Association des radiologistes du Québec: update on activities

CAR FORUM 1998;42(3):6-7

© 1998 Canadian Association of Radiologists

Membership

In agreements reached between the Fédération des médecins spécialistes du Québec (FMSQ, Federation of Medical Specialists of Quebec) and the Quebec Ministry of Health and Social Services on Oct. 1, 1995, and July 1, 1997, a retirement allowance was introduced for specialists 65 years of age or older. As a result, by July 1, 1998, 64 radiologists will have retired. This program will affect radiologists who reach the age of 65 by the year 2001.

The loss of these 64 radiologists was partially offset by the entry into practice of 58 new radiologists during this period. Even so, some regions have been left with no radiologist and several other regions, especially those served by just one or two radiologists, are experiencing problems with finding replacements. This situation will only get worse, given the limited enrolment in residency (there are currently only nine residents in first-year training in Quebec's four universities).

Quebec radiologists will be enumerated at the beginning of 1998, and a survey will be conducted to determine workforce needs — both new and replacement — of radiology departments for the next few years.

Financial matters

Discussions took place between FMSQ and Ministry in July 1997, with a view to introducing mixed remuneration for medical specialists. This mixed remuneration was to be mandatory for university hospitals and optional for other hospitals. However, it is now anticipated that all hospitals will be given a choice in the matter, regardless of their status. Private practice remuneration is not affected.

Mixed remuneration consists of a per diem amount to which a percentage of the fee for each examination is added. Discussions are under way and will continue in 1998.

Private practice

The conjoint committee of the FMSQ and the Ministry on licence applications for laboratory and general radiology operations has pursued its mandate. The committee has made some recommendations to the Minister to promote more efficient use of resources to meet the needs of each region.

Quebec's private practice network is in a precarious financial situation because of a chronic lack of financing, which worsens yearly in the absence of appropriate fee increases. Fee ceilings (both professional and operational) exacerbate the problem, as the disincentive rate once the ceiling has been reached (25% of the basic fee) does not even offset variable operational costs.

The 1995 and 1997 agreements have also resulted in the closure of many radiology practices, with their numbers dropping from 122 in 1995 to 111 in 1997.

Breast cancer screening and mammography

The Association and the FMSQ have combined their efforts to negotiate an agreement with the Ministry under which private clinics can conduct screening mammography for women 50 to 69 years of age as part of the Programme québécois de dépistage du cancer du sein (PQDCS, Quebec Breast Cancer Screening Program).

The PQDCS possesses three unique characteristics: it is decentralized, and managed by regional boards; it will be offered immediately throughout the province; and it will be associated with private clinics wherever they are available and interested.

For each breast cancer screening mammogram, a supplement of $7.50 will be paid to offset the extra administrative cost of meeting program requirements. It is estimated that between 50,000 and 60,000 more mammograms per year will be conducted as a result of the screening program.

Regional boards have yet to finalize the standard contract for screening centres and determine the method by which the Ministry will allocate funds to screening centres for computer software and hardware.

The PQDCS will be introduced progressively in Quebec's regions starting in January 1998.

Radiology Education Research Fund

In 1997, the Radiology Education Research Fund provided subsidies for three researchers, following a high-quality competition sponsored by the Fonds de recherche en santé du Québec (FRSQ, Quebec Health Research Fund). Provision has been made for a sum of $100,000 to be set aside annually for radiologists for research and education purposes. Projects involving teaching and setting up teaching tools are being considered for possible subsidies.

FMSQ/ARQ relations

The Association has decided to appeal an adverse ruling made by judge André Rochon on Mar. 19, 1997. The appeal will be heard in March 1998.