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LE SPÉCIALISTE
LE MAGAZINE DE LA FÉDÉRATION DES MÉDECINS SPÉCIALISTES DU QUÉBEC
Vol. 12 no. 4 December 2010
Votre
assurance
invalidité
voir texte p. 35
Concours Prix IMS Brogan 12e édition
Deux bourses
de 3 000 $ à gagner
DESCRIPTION DU CONCOURS RÈGLEMENTS
Le Conseil consultatif d’information sur la santé d’IMS L’auteur principal (premier auteur) de l’article doit être
Brogan a créé les Prix IMS Brogan pour souligner les travaux un médecin spécialiste membre d’une association affiliée
de médecins et pharmaciens concernant l’utilisation clinique à la Fédération des médecins spécialistes du Québec. Tout
efficiente des médicaments. Ces prix représentent une valeur article original paru dans une revue pharmaceutique ou
totale de 30 000 $ qui est répartie de la façon suivante : médicale spécialisée (excluant les entrevues et articles de
journaux) au cours de l’année civile (de janvier à décem-
ƒ à la Fédération des médecins omnipraticiens du Québec
bre 2010) peut être soumis à condition qu’il appartienne
(FMOQ) et à la Fédération des médecins spécialistes du
à l’une des catégories précisées ci-dessus. De plus,
Québec (FMSQ) deux prix de 3 000 $ à chaque fédération
pour un article sur l’utilisation appropriée des médicaments; ƒ les traductions, adaptations ou reproductions d’articles
ne sont pas admissibles;
ƒ aux pharmaciens, par l’entremise de l’Association
québécoise des pharmaciens propriétaires (AQPP), deux ƒ les articles acceptés pour publication mais non encore
prix de 3 000 $ chacun pour un article sur l’utilisation publiés ne sont pas admissibles;
appropriée des médicaments;
ƒ les articles en deux parties comptent pour un seul texte;
ƒ à chacune des quatre facultés de médecine, un prix
ƒ si un article a été rédigé par plus d’un auteur, le prix
de 2 000 $ à un étudiant pour la meilleure note en
sera remis à l’auteur principal.
pharmacologie;
ƒ aux facultés de pharmacie (Université de Montréal et
Université Laval), deux prix de 2 000 $ aux étudiants SÉLECTION DES ARTICLES
méritants pour un stage à l’extérieur. Les articles seront soumis par leurs auteurs qui devront les
faire parvenir, avant le 31 janvier 2011, au directeur de
l’Office de développement professionnel de la Fédération
DESCRIPTION DES PRIX DÉCERNÉS des médecins spécialistes du Québec, 2 Complexe
Deux bourses de 3 000 $ seront décernées à deux méde- Desjardins, porte 3000, Montréal (Québec) H5B 1G8. Ils
cins spécialistes (ou deux groupes de médecins) s’étant seront ensuite évalués par un comité de sélection mis sur
distingués par l’excellence de leur article sur l’utilisation pied par l’Office et composé d’un représentant de chacune
efficiente de médicaments, à titre d’exemple : des quatre facultés de médecine du Québec.
ƒ importance de l’observance du traitement médicamenteux; Le directeur de l’Office communiquera à IMS Brogan le
nom des auteurs des deux articles retenus comme étant les
ƒ meilleur traitement dans le cas d’une maladie donnée;
meilleurs. IMS Brogan remettra officiellement le prix lors
ƒ revue de l’utilisation de médicaments dans un contexte d’une conférence de presse.
clinique;
ƒ utilisation efficiente de médicaments les uns par rapport
aux autres dans un contexte clinique.
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PUBLIREPORTAGE
Summary
LE SPÉCIALISTE IS PUBLISHED 4 TIMES PER YEAR BY THE 7 WORD FROM THE PRESIDENT
FÉDÉRATION DES MÉDECINS SPÉCIALISTES DU QUÉBEC
The Importance of Participation
10 IN THE NEWS
EDITORIAL COMMITTEE PRINTING
Dr. Bernard Bissonnette Impart Litho
Dr. Raynald Ferland
Dr. Diane Francœur CIRCULATION
13,200 copies A Cry for Help!
Maître Sylvain Bellavance
13 DID YOU KNOW...
Nicole Pelletier, APR, director
TO JOIN US
Patricia Kéroack,
EDITION
Q
communications consultant
DELEGATED PUBLISHER
Telephone: 514 350-5021
Fax: 514 350-5175
E-Mail: communications@fmsq.org 15 LEGAL ISSUES
Nicole Pelletier, APR
PUBLICITY
RESPONSIBLE FOR Telephone: 514 350-5274 The Federation Files Suit Against the MSSS
DOSSIER
PUBLICATIONS Fax: 514 350-5175
Patricia Kéroack E-Mail: fcadieux@fmsq.org
www.magazinelespecialiste.com 16
REVISION Fédération des médecins
Angèle L’Heureux spécialistes du Québec
2, Complexe Desjardins, porte 3000 HAÏTI
ASSISTANT C.P. 216, succ. Desjardins,
The 1st Year...
Annie Bissonnette Montréal QC H5B 1G8
Telephone: 514-350-5000
GRAPHISME • Centre for International Studies
Dominic Armand PUBLICATIONS MAIL
Mailing Indicia 40063082 and Cooperation . . . . . . . . . . . . . 18
TRANSLATION • Médecin du Monde (Canada) . . . . 21
Anne Trindall Legal Deposit
Annette Grimaïla 4th quarter 2010 • Médecins Sans Frontières . . . . . . 23
Bibliothèque nationale du Québec
PUBLICITY ISSN 1206-2081 • GRAHN, a Universal Vehicule
France Cadieux of Hope . . . . . . . . . . . . . . . . . . . . 25
All pharmaceutical product advertisement's have been approved by the
• Rebuilding Haïti . . . . . . . . . . . . . . 27
Pharmaceutical Advertising Advisory Board (PAAB). • Learning from Others . . . . . . . . . . 28
CCAB audits the medical specialists and residents database
30 FOLLOWING SEPTEMBER’S EDITION
(10,770 copies audited for June 2010) The FMSQ also
distributes around 1,000 copies to Researchers and
Professors of the 4 Medical Faculties in Quebec, as well as managers and leaders
of the Québec healthcare system.
Leaving Medicine... or Leaving Quebec!
31 GREAT NAMES IN QUEBEC
The authors of signed articles are sole responsible for the opinions
expressed therein.
MEDICINE
The Fédération des médecins spécialistes du Québec represents the following
specialties: Allergy and Clinical Immunology, Anesthesiology, Cardiac Surgery,
Cardiology, Community Health, Dermatology, Diagnostic Radiology, Emergency
Medicine, Endocrinology, Gastroenterology, General Surgery, Geriatrics, Hematology
Dr. Ernesto Schiffrin, internist
32 CONTINUING PROFESSIONAL
and Medical Oncology, Internal Medicine, Medical Biochemistry, Medical Genetics,
Medical Microbiology and Infectious Diseases, Nephrology, Neurology, Neurology,
EDUCATION
Nuclear Medicine, Obstetrics and Gynecology, Ophthalmology, Orthopedics,
Otorhinolaryngology, Pathology, Pediatrics, Physiatry, Plastic Surgery, Pneumology,
Psychiatry, Radiation Oncology, Rheumatology and Urology.
An Infrastructure Needed... and the Means!
34 SOGEMEC ASSURANCES
36 FINANCIÈRE DES
THIS EDITION’S ADVERTISERS:
PROFESSIONNELS
• IMS Brogan 2
• Fondation Lucie et André Chagnon 3
37 LE MOT DU PRÉSIDENT
• RBC Banque Royale 4
• Financière des professionnels 6
• La Personnelle 8 L’importance de la participation
40 MEMBERS SERVICES
• ASSS du Bas-Saint-Laurent 11
• Club Voyages Berri 14
• Sogemec Assurances 35
• Services aux médecins MD 39 Commercial Benefits
LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010 5
WORD FROM THE PRESIDENT
Dr. Gaétan Barrette
The Importance of Participation
CMQ Elections
D
ramatically, on October 21, 2010 the name of the Furthermore, to be heard, you only need to attend meetings
person selected to be President of the Collège des very occasionally or contact your association. Instances where
médecins du Québec (the CMQ) was drawn by lot! In associations have acted or taken a position that differed greatly
actual fact, this election was a fantastic case that should be from that of their members have rarely been seen. Conse-
studied in all universities and even in society at large when quently, there is a far greater chance that the positions
the time comes for people to be convinced not only to defended by your association’s delegate are close to your own.
become involved, but that their vote actually counts. But, how
does it really count? The opposite is true at the CMQ, however. Except in very rare
cases, most of you do not know the positions that will be
First of all, at the level of the CMQ Board of Directors, where defended by those for whom you have voted. Usually, the vote
the first difficulty arises. The Board is composed of is based on perception, a candidate’s reputation, specialty or
28 members, 20 of whom are elected physicians with the right the university to which they belong. In short, the degree to
to vote. It may be thought that the intention when the CMQ which this vote is “blind” is greater than that for a vote cast
statutes were drawn up was that the two groups making up in your association. The same goes for many candidates;
the medical community in Quebec – i.e. generalists and they only have a more or less accurate idea of how the
specialists – should have equal representation. That would be CMQ functions.
logical, because their numbers are still more or less equivalent
today. However, such equal representation can never truly
IF YOU TAKE THE DELEGATES ALONE,
become reality precisely because it is inevitably skewed by
THE REPRESENTATION HFOR THE FMSQI
the CMQ’s method of election. Since the vote is “by region”,
IS 125 FOR AROUND 8,500 PAID=UP MEMBERS,
it is easy to see that it is impossible to achieve the 10-10 split
OR APPROXIMATELY 1 DELEGATE FOR EACH
desired as, apart from the Island of Montreal, Sherbrooke and
Quebec City, general practitioners are in a strong majority.
70 MEMBERS. THE CMQ EQUIVALENT IS
Let’s look at the Montérégie, for example. There are
20 ELECTED MEMBERS C OR AROUND
1,443 general practitioners on the Order’s rolls versus
1 ELECTED MEMBER PER 800 MEMBERS!
1,013 specialists – i.e. 42.5% more generalists. It is
therefore clear that it is virtually impossible for a medical
specialist to achieve election outside Montreal, Quebec City or
Sherbrooke. Only one conclusion can be drawn from this
demographic: if balanced representation of both groups is
desired, this intention must be stated in the statutes of the Is the vote too blind? Not necessarily: perception, reputation,
CMQ itself. specialty and university affiliation remain relevant criteria with
regard to “regional” selection. But is compulsory equalization
Now, what about the election of the Board of Directors and with regard to candidates for the presidency too blind? We
the President? Let’s take the FMSQ. Its Board is composed believe that it is.
of 9 members elected by an assembly of 125 delegates who
themselves are designated by the Executive of an affiliated The detailed voting results in this respect are very instructive.
association’s Board which, in its turn, is elected by the First of all, it is obvious that, despite similar participation levels
members of each association. If you take the delegates alone, in previous years, voters took an uncompromising attitude to
the representation is 125 for around 8,500 paid-up members, Dr. Lamontagne’s slate of candidates: all but one were
or approximately 1 delegate for each 70 members. The CMQ beaten. That sends a very clear message. In fact, if it were
equivalent is 20 elected members – or around 1 elected not for what follows, it is likely this last member would also
member per 800 members! At the FMSQ, the President is have gone down to defeat. The number of votes obtained by
elected, by name, by 125 delegates; at the CMQ, the person each person elected clearly indicates not only what happened
is elected by name by only 20 elected members. but, above all, the value, true importance, weight and absolute
necessity of taking part in a vote of whatever kind. Yes! Each
If you take a closer look at the FMSQ, your opinion – even if vote does count – and voting works!
you do not actively participate in your association – has a
greater chance of being heard because your representatives Many groups and organizations strongly urged their members
are aware of the realities of your life, if only by dint of practising to vote. We ourselves did so several times, particularly to
in the same field. So it is difficult for them to act in a vacuum. improve the representation of medical specialists, and we
LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010 7
Votre Fédération fait de vous
quelqu’un de privilégié
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WORD FROM THE PRESIDENT FSUITEG
partially succeeded. But specialists’ response to the FMSQ’s But that is what led to the random drawing which, in itself, is
call varied greatly “geographically”. Other groups and most disturbing. In actual fact, this vote should in a way be
organizations did the same, particularly with regard to family that of “delegates” only – representatives of certain regions.
medicine and FM Groups, as well as at McGill. Hence the Period. Unfortunately, the election became a campaign for the
slate effect. Dr. Desbiens’ team, even though very incomplete presidency, which in our opinion was inappropriate.
(only eight candidates instead of ten) included two leading Physicians cast their individual votes with a normal level of
lights in the field of family medicine (Dr. Lajeunesse and, in interest, which is how it should be.
particular, Dr. Authier), whose outstanding reputations speak
Perception, reputation, specialty and university affiliation
for themselves. Two other candidates practise at McGill:
were relevant criteria for “regional” selection. We believe that
Dr. Côté and Dr. Freeman. It is interesting to note that it was
that blindly took precedence. Locally-justified slates were
their first election to the Collège in each case. Drs. Fiset and
perhaps blindsided with respect to the candidacy for the
Martin (Dr. Bernard’s team) were elected; both practise at
President’s position.
McGill. Finally, and this is what is most fascinating, the
candidates who received the largest number of votes were, But there is a clear lesson here and an obvious parallel with
Dr. Freeman, Dr. Authier, Dr. Fiset, Dr. Martin, Dr. Lajeunesse, the FMSQ. When the time comes to vote and above all get
Dr. L’Espérance and Dr. Garner. Again, the message could mobilized, everything counts and those who are absent or
not be clearer! McGill and family medicine practitioners inactive will always be at fault. Moreover, they will get exactly
obviously looked after their own affairs and answered the call what they deserve.
– and we say “Bravo!” to them. Voting works! And, more than
ever before, it can be said that those who were absent were That’s it. That’s all.
the ones at fault. Yours in solidarity!
L S
New medical specialties…
By Maître Sylvain Bellavance
The Collège des médecins du Québec (the CMQ) has been the extent of the changes will depend on the number of
working for several months on harmonizing Quebec’s practitioners who will be recognized with regard to these
medical specialties with those recognized by other new specialties and their decisions as to setting up specific
Canadian authorities. This work is now finished. The final measures of remuneration or new associations to represent
Regulation respecting Medical Specialties was published them. In the latter case, it will also be necessary to assess
on November 10 in the Gazette officielle and became the impact on the Federation’s Bylaws and the manner in
effective on November 25, 2010. which associations are represented.
The new Regulation recognizes 19 new medical specialties Before submitting an application for certification in a new
by the CMQ, thus bringing the number of specialties specialty, it is obvious that some physicians might first want
recognized in Quebec to 54. Changes have sometimes to know the impact such action could potentially have on
been made to the length of training. Slight alterations have their remuneration. However, this may not be possible given
been made to the names of six existing specialties. For the six-month deadline for submitting an application, the
example, Endocrinology becomes Endocrinology and need for recognized physicians to make decisions on how
Metabolism. You can consult the Regulation respecting they will be grouped and subsequent discussions on
Medical Specialties at www.fmsq.org (in French). methods of remuneration.
At the time of writing, the CMQ should have forwarded a For the moment, it appears that the physicians concerned
notice to all physicians informing them of the creation of will therefore have to make such decisions without the
these new specialties and the modalities for applying for benefit of such details. To follow…
certification. It appears that the deadline for submitting an
application is six months after the CMQ’s* notice is sent out.
* Other provisions in the Regulation may allow certain physicians to
disregard this time period and apply for recognition after the
Recognition of these new medical specialties has already deadline. This is, however, not yet certain and will only be able to be
caused a number of medical specialists to wonder about studied on a case-by-case basis by the CMQ, with the risk that the
their possible impact, particularly with regard to the physicians concerned may have their application rejected. That is
remuneration provisions already contained in the FMSQ- why the CMQ has informed us that the notice being sent out will lay
particular emphasis on the specific rule applicable in the
MSSS Agreement. There is no doubt that adjustments and circumstances, which provides for a six-month deadline for
changes will have to be made to the Agreement to meet presenting an application.
the situation. It is, however, important to understand that LS
LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010 9
IN THE NEWS
By Mylène Bédard, MD
A Cry for Help!
PSYCHIATRIST
In my role as a delegate from the Association des médecins physicians for whom the work environment posed problems.
psychiatres du Québec (AMPQ) to the FMSQ, I was surprised Since 2003, the PAMQ has also been accepting individuals
during a meeting to hear a colleague question the mission of the whose distress is mainly related to professional factors
Quebec Physicians’ Assistance Program (Programme d’aide (pressure and burn-out). Its expertise is often called upon by
aux médecins du Québec – PAMQ). She was especially teams that have become dysfunctional because of a lack of
surprised by the nature of the health problems treated. Ever manpower, inappropriate behaviour and, unfortunately, regrettable
since, as a clinical professor at Hôpital Charles LeMoyne, I have events that upset colleagues.
got into the habit of discussing this with my students who,
almost always, are also surprised to learn that mental illness is Since its creation and in spite of the changing and complex
the main cause of disability for Quebec physicians. In itself, needs of its clientele, the three main principles of the PAMQ’s
there is nothing really surprising about this fact, since mission have always been the same: intervention, prevention
psychiatric illnesses are in the process of becoming the and research. Contrary to popular belief, addiction is not the
principal cause of disability in our society, if this is not already chief factor behind calls for assistance; instead, it tends to be
the case. What is astounding is physicians’ reaction of surprise, mental health problems (in the broadest since of the term) that
even denial, when faced with this data. It is hard to ignore a lead physicians and residents to consult. The problems can
certain medical culture that, too often, seems to deny that a include psychiatric illnesses (burn-out, anxiety, stress, post-
physician is, more than anything else, a human being. Could it traumatic stress); substance abuse or dependency (alcohol,
be that the taboo that seems to persist concerning these medication, drugs, sex, gambling); interpersonal difficulties
illnesses is, sadly and paradoxically, more tenacious within the (family or conjugal problems, financial stress, physical
medical community (and, in all humility, I have to include my conditions having a psychological or professional impact,
own specialty)? bereavement); professional problems (complaints, lawsuits,
professional investigations, academic failure or difficulty,
Simply consider how peers judge an affected colleague: it harassment, intimidation, professional misconduct, age- or
certainly does not encourage anyone to ask for assistance. We retirement-related problems, career change).
should not forget the impact of a disability on peers in clinical
settings where a precarious balance already exists between During the last few years, many voices have attempted to break
work overload and the impossibility of getting replacements. the silence and fight the taboos. In February 2010, the
The inevitable increase in stress and pressure on colleagues, Canadian Medical Association produced a strategic report in
which certainly does not foster empathy towards those order to optimize the assistance available to physicians with
affected, places colleagues still in place at risk. And so we get mental health problems. In Quebec, a third conference on
into a vicious circle. physicians’ health will take place in September 2011. And, on
an individual basis, more and more physicians with a mental
In the spring of 2010, the General Manager of the PAMQ, illness agree to speak out publicly.
Dr. Anne Magnan, advised the AMPQ of her concern. Between
2007-2008 and 2009-2010, new applications by medical The AMPQ is already well aware of the increase in mental health
specialists for assistance from the PAMQ have increased problems among physicians, and has recently assured the
substantially, from 56 to 105 (without counting those who go PAMQ that its members would be available to assist colleagues
elsewhere or who do not ask for help…). The new cases are in difficulty, in particular by facilitating access to care. In short,
people who had never before dared get in touch with the PAMQ physicians will be helping physicians for the improved well-
and who were therefore more or less familiar with the program. being of all members of our profession.
The history of the PAMQ clearly shows how its clientele has
evolved. The creation of an assistance program for Quebec
physicians in 1990 was based on the realization that physicians,
too, could become ill... and that most of them remained
isolated, without help, not knowing where to turn. Towards the Editor’s note: The Fédération des médecins spécialistes du Québec
took part in setting up the PAMQ and provides a portion of its
end of the 1990’s, retirement programs met with a great deal of
financing every year. In 2010, the FMSQ’s annual contribution paid
success (too much!). The first signs of burn-out began to was of $370,000. In addition, the FMSQ takes part in organizing
appear among physicians who continued practising. Shortly the medical federations’ golf tournament in aid of the PAMQ.
afterwards, the PAMQ started to see a new clientele among
LS
10 LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010IN THE NEWS
FIQ-MSSS Agreement in Principle Another Proposed Private
The Fédération interprofessionnelle de la santé (FIQ) has reached Member’s Bill to Watch Out For
an agreement in principle with the government on the renewal of
the collective agreement covering its 58,000 members (nurses, The MP for Winnipeg, Rod Bruinooge, tabled a private mem-
nursing assistants and respiratory therapists). The agreement in- ber’s bill last April that would impose penalties on any person
cludes an increase of approximately 3.45% in work shift overlap who might induce or push a woman to have an abortion. This
payments for full-time nurses employed in a hospital, a 40% re- new private member’s bill appears to join the parade of other pri-
duction in the external workforce (personnel from private agen- vate member’s bills like C-484, C-291 and C-43 all of which have
cies) within five years, overtime pay for clinical nurse specialists so far been defeated or dropped. Called Roxanne’s Law, this bill
working in centres where services are available all the time, and was named for a young Winnipeg woman, Roxanne Fernando,
a substantial increase in premiums for evening work (from 6% who was beaten to death in February 2007 after having refused
to 8 %), night work (maximum premium from 11% to 16%) and to have an abortion.
critical care (premiums from 12% to 14%). All increases are in
According to many observers, this private member’s bill is, once
addition to the salary increase of 7% over five years negotiated
again, a pretext for giving legal status to a fetus. The FMSQ is ac-
with the Common Front. The agreement must be ratified by the
tively following developments since, if the bill passed, it could
FIQ membership.
have serious repercussions on the work and professional liabil-
ity of medical specialists in Quebec.
A (Small) Opinion Poll
On its Internet site, L’Actualité médicale, a private publication belonging to the Rogers Group, asked physicians what their
position was on the lawsuit brought by the Conseil de protection des malades, which claims $7 million in damages from medical
specialists as a result of their three-day strike in 2002 and 2003.
Rate of response: 50 physicians in total!!! Of these, 63% replied, “It was unfortunate for our patients, but we have to be able to say
what we think”; 29% said, “It could have had serious consequences for patients. It is normal that they should be compensated”;
and 5% indicated, “Financial compensation, why not? But $7 million? That’s a joke!”
LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010 11FOLLOWING THE NEWS
Building the new UHCs
Since September, we have been reporting photographically on how construction work is advancing
on the new university hospital centres being built in Quebec. As a picture is worth a thousand words,
it's a pleasant way to keep track of these projects!
The new McGill University Health Centre will open its doors in the fall of 2014, while the CHUM is
expected to open in 2018.
CHUM
Picture taken on November 14, 2010
MUHC
Picture taken on November 16, 2010
LS
12 LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010DID YOU KNOW...
Prizes and Awards International Society of Nephrology Prize
Dr. Daniel Bichet, a nephrologist and
Annual Prizes – Société canadienne- researcher at Hôpital du Sacré-Cœur
française de radiologie Research Centre in Montreal, has received
the International Society of Nephrology’s
The SCFR recognized the work of a number of
Jean Hamburger Award. This medal, the
radiologists during its annual meeting, as well as their
highest distinction given by this organization,
outstanding contribution to the profession or in a
underlines the outstanding contribution of
parallel field of activity. Four prizes were awarded,
Dr. Bichet’s laboratory to the understanding
three of them to radiologists.
of hereditary diabetes insipidus.
Prix Albert Jutras 2010 2010 André-Dupont Prize
(awarded posthumously)
The Club de recherche clinique du Québec
Dr. Marie-Claire Descary who has awarded the André Dupont Prize to
passed away a few short months Dr. Paul Khairy of the Montreal Heart
ago, is considered a radiology Institute to mark the excellence of his work
pioneer. The first woman with a in the field of biomedical research. This prize
subspecialty in cardiopulmonary is awarded annually to a young researcher
imaging, she was a career-long who has no more than 10 years’ experience
clinician, teacher and administrator, as an independent researcher. Dr. Khairy’s
mainly within a CPDP. Interested in research has already had a major impact
ethical issues, she helped develop with regard to electrophysiology and congenital heart disease.
the specialized higher studies degree (DESS) teaching
program, the Master’s program in bioethics and the Montreal Heart Institute Foundation
Université de Montréal ethics teaching program
To underline Dr. John D. Rioux’ contri-
for residents.
bution to the advance of personalized
medicine, the Montreal Heart Institute
Prix Bernadette Nogrady 2010
Foundation awarded him the 2010 Martial
Highlighting both her academic/ G. Bourassa Prize. Dr. Rioux is an associate
scientific accomplishments and her professor of medicine at Université de
human qualities, Dr. Isabelle Trop Montréal, director of the Laboratory in
is a leading figure in breast imaging Genetics and Genomic Medicine of
in Quebec. An assistant clinical Inflammation at the Montreal Heart Institute,
professor, clinician, researcher and and also holds the Canada Research Chair in Genetics and
the person responsible for the Genomic Medicine of Inflammation.
radiology fellowship program, a
speaker and member of a scientific An Avalanche of Honours for Dr. Michel L. Roy
review committee, Dr. Trop has also authored thirty or so
The Society of Obstetricians and Gynaeco-
scientific articles, many of which have received recognition
logists of Canada has awarded the President’s
Medal for 2010 to Dr. Roy to mark his contri-
Prix Personnalité SCFR 2010
bution and commitment to the promotion of
Since becoming certified, Dr. Robert excellence in the practice of obstetrics-
Fradet has rapidly become a gynecology and women’s health.
notable and dynamic figure in the During the 26th International Conference
profession. With both a hospital and on the Human Papilloma Virus (HPV),
office practice at Sherbrooke, Dr. Michel L. Roy received the Interna-
Dr. Fradet is also a department tional Papilloma Virus Society Prize for Excellence for his
head in various hospitals in the exceptional contribution to HPV research and teaching.
region (Asbestos, Memphrémagog
and the Institut de gériatrie). In Lastly, in 2010 the Argentinian Society for Gynaecological
2008, he became president of the RadiologiX group, Oncology and Colposcopy named Dr. Roy an Honorary Member
which has the mission of protecting the integrity of for his contribution to the development and teaching of conser-
radiological care delivered and promoting the business vative surgical techniques in the field of gynecological cancer.
development of private radiology clinics.
LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010 13DID YOU KNOW... FSUITEG
2010 Mental Health Champion Prize Things are buzzing at the AMLFC
As part of Mental Awareness Week, the The Association des médecins de langue
Canadian Alliance on Mental Illness and française du Canada (or AMLFC) revamped
Mental Health presented its Champions its image. With a new name and new logo,
of Mental Health Awards to mark the the Association is now better equipped to
contribution of people who have had a meet the changing needs of French-
positive impact regarding the issue of mental speaking physicians. This repositioning is
health in Canada. The Alliance awarded the the outcome of deliberations that began
Mental Health Champion Prize in the some years ago. The new name – Médecins
Research Category to Dr. Brian G. Bexton. francophones du Canada (AMFC) – and the
logo were unveiled during the 5th French-Language Symposium
Award for Excellence in Research on Medicine held in Montreal at the end of October. The
Association’s new President is Dr. Conrad Pelletier.
The Journal of Continuing Education in the
Health Professions gave its 2009 Award for
Médecin de coeur et d’action Prizes
Excellence in Research to Réjean Laprise,
Dr. Robert Thivierge, Dr. Gilbert Gosselin Médecin de coeur et d’action” prizes were awarded to
et al for their article on Improved 10 recipients to mark the quality of their work and commitment.
cardiovascular prevention using best CME Four Quebec medical specialists were honoured:
practices: A randomized trial. Réjean
Laprise, Ph. D., is a senior research Dr Pierre Drouin
consultant in the FMSQ’s Office of obstetrician-gynecologist
Professional Development. This prize is
given annually by the JCEHP in conjunction
with the Alliance for Continuing Medical
Education, the Society for Academic
Continuing Medical Education and the
Association for Hospital Medical Education.
Dr Horacio Arruda
community health
medical specialist
Chaque lever du soleil vous
révèle une nouvelle aventure.
Dr Hubert-Antoine Wallot
psychiatrist
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14 LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010LEGAL ISSUES
By Maître Sylvain Bellavance
The Federation Files Suit Against
DIRECTOR, LEGAL AFFAIRS
the MSSS
On October 28, 2010 the Federation took legal action against were thus banned from grouping themselves in another manner,
the MSSS with the aim of having certain provisions of the Act placing restrictions on their freedom.
respecting health services and social services (AHSSS) as it
The Federation has made various representations in an attempt
applies to specialized medical centres (SMC) declared null
to correct these measures. This process finally stretched over a
and void.
period of more than three years, during which time a new
Filing suit against the MSS is a very unusual occurrence. Indeed, regulation was adopted by the government specifying 50 other
legal action by the FMSQ against the MSSS has only happened specialized medical treatments covered by the SMC
a few times over the years. And that in itself is a good thing, requirements. The effective date of this regulation was
because when we have to take such a step it calls for two postponed, thus permitting the adoption of new SMC measures
unfortunate conclusions. within Bill 34, passed in June 2009.
It means that the government has exceeded the acceptable We had to wait until March 31, 2010 for the different rules on SMCs
limits of its role and has adopted a line of conduct or action with to really come into effect and be enforced by the government.
regard to physicians or their patients that we consider must be
The Federation’s representations over the years achieved some
condemned, that rights have been infringed. It also means that
leeway in the SMC rules. However, the government still wanted
the government and its institutions, as well as those working in
to hear nothing about the restriction on participating/non-
them, have not known how to listen sufficiently well to modify
participating physicians’ freedom to practise. The Federation
their approach, and that the Federation’s efforts and
argued for a long time that such a restriction infringed physicians’
representations to correct this situation have been unsuccessful.
rights and freedoms and was unacceptable. We emphasized the
It indicates nothing more nor less than a failure of our fact that there was no valid reason for preventing participating
democratic system and our institutions. There is, therefore, no and non-participating physicians from being in practice together,
other option than to apply for the intervention of the Courts. that there was absolutely no justification for the ban with respect
to the quality and safety objectives identified from the beginning.
A brief reminder of the situation We stated that the ban would have the effect of ending already-
existing physician partnerships and thus cause various types of
The SMC issue first surfaced in 2006 when we were in the
harm, notably to their patients.
middle of a dispute with the government. On December 13,
2006 the National Assembly passed Bill 33 tabled by Philippe The government refused to withdraw the restriction. The most it
Couillard, the then Minister of Health. Some of the provisions of did was pass a temporary provision allowing certain
this Bill covered the setting up of SMCs. The explanatory notes participating/non-participating physicians to continue their joint
specified that “The bill provides for supervision of the quality and practice for a certain period of time.
safety of the medical services provided in a specialized medical
centre.”” The services in question were hip or knee replacement, The legal action taken
cataract extraction or other specialized medical treatment
In its suit, the Federation asks the Court to declare the
determined by regulation of the Minister.
provisions contained in the AHSSS banning the joint practice of
The Federation supported the measures intended to foster the participant and non-participant physicians null, void and
quality and safety of treatments in centres. The Bill provided that inoperative. The text of the action (available in the Federation’s
a majority of the owners of such a centre must be physicians, website at www.fmsq.org – In French only) gives a fuller
that a medical director should be appointed to ensure the quality explanation of the various problems arising from the passage of
and safety of care and that the SMC must be certified by a this ban. The legal action was taken jointly with a medical
competent body. specialist, Dr. Claude Trépanier, an anesthesiologist, in order to
support the problems identified.
The Federation however opposed all measures and
requirements that did not relate to the objectives of quality and It is unfortunate that we have to have recourse to the Courts
safety, including those that effectively called into question the to defend the rights of medical specialists. The Federation
rights and fundamental freedoms of physicians, their professional will never hesitate to take such action when circumstances
independence or their relationship with their patients. Among justify it, whatever the number of physicians affected by a
these was one that provided that an SMC must be composed discriminatory measure.
only of physicians participating in the Quebec health insurance S
L
plan or only of physicians not participating in the plan. Physicians
LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010 1516 LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010
Dossier
In a few short weeks from now, Haiti will be remembering the day when, just
a year ago, the earth took away the lives of hundreds of thousands of
persons and destroyed daily life for all Haitians. In just a few minutes on
January 12, at 4:53 p.m., an earthquake measuring 7.0 on the Richter scale,
with an epicentre located a few kilometres from Léogâne, destroyed the
capital city of Port-au Prince which alone had more than 2 million
inhabitants, along with some coastal villages on the southern side of the
island. Because of the extent of the disaster, the entire world would unite and
organize immediate rescue plans. The needs were considerable, especially
supplying the population with the basic necessities of life and survival, such
as water, food and first aid.
As a result of the catastrophe, the Fédération des médecins spécialistes du
Québec took action on several fronts. It first responded to the many requests
from physicians who, touched by the distress of the Haitian people, wanted
to know how to get there and give their time to deliver first aid. The
Federation then donated $70,000 to be divided between the three
organizations that have a direct link with the work of our medical specialists
in Quebec (Doctors Without Borders, Doctors of the World (Canada) and the
Centre for International Studies and Cooperation). Lastly, it set up a vast
fund-raising campaign covering the whole community of medical specialists,
both active and retired. This latter initiative brought in close to $160,000, in
just a few days.
What has been happening, then, over almost a full year? Le Spécialiste has
invited the three organizations who received the sums donated by the
Federation to bring us up to date. One reports on what has been
accomplished in the field; the second takes a critical look at the situation that
still exists; and the third, managing yet another health crisis in Haiti, deals
with the current situation including the cholera epidemic. Le Spécialiste also
wanted to take another look at the media storm surrounding the request
made by orthopedic surgeons, and asked the President of the Association at
that time to talk about what happened. The editorial team has added a
summary of the events and action taken in this regard.
But, Haiti has still not been rebuilt. Far from it. What about the rebuilding
projects that were covered so extensively by the media during the first
summit meeting in Montreal? Le Spécialiste has met a few members of a
citizens’ group within the Haitian community who are totally dedicated to the
sustainable reconstruction of their native land. The group includes several
Quebec medical specialists, and has just published its vision for a new Haiti:
a Haiti they hope to see rebuilt, with a more open, fair society that will one
day be able to meet its own needs.
The editorial team wishes to thanks the Centre for International Studies and
Cooperation, Doctors of the World (Canada) and Doctors Without Borders for
having granted us permission to use their photos in this present dossier.
LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010 17Special Collaboration – Report from the
Centre for International Studies and Cooperation (CECI)
Haiti: Strength through Unity
On January 12, 2010 the most devastating countrywide earthquake in human history
overwhelmed Haiti, affecting the lives of thousands of people: 200,000 of them died and
1.5 million were victims of the disaster. Our 160 Haitian colleagues who make up our national
team (the one located in Haiti) have been working ceaselessly since the day immediately
following the catastrophe, and have made every effort to support the Haitian population and
provide the basic necessities of life.
Since the first day of the Emergency Haiti “ON JANUARY 12, Following the earthquake, CECI completed
Campaign launched by CECI, donations of
AT 4:53 P.M., the last activities that had been planned as
LIFE STOPPED FOR
goods and money totaling more than part of its program aimed at women.
EVERYONE IN HAITI.”
$17 million have been collected. Today, nearly Financed by the Ministère des Relations
600,000 individuals have benefited from our internationales du Québec (MRI) and
= LÉONEL GARNIER,
actions overall. carried out in collaboration with Haitian
EMERGENCY
organizations promoting women’s rights,
OPERATIONS
During the initial phase of the emergency, this portion of the program made it
COORDINATOR
CECI was one of the first organizations to possible to offer medical care and
mobilize to help victims. CECI has been
FOR CECI IN HAITI.
distribute medicine in its temporary
present in Haiti for close to 40 years and used shelters. Pregnant or nursing women and
its expertise and detailed knowledge of the children under a year old benefited from
area to maximize the effectiveness of its actions. During the this program. Pregnant women also received kits containing
very first days of the disaster, the organization came to the supplies to help make delivery safer, items for newborns and
rescue of thousands of victims in Port-au-Prince, Delmas, food. Hygiene kits as well as women’s and children’s clothing
Croix des Bouquets, Carrefour, Gressier and Léogâne, were also distributed under this part of the program.
distributing emergency supplies it had stored in the
warehouses of the Organization for the Development of At the same time, the first humanitarian aid convoys set out
the Artibonite Valley (ODVA) in preparation for the 2010 from the neighbouring Dominican Republic, with the help of a
hurricane season. Dominican partner. Additional personnel flew in on January
15 to support our teams on both sides of the border. In the
field, work was coordinated with the Civil Protection
Department (Direction de la protection civile - DPC), the
Catholic Relief Service (CRS), Oxfam Québec and Caritas.
From January to July 2010, more than 120,000 victims
received health care from medical teams recruited in Canada
by CECI and assigned to hospital centres in Carrefour
(Haitian Adventist Hospital), Saint-Marc and Gonaïves. CECI
also distributed medication and medical supplies valued at
$1,230,427 overall; $1,210,026 was in the form of goods,
$20,401 was from funds raised. These amounts included the
cost of sea and ground transportation, customs,
warehousing, and labour to assemble and distribute the kits.
During this same period, CECI also implemented a specific
program for women dealing with reproductive health
(pre- and post-delivery, and infant care) and with the
recapitalization of women. The program, financed by the MRI
and carried out in collaboration with Haitian organizations
promoting women’s rights, has had conspicuous results:
18 LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010jointly by CECI and the Center for International Cooperation
in Health and Development (CCISD) and has allowed the
distribution of medicine and medical supplies throughout the
country, particularly in hospitals in the Artibonite region, the
North-East, the Central Plateau, the South and the Gonâve
area. An agricultural program was also implemented to
support hundreds of displaced persons and host families in
the commune of Verrettes in the Artibonite region.
It must also be emphasized that CECI obtained more than
US$5,000,000 last July from USAID to finance a large-scale
program for displaced persons in 11 communities in the
Artibonite. This project mainly deals with recapitalizing
women. In addition, this financial aid has enabled the
introduction of a major cash-for-work program that will help
restore agricultural infrastructures and work on watershed
protection. Other activities covered by the project are a
widespread hygiene campaign targeting 20,000 persons
and the construction of three community centres, each
capable of accommodating more than 500 persons in cases
of natural disasters.
Helping the Economy by Recapitalizing
Women
If we consider the traditional role of women in certain
cultures, they are often more vulnerable than men when a
disaster occurs. After the earthquake in Haiti, one of the
priorities announced on February 27, 2010 by the Haitian
Minister of Women’s Rights was the importance of fighting
• Assignment of a medical team made up of five women against the feminization of poverty.
recruited in Canada (two physicians, two nurses and one
Although the specific needs of the most vulnerable women
social worker) to the Diquini Camp to support and reinforce
were systematically taken into account, business women had
two nurses who live on site and act as midwives in a
lost all their sources of income during the earthquake. That is
mobile clinic;
why CECI chose to provide capital to women who had lost
• 400 medical consultations of pregnant or nursing women, their small businesses to the quake. The loss of the income
and children less than 1 year old; used to support several members of a family gave rise to an
extremely precarious situation in the shelters, leaving women
• Distribution of medicines, vitamins, etc. following medical vulnerable to various forms of exploitation.
consultation;
Recapitalizing displaced women who lost
• Distribution of 500 kits for pregnant women (providing their businesses enabled them to re-enter
supplies to help ensure safer deliveries); the economy, better provide for the needs
of their children and other relatives, and be
• Distribution of 1,000 kits for newborns and 2,000 kits better equipped to leave the shelters. The
containing hygienic items for mothers. This program strategy has had very promising results. To
enabled us to provide financial help and technical support date, more than 1,500 women have each
to more than 500 business women to restart their received a start-up amount of CA$400.
economic activities. This has allowed them to finance a basic
inventory for their businesses. We esti-
Outside Port-au-Prince, CECI’s actions affected displaced mate that each recipient can provide for
persons and host families in several communities. Activities the needs of five to seven persons. Many
included health services in Artibonite through the PALIH-2 of them have been able to leave the
team, a project financed by the Canadian International camps thanks to this support.
Development Agency (CIDA) designed to improve the quality
of health services in this target area. The project is operated
LE SPÉCIALISTE VOL. 12 NO. 4 DECEMBER 2010 19Vous pouvez aussi lire
