Obstetrics and gynecology clinics are closing one after another due to the lack of an agreement between specialist physicians and the Quebec government to address the underfunding of office expenses. The allocation intended to cover administrative costs has not been increased in about 15 years.
Obstetrics, which deals with childbirth and pregnancy monitoring, is a particularly underpaid specialty. According to the Quebec Association of Obstetricians and Gynecologists (AOGQ), physicians receive $29.45 for each pregnancy follow-up visit, of which $6.55 is allocated to cover clinic operating costs, including rent, staff, electricity, internet, and telephone expenses.
Over the past year, six obstetrics or gynecology clinics have permanently closed. Within two years, at least five more clinics could join them.
“Office fees are one of the points of discussion for which it is essential that we correct the underfunding. We are not the only specialty that has problems. In our case, what is unfortunate is that it has taken so long to get back on track that for us, there are already clinics that will not go back and that are already closed or will close in the coming weeks,” said the president of the AOGQ, Dr. Dominique Tremblay, in an interview.
This is the case of an obstetrics and gynecology clinic located in Châteauguay, which will officially close on April 30. The eight doctors who ran the clinic followed approximately 900 pregnant patients per year, representing 23,000 annual visits.
The doctors will go to work in a GMF, but will no longer do pregnancy follow-ups, only gynecology.
Dr. Olivia Marra, co-owner of the clinic, says the decision to close the clinic was “heartbreaking.” She and her colleagues had to decide in May 2025 whether or not to renew the lease, for a term of five to ten years.
The physician-owners tried several solutions, including recruiting other gynecologists to the project. “We even met with our CIUSSS to see if there was a possibility of getting funding from them to try to keep our doors open. And unfortunately, we weren’t able to,” she says, disappointed.
Dr. Marra gives an example of the financial challenges. “The funding we receive for a half-day of obstetrics is $550. And the cost of the operation for that half-day is $580. We had already been operating at a slight loss for two or three years,” she says.
Dr. Marra is particularly worried about the future for her patients. “In our region, we have family doctors who specialize in obstetrics and provide prenatal care, as well as a midwifery service. But these healthcare professionals already existed. They are already overwhelmed with prenatal care, so we unfortunately anticipate a significant gap in our region for prenatal care,” the doctor laments. She believes women will be forced to travel to neighboring towns to give birth and receive their medical follow-up, but other regions are just as overwhelmed.
Closures that will be difficult to stop without an agreement
As with dermatology, obstetrics generally no longer has dedicated space in hospitals, which means that patients are largely treated in private practices.
“Most of the clinics that have closed recently requested a repatriation of their services. Some clinics have managed to transfer a portion of their activity to hospitals,” says Dr. Tremblay. “Hospitals sometimes don’t have the space to take them over. And at that point, we end up with a net loss of visits.”
The AOGQ calculates that within two years, patients will be deprived of nearly 90,000 annual visits.
Negotiations between the Quebec Federation of Medical Specialists (FMSQ) and the government remain stalled. The doctors are demanding a 14.5 per cent pay increase over five years, while Quebec maintains that its proposed 11 per cent increase is its final offer.
“We can hope that the negotiations will prevent the continued carnage that risks occurring with the repeated closure of clinics,” commented Dr. Tremblay. “[…] The more time passes, the more announcements we get of clinic closures. So, we are particularly worried about the availability of services to the population.”
He maintains that the FMSQ is well aware of the office expense issue and is advocating for this point during negotiations. However, without an agreement, clinics will continue to close, according to Dr. Tremblay. “It’s something that will be difficult to stop unless there’s a significant change in the situation,” he says.
—The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this journalistic content.
–This report by La Presse Canadienne was translated by CityNews
