Bill 114: Who broke trust?

Your editorial1 was based on poorly researched information, and the statement that “the ED had closed for the night because none of the hospital's 60 family physicians or internists were available to staff it” requires clarification. How many full-time equivalent physicians practise in the hospital? How many have recently left or retired who also used to work in the emergency department?

As chair of a committee on medical manpower for general practitioners in the Montreal area, I am aware that Quebec counts on its list of physicians many doctors who no longer practise or who now practise part time. Quebec is not alone: many other governments and organizations do the same.

If there is a manpower shortage, we can assume that it is due to the early- retirement program you mentioned and to a lack of incentives for physicians working outside major centres. But how much do physicians have to do to make up for the negligence of the system's managers? For example, must a GP give up a HIV practice to retrain in emergency medicine?

I agree that the physician–patient trust relationship is deteriorating, but it has been doing so since the government implicated itself in the health care system. As Osler said, “the physician must always retain control of the ward.”