Just days away from Saturday’s deadline to adopt Quebec’s family doctor reform legislation, Bill 19, final details are still pending, and it still needs approval from the federation of family doctors.
Meanwhile, specialist doctors with the FMSQ, the federation of medical specialists of Quebec, are stepping up pressure tactics as contract talks stall, cutting back administrative work and parts of the referral system.
“They’re not making very good headway in those negotiations, that the FMSQ is asking for certain things that the government is unwilling,” said Dr. Earl Rubin, a pediatric infectious disease specialist and member of the FMSQ.
Quebec Health Minister Sonia Bélanger tabled Bill 19 earlier this month, replacing parts of former minister Christian Dubé’s Bill 2 after a deal with family doctors. The goal: connect 500,000 more Quebecers to a family doctor by June 2026, including 180,000 vulnerable patients, using bonuses instead of penalties. Family doctors would also get a 14.5 per cent pay increase and move to a capitation model.
“We all believe in this model that this is going to be better for primary care,” said Dr. Michael Kalin, at Montreal family doctor and local coordinator with the Département territorial de médecine familiale de Montréal (DTMF).
“We’ll never get to 100 per cent because not everybody wants a doctor, believe it or not, but we do want to register people as much as possible.”
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With Saturday’s deadline right around the corner, Kalin says key details are still pending.
The FMOQ, the federation of family doctors in Quebec, gave its board full authority to negotiate, meaning the board alone will approve or reject Bill 19 without a member vote. Kalin adds that even if the deadline passes, Bill 2 likely won’t take effect automatically; it had been delayed to allow more time for negotiations.
“There seems to be a lot of progress, but the FMOQ has been clear: there is no finality on a new compensation model yet,” he said.
In the meantime specialist doctors still don’t have an agreement. Their last framework expired in 2023, and they say they remain among the lowest paid in the country. They’re pushing for parity with other provinces.
“The sense that a lot of the specialists have is that they are really dividing, I don’t know if it’s dividing and conquering, but they’re dividing the FMOQ from the FMSQ,” Rubin said.
Now the FMSQ is stepping up pressure tactics, pausing training tied to the Digital Health Record, scaling back administrative duties, and soon pulling out of the province’s main referral system. Rubin adds that more specialists are already applying for licences in Ontario and New Brunswick.
“Frustration because there was good faith negotiation with the family docs and not with the specialists to date,” he said.
Quebec is offering an 11 per cent raise; specialists want 14.5 per cent. The government calls that unreasonable and says talks must continue. In a statement to CityNews the health minister’s office said: “We have completed the detailed study of Bill 19. This is an important step that is now complete. The bill is expected to be adopted by February 28. Bill 19 takes into account the agreement in principle with the FMOQ and removes most of the provisions that apply to the FMSQ. That said, negotiations between the government and the FMSQ are ongoing.”
Just days away from Saturday’s deadline to adopt Quebec’s family doctor reform legislation, Bill 19, final details are still pending, and it still needs approval from the federation of family doctors.
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It’s not just about the pay, Dr. Rubin said.
“There is the infrastructure. There is accessibility. We all want the same thing. We want improved access to care,” he said.
“We desperately need the specialists to find an agreement because primary care needs secondary care,” added Dr. Kalin.
