half a million quebecers registered through gp deal, but most didn’t get their own doctor

despite being signed up to a family medicine group for over a year, sylvie lavoie has never landed an appointment with the clinic. instead, the 68-year-old — who lives with diabetes, hypertension and an hiv infection from a tainted blood transfusion — bounces around the health system, seeing doctors with no knowledge of her medical history. “when i’m sick, i go to the hospital’s emergency room or i call 811 and retell my story every time,” said lavoie, who lives in joliette on montreal's north shore. “it’s very arduous.” lavoie feels like an orphan patient, but quebec’s health ministry counts her as a patient taken into medical care. she’s part of a growing group of 1.7 million quebecers registered with a family medicine group but not assigned to an individual doctor. a total of 519,380 patients were brought into the collective care of a family medicine group between nov. 15, 2025 and june 30, 2026. they form the bulk of the 657,616 patients signed up in that time frame; the remaining 138,236 were signed up with an individual doctor, while another 151,646 moved from collective to individual care, according to the régie de l’assurance maladie du québec.in may, quebec health minister sonia bélanger announced that the province had reached its goal of signing up 500,000 new patients as part of a december 2025 agreement in principle with family doctors. collectively registered patients figured into that tally. collective registration "is a bit of an artificial follow,” said régis blais, a professor at université de montréal’s school of public health. when signed up to one doctor, “you’ll have a doctor who knows you, who can follow you, who knows your history.”“a collective registration is a different doctor almost every time,” blais said. "the follow isn't the same quality."in recent weeks, lavoie said she received a letter informing her that she had been reassigned to a new clinic, where she will remain under the care of multiple doctors. given her complex medical situation, she would prefer to have her own doctor. “hiv is considered a chronic illness and there are a lot of effects. and for diabetes, i’d also like to be followed for that,” she said. blais agreed that someone like lavoie should have their own doctor. "chronic illnesses require a follow, a knowledge of the patient,” he said. “with an aging population, we have more chronic illness.” clinics taking in collectively registered patients are required to make one appointment available per registered patient every year. to see a doctor, collectively registered patients call the guichet d’accès à la première ligne (gap), which will either assign an appointment with their family medicine group or with another clinic, depending on availability. "there isn’t a big difference" between collective registration and being an orphan patient, blais said, since orphan patients can also make bookings through the gap. but according to dr. michael kalin, who owns the santé kildare family medicine group in côte-st-luc, a collective registration is still an improvement for previously unregistered patients. “individual registration is the gold standard,” he said. “you have your own doctor who knows you and follows you long-term. ... if you’re collectively registered, that’s sort of the silver.“as a (collectively registered) patient, you may not be seeing the same doctor consistently, which is not ideal for a lot of conditions that are maybe more chronic,” he said. still, “it’s far better than going to a different clinic each time, because at least your file is in one place and the doctors in that group work together.” taking a patient into individual care requires a long-term commitment, which kalin said can be intimidating for young doctors. “with all the uncertainty around medicine in quebec and family medicine in particular, i think young doctors are looking for a different model of care,” he said. of santé kildare’s approximately 50,000 patients, kalin said about 15,000 are collectively registered. since doctors approved the agreement in principle with the province last december, he said his clinic has added around 5,000 collectively registered patients. as part of that deal, quebec offered clinics bonuses to sign up new patients, paying $100 per collectively registered patient and $231.75 for an individual sign-up. passing the 500,000-patient sign-up goal was “a huge accomplishment,” kalin said. “maybe it’s not as perfect and as ideal as we want, but it’s something we need to recognize as a significant feat.” politicians have exaggerated the importance of patient sign-up numbers, said erin strumpf, a health economics professor at mcgill university.“we’ve made a grave error in quebec by confusing the sign-ups with the goal,” she said. “it’s not a measure of access to care. it’s not a measure of quality of care.“you hear from patients all the time ... that yes, they’re registered, but they can’t get an appointment, they can’t get care when they need it. so we can’t say we’re done because we ticked this box,” strumpf said. jawilson@postmedia.com

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