Doctors, patients ultimately decide

As a doctor, my priority is to take care of my patients to the best of my ability. That means the patient should get his or her treatment within an appropriate time frame, receive exactly the treatment option(s) suited to his/her condition, and receive the outcomes he or she wants and needs.

Only the doctor and the patient know what this constitutes. All other influences should either facilitate the process or stand aside.

The Régie de l’assurance maladie du Québec (RAMQ) and Health Minister Gaétan Barrette have taken power away from patients and their doctors. For example: Not all generic medications are created equal or have the same predictable effect on the patient. Yet, for the first time, the doctor’s choice of prescribing an original medication rather than a generic may now be subject to a $1,000 to $10,000 fine, as judged by a bureaucrat with no medical knowledge.

Would you take that risk if this fine could be imposed on you?

In this RAMQ act, the patient’s rights are blocked while shame, blame and presumption of guilt are transferred to the doctor.

Federal and provincial governments continue to debate more ways to apply focused austerity to the budgets of hospitals and clinics, as they politicize and discredit doctors and their finances. What doctor’s office can survive when regulations change on a whim?

While it might be easy to say, “that’s it, I’m leaving the province,” I have survived the last two years mostly because I am truly committed to my patients.

When it comes to health care, every statement, decision, act or law by the decision-makers should be designed to help and empower physicians and patients to deliver and obtain well-timed and effective care and solutions. Otherwise, stay out of our way.

Shawn Cohen, MD, Montreal