Advertisement oopStory continues belowThis advertisement has not loaded yet, but your article continues below.

Manage My Account

Advertisement 2AdvertisementThis advertisement has not loaded yet, but your article continues below.

Article contentRemember that Younan, the surgical oncologist, said he’s working non-stop, yet it’s impossible for him to decrease his backlog by even one per cent.Article content“You know, this goal of 56 days doesn’t make sense because it does not distinguish between so-called indolent cancers and more aggressive ones,” he explained. “A patient with an aggressive cancer should not wait more than 28 days.Article content“We give priority to the most complex and aggressive cases, and right now we’re operating on these cases beyond the 28-day mark,” Younan added.Article contentWhat’s more, Law 2 compels a wide range of medical specialists (not just cancer surgeons) to achieve the 56-day target — from anesthesiologists to nearly every kind of surgeon, including those who operate on heart patients and obstetrician-gynecologists. Yet the law is silent on the responsibility of medical-imaging technologists and nurses who play a key role in handling cancer surgery volumes.Article contentThus, should surgical oncologists fail to achieve the goal (along with related objectives), they would risk a cut of up to 15 per cent in their remuneration, but the pay of cancer nurses and imaging techs would not be affected.Article contentAdvertisement 3Story continues belowThis advertisement has not loaded yet, but your article continues below.Article contentDr. Gerald Batist, medical director of the Segal Cancer Centre at the Jewish General Hospital, described some of the logistical challenges surgical oncologists face routinely:Article content“Of course, a surgeon’s ability to operate is dependent on many factors long before his or her availability is in play,” Batist said.Article content“Generally, they always want to operate a lot,” but they are limited because of problems with “access to imaging — CT, MRI and PET scans; access to previous biopsy results, including from interventional radiology and pathology; and the availability of anesthesiologists, nurses, operating room technicians and pre-op clearance by internal medicine.”Article content Dr. Gerald Batist, director of the Segal Cancer Centre, says surgical oncologists are dependent on many factors to operate for which they have no control. Batist is seen in May 2016. Photo by John Kenney /Montreal GazetteArticle contentAccess to the post-op recovery rooms and beds in the intensive-care unit often poses a problem for surgical oncologists, too — as well as for heart surgeons, which helps explain why a growing number of cardiac patients are dying of sudden death at home as they wait for the phone call to come to the hospital for their operation.Article contentAdvertisement 4Story continues belowThis advertisement has not loaded yet, but your article continues below.Article contentThe emergency room nightmareArticle contentLaw 2 sets a lofty goal for Quebec’s congested ERs: 80 per cent of patients should be examined by a physician within 90 minutes from the moment of their triage by a nurse. The government is giving ER physicians six-month increments to gradually boost the number of patients who are seen by a doctor within the 90-minute time frame.Article contentBut here is the uncomfortable reality: As of Nov. 10, the most recent date reported by the government, the average wait time to be examined by an ER doctor in Quebec was two hours and 33 minutes. Cité de la Santé hospital in Laval recorded the longest average wait to be seen by an ER doctor after triage: five hours and 14 minutes — meaning that only a tiny percentage met the government’s target of less than 90 minutes.Article contentEqually daunting is another ER goal in Law 2: the average stay for a walk-in patient in an ER after triage should not exceed four hours, and for patients arriving by ambulance who are languishing on a stretcher in a hallway, the average wait should not go beyond 14 hours.Advertisement 2This advertisement has not loaded yet.

Advertisement 3Story continues belowThis advertisement has not loaded yet, but your article continues below.

Article contentIn a somewhat encouraging sign, on Nov. 10, ER doctors across Quebec were close to meeting the government objective for walk-in patients, as the average wait provincially was four hours and 33 minutes.Article contentBut the average ER wait for patients on stretchers was 17 hours and nine minutes. Meanwhile, at the Royal Victoria Hospital, part of the Glen site in Notre-Dame-de-Grâce, the average wait for such patients was the highest in the province: 30 hours and 56 minutes — more than double the length of time established in the government objective.Article content“Those are lovely goals, you know,” said Dr. Todd Lee, a specialist in internal medicine who often takes care of patients in the Royal Vic ER. “I would also like a tree that grows money in my backyard.”Article contentThe last time the Royal Vic’s ER met any of the government targets was during the lockdowns of the COVID-19 pandemic, in mid-April 2020.Article content On Nov. 10, the average wait for a stretcher patient in the Royal Vic’s ER was nearly 31 hours. Photo by John Mahoney /Montreal Gazette filesArticle contentLee criticized Law 2’s ER goals for showing “a real lack of understanding of how emergency rooms actually work. This is not the McDonald’s drive-thru line.”Article contentAdvertisement 5Story continues belowThis advertisement has not loaded yet, but your article continues below.Article contentER patients, Lee explained, are assigned according to the Canadian Triage Assessment Scale (CTAS), based on the severity of their medical condition — with patients suffering from a heart attack being treated immediately and someone with a sprain to their ankle having to endure a longer wait.Article contentLee lamented what he viewed as a glaring ignorance of the conditions ER staff work under every day in Quebec.Article content“I mean, how many people do they imagine are staffing the emergency rooms of this province at any one given time? There’s only so much that any one person can do (on an overnight shift), or three or four people.”Article contentUltimately, Lee warned, some ERs may game the system to artificially meet the government targets. Even before Law 2 was passed, several hospitals in Montreal have been known to transfer emergency patients to wards that don’t count in the ER statistics — with those patients still waiting for beds in individual rooms.Article contentThe endless wait for a family doctorArticle contentUnder Law 2, Quebec’s family physicians will be required to provide 17.5 million medical appointments per year. During his tenure as health minister, Dubé (a self-described “numbers guy”) has set up a highly detailed dashboard on the Health Ministry’s website that features all kinds of statistics — except for the total number of medical appointments per year.Article contentAdvertisement 6Story continues belowThis advertisement has not loaded yet, but your article continues below.Article contentDr. Mark Roper, director of the division of primary care at the McGill University Health Centre, was at a loss to understand how the government came up with the figure of 17.5 million appointments in family medicine annually.Article contentHowever, the Fédération des médecins omnipraticiens du Québec (FMOQ) has estimated that up to 750,000 such appointments are lost each year because of a lack of health professionals that should be available to family doctors — from nurses to social workers and pharmacists.Article contentRoper, who is also director of the Queen Elizabeth Family Medicine Group in N.D.G. — which is at risk of closing because of financial constraints imposed by Law 2 — argued the government is missing the point.Article content“This is not a smart way of doing things,” Roper said. “Why doesn’t the government allow, say, Montreal to hire the doctors it needs?”Article content Dr. Mark Roper, director of the division of primary care at the McGill University Health Centre, says the government is missing the point in dealing with the crisis in family medicine in Montreal. Roper is seen in April 2022. Photo by Pierre Obendrauf /Montreal GazetteArticle contentRoper has previously sued the provincial government on behalf of Montreal family doctors, arguing unsuccessfully in court that the way the health minister allocates new physicians to different regions of the province — under a system known as Plans régionaux d’effectifs médicaux, or PREMs — has unfairly penalized the city.Advertisement 3This advertisement has not loaded yet.

Advertisement 4Story continues belowThis advertisement has not loaded yet, but your article continues below.

Article contentLaw 2 keeps in place the PREM system, and thus does not address the severe shortage of family doctors on the island of Montreal, Roper contends.Article contentOther family physicians — and even pediatricians — have blasted Law 2 for potentially decreasing access to patients who are deemed healthy by giving priority to the most vulnerable individuals. But one of the tenets of family medicine is to catch medical problems early — long before a patient becomes vulnerable.Article contentFrom pulp-and-paper executive to health ministerArticle contentSince Dubé was appointed health minister on June 22, 2020, he has been on a mission to reform the province’s beleaguered medical system, using dramatic analogies like “shaking the foundation” and hiring “top guns” from the private sector to run Santé Québec.Article contentIn September, the former pulp-and-paper executive authorized a $250,000 publicity campaign to drum up support for his doctors’ reform.Article contentUnder the headline “Access to health care: change is needed,” the government ads laid out in stark terms the following: that Quebecers pay nearly $9 billion a year in doctors’ fees, yet 1.5 million people — including 200,000 vulnerable individuals — do not have a family physician. Moreover, 148,000 people are waiting for surgery, and nearly one million Quebecers are in need of a consultation with a specialist.Article contentAdvertisement 7Story continues belowThis advertisement has not loaded yet, but your article continues below.Article contentMany doctors read into that campaign that they’re basically responsible for the health system’s woes, and it sheds light on why more than 12,000 physicians and medical students packed the Bell Centre in an unprecedented rally last week to denounce Law 2.Article content Quebec doctors held a concert-like protest against Law 2 at the Bell Centre in Montreal on Nov. 9, 2025. Photo by Dave Sidaway /Montreal GazetteArticle contentYet under constant pressure by the doctors — and with public-opinion surveys backing them — Dubé appears ready to drop clauses in Law 2 that would have allowed Santé Québec to appoint a “national inspector” to effectively patrol the professional activities of doctors.Article contentAnd thus without such an inspector to monitor doctors, performance targets that have already been decried as impossible will no doubt become even harder to enforce.Article contentArticle contentArticle contentAdvertisement 4This advertisement has not loaded yet.

Featured Local Savings

Original source: ca