Quebec advocates for salary structure based on employee productivity.

Quebec's Proposed Shift: Performance-Based Remuneration For Specialists

The Quebec government has floated a new idea, aiming to link a quarter of specialists' remuneration to collective performance. This proposition was made during negotiations with the Fédération des médecins spécialistes du Québec (FMSQ), according to their website, under the framework agreement.

This change in reimbursement tactics means specialists will no longer solely depend on fee-for-service or fixed rates. Quebec's plan includes national and local targets specific to each specialty. For instance, 99% of surgeries should occur within a year, and 95% of medical imaging exams should be analyzed within five days.

To guarantee uninterrupted service, the government requests "100% execution of regional coverage plans for sectors at risk of critical coverage gaps." This objective also appears in the agreement proposal submitted to family doctors.

Wait times for specialist consultations are another focus. As of February 8, over 900,000 patients were waiting for a specialist appointment, according to the latest data from the Ministry of Health and Social Services.

Quebec takes things a step further, tying the collective performance of specialists to the average length of patient hospital stays. For example, a COPD patient should not stay beyond 7.1 days, while a stroke patient's stay should be limited to seven days, and an acute myocardial infarction patient no more than 4.9 days.

To attain these objectives, Quebec offers a collective financial incentive.

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Minister of Health Christian Dubé's office, when asked for comment, stated, "There are still too many patients" waiting for surgery or a specialist consultation. "Bill 15 allowed us to make our managers more accountable," they added. "Now, we are working to give Santé Québec the necessary levers to improve access and increase the accountability of doctors within the framework of negotiations with the FMSQ."

The FMSQ acknowledges a "significant gap" between its position and the government's but plans to "continue negotiations with the Treasury Board." They expressed concern over the government's tone, contrasting it with a climate of collaboration prevalent in other Canadian provinces, where arbitration mechanisms are available to doctors.

Last October, the FMSQ filed a lawsuit against Quebec to expedite negotiations for an arbitration mechanism. The FMSQ emphasizes that its main priority is "to improve access to specialized care for the population." "Accountability should not be one-sided," they added.

The doctors' union asserts it "expects to be treated in a similar manner to other health professionals and public sector workers, while ensuring fairness with the rest of Canada."

Insight: Performance-based compensation models for healthcare providers have become common practice, aiming to encourage efficient, high-quality care. However, the details surrounding Quebec's proposal require further investigation via official government announcements or health department publications.

The Fédération des médecins spécialistes du Québec (FMSQ) intends to continue negotiations with the Treasury Board, as performance-based remuneration for specialists, proposed by the Quebec government, presents a significant gap between the FMSQ's position and theirs.
The FMSQ, in its pursuit of improving access to specialized care for the population, expects to be treated in a similar manner to other health professionals and public sector workers, while ensuring fairness with the rest of Canada.
Quebec's proposal to link a quarter of specialists' remuneration to collective performance also includes tying the average length of patient hospital stays to the collective performance of specialists.
The Quebec government aims to attain objectives like reducing patient waiting times for specialist consultations and ensuring 100% execution of regional coverage plans, as stated in the agreement proposal submitted to family doctors.
Within the framework of business and finance, the Quebec government offers a collective financial incentive to attain these objectives and increase the accountability of doctors, as part of their performance-based remuneration plan for specialists in Quebec.