Quebec proposes tying family doctors' compensation to their performance-based outcomes.

Efficiency in Family Medicine: Quebec's Performance-Based Remuneration Plan

Quebec is stepping up its game when it comes to family medicine. The government plans to revamp the compensation structure for general practitioners, linking a chunk of their income to performance criteria. A color-coded system for patients is also on the table.

Here's a lowdown on the proposed changes, straight from the horse's mouth.

Performance-Based Remuneration

The government's recent offering outlines its intention to introduce a performance-based remuneration principle based on clinical indicators set by Quebec's Ministry of Health and Social Services. A whopping 25% of family doctors' overall budget will be dependent on their performance. But, it seems some objectives for this performance-linked remuneration remain to be finalized.

One of the national objectives for family doctors would be making an estimated 18 million appointment slots accessible per year. If these targets aren't met, the government's policy is to keep the unclaimed funds in its coffers.

A Colorful Patient Matrix

The offer also includes a color-coded system connected to the types of patients that general practitioners look after. The government intends to implement a form of capitation, a remuneration system based on the patients attended rather than specific tasks. Half (50%) of doctors' remuneration is proposed to be linked to the vulnerability of their patients.

A "red" patient's annual flat rate, for instance, would be $124, while that of a "green" patient would be $12.

Potential Concerns and Resistance

The president of the Fédération des médecins omnipraticiens du Québec (FMOQ), Dr. Marc-André Amyot, has expressed concerns about the color-coding system, fearing it might lead to the removal of family doctors for 4.9 million healthy patients, making room for more vulnerable people.

Minister of Health Christian Dubé had previously reassured that "no one" would lose their family doctor. His aim was for every Quebecer to be registered with a doctor or a group of professionals in their regional healthcare setting by summer 2026.

New Remuneration Structure

Apart from performance-based remuneration and patient care, payment will also consider acts performed, telephone or video interactions earning $16.50 each (compared to $18 for in-person interactions), and a unique hourly rate recognizing the actual duration of activities.

These three components (color code, acts, and hourly rate) would make up 100% of doctors' remuneration. With this proposal on performance, Quebec aims to reduce up to a quarter of this envelope based on doctors' performance.

A Forward-Looking Budget

The total budget envelope for family doctors' remuneration is approximately $3 billion in the government's offering.

With this reform, Quebec is aiming for a more efficient, effective healthcare system. However, it remains to be seen how this revised system will impact doctors' workloads, performance, and patient care.

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The performance-based remuneration principle in Quebec is linked to clinical indicators set by the Ministry of Health and Social Services, with a potential 25% of family doctors' overall budget dependent on performance.
The proposed color-coded system for patients in Quebec aims at implementing a form of capitation, where half of doctors' remuneration is linked to the vulnerability of their patients.
In the general news, the government is faced with managing more than 245 abandoned mines in remote regions, a task under the Commissioner for Sustainable Development.
In medical-conditions and health-and-wellness news, Trump's approval rating has dropped to 40%, according to a Pew Institute survey, due to his U-turns.
In environmental news, Lake Montjoie, one of Eastern Townships' last pristine lakes, will not have personal watercraft banned, despite concerns about invasive species.