Why Tiny Tots Medical Centre has run out of
appointments and how you can make sure that this never happens again.
If you would like to file a complaint, with the decision
makers who make the rules that have created our closure and made it
impossible for you to get an appointment today, please click this link:
Letter
of complaint to the Quebec Healthcare Policy Makers
The email will be sent to :
Dr. Yves Bolduc, Minister of Health, Québec
– (514-873-3700) ministre@msss.gouv.qc.ca
Dr. Serge Lenis, Director of Professional Affairs, FMSQ
(514-350-5000) aff.professionnelles@fmsq.org
Dr. Mark Roper, Chief of the DRMG. Agency for Health and social
services, Montréal. 514-286-6500 mark.roper@mcgill.ca
Dr LOUIS GODIN, PRESIDENT of the FMOQ lgodin@fmoq.org
The following email will be sent (feel free to add your own comments, share a personal experience, etc.):
My child's doctor works at Tiny Tots Medical Centre (203-3400 du Marché, DDO, QC. H9B 2Y1), where my child's complete medical dossier is located. I was not able to get an emergency appointment for today and was told that my doctor was forced to stop working because they had reached their Medicare Billing Ceiling. Other doctors who could be working to replace my doctor have been forced to work elsewhere to fulfill their AMP's. I understand that the administration of Tiny Tots Medical Centre has unsuccessfully applied to have billing ceilings removed for urgent after hour's care in their facility as well as to have hours of medical service contributed by their doctors count as admissible for AMP's.
I do not understand why these requests have been rejected as Tiny Tots has functioned as a perfect model of care and continuity of care for my children. I am now forced to seek less appropriate care at a walk-in clinic or overcrowded hospital emergency room; neither have access to my child's medical chart and where I will have to wait several hours. All of this creates an unnecessary risk to my child's and family's well being. I find this situation ludicrous and intolerable, and would urge you to consider work done by physicians at Tiny Tots Medical Centre to be free of any Medicare Billing Ceilings and admissible towards AMP activities.
Sincerely,
Name:
Address:
Email address:
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Background
Tiny Tots Medical Centre, established in 1985, is open 365 days of the
year and has the capacity to see over 300 sick (and healthy) children
daily. This number is in excess of the number of children seen at The
Montreal Children’s Hospital’s or St-Justine’s
Hospital’s Emergency Department daily.
In an effort to contain health care spending, the Quebec Ministry of
Health in conjunction with its agencies RAMQ (Regie de
l’assurance maladie du Quebec = Medicare), and the DRMG (Montreal
Regional Department of General Medicine), as well as the FMSQ
(Federation of Medical Specialists of Quebec) and the FMOQ (Federation
of Omnipractitioners of Quebec) have created budgets and a series of
regulations and strategies to limit these budgets. Two of these
strategies are Doctor’s Billing Ceilings, and AMP’s
(Particular Medical Activities), and are explained in detail below.
The Quota System (Doctor’s Billing Ceiling)
limits the number of patients for which a doctor may bill Medicare in a
given time period. Once the doctor has reached their limit, they are
paid anywhere from 10% to 25% of the usual pay. Of note, Quebec doctors
are already amongst the lowest paid in Canada. The reduced amount of
pay does not even cover the overhead costs of seeing a patient. In
other words, even if a doctor agreed to see patients over their limit,
it would actually cost them out of pocket to come to work each day.
At certain key times of year, many of our doctors
reach their Medicare Billing Limit and chose to stop working. This
creates a shortage of available appointments and is one of the
reasons why you cannot always get an appointment when you need one.
There are certain healthcare institutions in Quebec where this billing
quota system does not apply. Hospitals are an example of one such type
of institution. We have applied repeatedly over the last 15 years
for a status that would give is equivalency to a Hospital Emergency
Room, and have been turned down every time. We feel legitimate in
this respect as we function much in the same way as a hospital
emergency room, only with much more efficiency and convenience for our
patients (considerably shorter waiting room time, on site lab services,
same day service, etc.). In addition, when a patient is forced to go to
a hospital emergency room, the actual cost to the healthcare system is
700% higher than if they were to be seen at Tiny Tots Medical Centre.
Moreover, patients are unnecessarily exposing themselves to more
virulent germs while waiting long hours at a hospital, and usually end
up missing a significant amount of work by being there for long
periods, often missing a night’s sleep in the process. The doctor
seeing your child at the hospital does not have access to your Tiny
Tots patient chart, and so they do not accurately know what medications
you have recently taken, what testing you have already undergone, etc.
The AMP (Activités médicales particulières)
program, enforces doctors to work 12 hours per week in designated
health care institutions of importance. This is 2 days per week that
many of our doctors are forced to work away from their patients in some
other location. In addition, only certain times of day often qualify
for these activities (e.g. evenings, weekends, and holidays) .
Accepted locations are:
A. EMERGENCY ROOM
B. ACUTE HOSPITAL CARE
C. MEDICAL SERVICES (INCLUDING ON-CALL AVAILABILITY)
- LONG TERM CAR HOSPITAL (CHSLD)
- REHABILITATION INSTITUTION (CR)
- HOME CAR PROGRAM (CLSC)
D. OBSTETRICS
E. VULNERABLE CLIENTELES
F. REGIONAL PRIORITY ACTIVITIES
We have applied on numerous occasions for a status that would let us
become a regional priority activity, OR considered as an equivalent to
a Hospital Emergency Room. We have been turned down each time.
So doctors who would otherwise be at work at Tiny Tots on
Weekends and evenings, are working in other health care institutions which the decision makers have decided are more important than your
child’s health. The bottom line is that the Minister of
Health and it’s agencies have decided that it would be best to
limit the ability for your child to be seen by their own doctor or a
designated replacement on their team, and it would be better if you
were seen at some other institution where you wait a very long time to
be seen, where the doctor does not have access to your child’s
medical chart, and where all of this costs the health care system more
(not less) money.
Please stop this insanity and send a preformatted complaint email to
the Health Care policy makers by clicking the
following link:link: