See a specialist in Quebec: 10 days private, 381 days public

At Fleurimont Hospital, University Hospital Center of Sherbrooke (CHUS), I had to wait a year to get breath tests […] And I wanted answers right awayexclaims Mrs. Tardif.

When we visited the Laval Clinic a few days ago, Specialist Jad Hobeika had good news for him.

: pas d’asthme, pas de maladie pulmonaire obstructive chronique, pas d’anémie, vous n’êtes pas déconditionnée”,”text”:”On a éliminé pas mal d’affaires dans votre cas: pas d’asthme, pas de maladie pulmonaire obstructive chronique, pas d’anémie, vous n’êtes pas déconditionnée”}}”>We have eliminated many cases in your case: no asthma, no chronic obstructive pulmonary disease, no anemia, you are not deconditionedhe explained to her.

Ms. Tardif drove more than seven hours and paid a few hundred dollars for her two appointments. She doesn’t regret her choice. I care more about my health than I used toentrusts Ms. Tardif.

Patient Sophie Tardif meets with a pulmonologist from Lacroix Medical Group.

Photo: Radio Canada

A record 784,000 pending requests

Getting an appointment with a specialist on the public network requires a level of patience that has not been seen in recent years.

According to the latest data from the Department of Health and Human Services (MSSS), there were 784,000 outstanding applications for all specialties in August, a 60% increase since September 2020.

The average time to get an appointment went from 267 to 381 days.

In Quebec alone, respiratory care alone had more than 27,000 applications pending with an average delay of 322 days (46 weeks).

A situation at odds with what the Laval Clinic claims to live.

I currently have a deadline of one to two weeks for a first appointmentsays pulmonologist Jad Hobeika.

Graduated in Internal Medicine and Pneumology since 2016, he joined Lacroix Medical Group in January 2022 after spending a number of years in the public sector, notably as Head of the Department of Pneumology at a CISSS in the greater Montreal area.

For the public, we have seen cancer patients and urgent cases in a matter of weeks. Otherwise we talked to the others about months or years of waiting […] I was not satisfied with the number of patients on the waiting listhe explains.

according to dr Hobeika, There is an accessibility issue in the system that the private sector allows me to fill in a bit […] We’re adding an offering for patients who can come to us without a referral for a second opinion, have access to expedited appointments, and receive diagnostic tests quickly.

A medical specialist discusses with a journalist.

Jad Hobeika, pulmonologist, Lacroix Medical Group

Photo: Radio Canada / Davide Gentile

As Lacroix Medical Group Administrative Director Jean-Nicolas Chagnon points out, the demand is there […] The growth is exponential every year.

People need services fast and we offer accessibility to complement the public networkhe adds.

A mental health nurse joined the group earlier this summer along with a GP.

Both appreciate the professional freedom that their employer gives them and also debunk the myth that the private sector is only frequented by the rich.

On the contrary, we see everything, including welfare recipients who have saved for comingemphasizes Émie Gervais, general practitioner in the private sector since graduating six years ago.

From humble beginnings in the Quebec region, Lacroix Medical Group now has 90 physicians in ten clinics across Quebec, two operating rooms, a private laboratory and nearly a hundred employees.

555 doctors bill without going through the RAMQ

In Quebec, more and more doctors are making the leap into the private sector. Sometimes they practice there full-time, if not alternating with their practice on the public network.

According to the latest data from the Régie de l’assurance maladie du Québec (RAMQ), the number of specialist doctors who have made the leap into the private sector has increased by 55% to 178 doctors in the last five years.

There are mainly dermatologists, plastic surgeons, but also anesthesiologists, gynaecologists, radiologists, psychiatrists and a handful of pulmonologists, such as Dr. Hobeika.

General practitioners are also more likely to venture into the private sector.

In the last five years, their number has increased by 27% to 377 doctors.

Overall, the proportion of doctors working outside the health insurance system is approaching 3%, while it was still below 2% in the mid-2010s.

There are more than 21,000 doctors in Quebec.

A doctor who decides to work in the private sector as a doctor not participate has to inform the RAMQ in particular, to point out to its patients that the fees will be paid in full and to post the fee rates in the waiting room of the surgery.

According to the MSSS, there are 22 specialized medical centers where only non-participating physicians practice.


In March 2022, the Médecins québécois pour le régime public group issued a press release recalling their concerns about private sector ambitions.

Every medical professional working in the private sector is one fewer medical professional in the public network. »

A quote from Quebec doctors for the public plan, March 2022

A doctor who works in both the public and private sectors can refer their own patients treated in the public sector to the private sector and increase their income. […] It raises important ethical questions through the blatant conflict of interest it createshe wrote.

Instead, at the Montreal Economic Institute, we encourage liberalization of the healthcare system, particularly through Abolition of the ban on double insurance as well as those of Restrictions on mixed practice by healthcare professionals.

In 2005, the Supreme Court of Canada ruled in the Chaoulli decision that if Quebecers cannot access public health care within a reasonable time, they should be able to obtain private insurance.

The Health Insurance Act was later amended to allow private insurance, but only for knee, hip, or cataract surgery.

party positions

Since the campaign began, most political parties have advocated increasing or reducing the outsourcing of health card operations to the private sector. A phenomenon that has reached around 15% of the volume since the beginning of the pandemic.

In particular, the Quebec Conservative Party (PCQ) would gradually explore the ability to give Quebecers the freedom to choose to purchase supplemental private insurance to receive health services already covered by the health insurance plan.

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