Canada's doctors are worried that actions taken in Quebec could trigger a nationwide assault against physician autonomy. That became clear during the CMA's 135th annual meeting in Saint John, NB, Aug. 19–21, when the Quebec situation dominated much of the debate.
“We have grave concerns over reports that the Quebec government is considering further action [that would] essentially make physicians government employees,” said CMA President Henry Haddad. “We feel this would create a layer between patients and physicians and have adverse consequences for the patient–physician relationship, upon which the entire therapeutic process is based.”
Quebec's Bill 114 mandates that MDs who have practised in an emergency department in the past 4 years must be available for further work. It was passed in July following the death of a patient whose local ER was closed because of a physician shortage (see page 530). The law, when combined with new legislation expected this fall, had many delegates worried that Quebec physicians will become government employees.
Haddad said the issue had already been discussed at a special meeting of the CMA and all 12 of its divisions. “Our concern is that these draconian measures do not offer a sustainable solution,” he said.
While obviously leery about walking into the political quicksand surrounding a provincial issue, Federal Health Minister Anne McLellan recognized “the importance of autonomy [to the] profession” and said “collaborative and cooperative measures are certainly more positive than coercive ones.” Dr. Stanley Vollant, president of the Quebec Medical Association, appreciated her promise to raise physicians' concerns about the Quebec situation during the upcoming meeting of the country's health ministers in Banff, Alta.
“This issue could affect every physician in Canada, and all health ministers must be made aware that the medical profession does not agree that such coercive measures are necessary,” said Vollant.
Delegates considered several motions concerning the Quebec situation, including one that condemned “any coercive legislation that constitutes an assault on professional autonomy.” The motions were debated during a special 1-hour session Aug. 21. — Steven Wharry, Saint John