Why are medical consultations in the public system often quick and rushed?

As a family physician of French origin, having practiced in France before settling in Quebec in 2016, I frequently notice a striking contrast between medical consultations on both sides of the Atlantic. In Quebec, many patients perceive consultations in the public sector as being quick, or even rushed. Why is this? Here is an analysis of the causes of this situation.

1. A glaring shortage of family physicians

In Quebec, the number of family physicians per inhabitant is lower than that observed in several other developed countries. This shortage creates a workload overload for practicing physicians. With long patient lists and significant appointment delays, doctors sometimes have to see up to 40 patients per day, which mechanically limits the time allocated to each medical consultation. In comparison, in France, the density of general practitioners is higher, which often allows practitioners to spend more time with each patient, although they also face overload challenges in certain regions.

2. Pressure to optimize resources

In the Quebec public system, medical consultations are often conditioned by the optimization of health network resources. Doctors must sometimes justify their actions and efficiency on quantitative bases, which encourages short consultations focused on managing the patient's primary problem, at the expense of more global follow-up or in-depth exploration. This logic of optimization is accentuated by fee-for-service funding in certain contexts, where remuneration is linked to the volume of patients seen—a different situation from the flat-rate remunerations observed in some countries.

3. Diversified responsibilities for physicians

In Quebec, family physicians often have multiple responsibilities. They split their time between office consultations, care in CHSLDs, hospital follow-ups, emergencies, and sometimes even teaching. This dispersion reduces their availability for prolonged consultations in the clinic. In France, although some general practitioners also practice in hospital settings, the majority dedicate themselves primarily to their office practice, allowing them to concentrate their efforts on patient care.

4. A growing and aging population

With an aging population and constantly increasing medical needs, quick consultations become a necessary response to meet demand. This reality particularly affects patients suffering from chronic or complex diseases, who require more time but sometimes find themselves facing time limits.

5. Underutilized digital tools

While other countries like Estonia or the United Kingdom use digital tools extensively to lighten the administrative burden and facilitate exchanges between doctors and patients, these technologies remain under-exploited in Quebec. The management of medical records and appointments could be more fluid, thus allowing physicians to devote more time to the relationship with their patients.

Towards an improvement of the system?

Although quick consultations are a reality in the public system, solutions exist to improve the quality of medical care:

• Time management reform: Allowing physicians to focus on longer consultations by hiring more administrative staff and lightening their workload.

• Virtual consultations for minor cases: By freeing up time for complex cases, virtual consultations help decongest the system.

• Encouraging private clinics: Platforms like Allodocteur.ca offer an alternative for quick and personalized appointments without prolonged waiting.

In conclusion, the speed of medical consultations in the Quebec public system is a reflection of structural and organizational constraints. If you are looking for longer and more personalized consultations, options such as private home clinics can offer a different experience, recalling the French model where family physicians are more accessible and sometimes travel to their patients' homes.

At Allodocteur.ca, we strive to provide community-based medicine by offering home visits, even with same-day availability, to meet your health needs quickly and efficiently.

Want a personalized consultation tailored to your needs? Book an appointment on Allodocteur.ca now.