The story has generated headlines around the world, and why not: There is a real novelty to wealthy professionals who are indignant about getting richer.
Hundreds of Quebec doctors have signed a letter objecting to a recent pay increase. Among other things, they decry the fact their heavier pay packets have come at the expense of other, more vulnerable areas of the public-health system.
“The only thing that appears to be immune from cuts is our remuneration,” their letter reads.
That’s true. The number of physicians in Quebec jumped 17 per cent from 2006-15, more than three times the rate of population growth. Meanwhile, the amount doctors billed Quebec’s public-health insurer doubled over the same period, from about $3.3 billion per year to roughly $6.6 billion.
A few weeks ago, the province approved another hefty multi-year raise, much of it destined to specialists.
At least the added billions bolstered access and increased services, right? Well, no.
An independent study commissioned by Quebec’s Health and Welfare Commissioner – a position the province abolished last December – found that, if anything, the raises have made doctors less productive.
According to the study’s authors, Quebec’s doctors saw fewer patients, worked fewer hours and provided less care in 2015 than they did in 2006 (the provincial government claims that the situation has since improved).
The study, led by health-policy experts and physicians, proposes a key fix: reforming the “complex and bureaucratically onerous” fee-for-service model.
This is an idea has been floated before, but this time the conversation may not be as curt as it typically is. There is real opposition to the current way of doing things, an opposition that evidently extends into Quebec doctors’ ranks.
Not every province has lavished wage increases on its doctors. According to the Canadian Institute for Health Information, the rate of growth in physician billing slowed to one per cent nationally last year, and dropped in some provinces.
Nevertheless, the Quebec study suggests it’s time we questioned our assumptions about physician compensation and the fee-for-service model. And not just in that province.