinot\/The Canadian Press)<\/p>\n

Olivier Jacques, professor at the school of public health at Universit\u00e9 de Montreal, said the law is designed to make doctors take on the most difficult cases and delegate the less difficult ones to other health professionals, such as nurses, pharmacists and physiotherapists.<\/p>\n

In theory, he said, the change would make it possible for doctors at GMFs to be even better compensated. He said concerns about doing away with preventive medicine would make more sense if the current model was working.<\/p>\n

\u201cI\u2019m not convinced the new system would really be much more of an issue for prevention,\u201d he said. \u201cWe\u2019re starting from so low.\u201d<\/p>\n

Cosette Wahba, who was at the clinic earlier this week with her three-year-old daughter, said she was saddened by the ongoing dispute.\u00a0<\/p>\n

\u201cI just find it a bit sad that people don\u2019t agree,\u201d she said. \u201cI feel like in any situation everyone needs to be involved in finding a solution.\u201d<\/p>\n

She said she\u2019s grateful that she has access to care and is aware that many in Quebec don’t.<\/p>\n","protected":false},"excerpt":{"rendered":"As a family doctor, Hiromi Tissera prides herself on taking a compassionate approach to her patients. She says…\n","protected":false},"author":2,"featured_media":131524,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[163,521,85,46],"class_list":{"0":"post-131523","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-health","9":"tag-healthcare","10":"tag-il","11":"tag-israel"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/131523","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=131523"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/131523\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/131524"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=131523"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=131523"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=131523"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}