Since their emergence in the early 2000s following accreditation by the Ministère de la Santé et des Services sociaux, Family Medicine Groups (FMG s) have completely transformed access to healthcare in Quebec. They are revolutionizing the healthcare sector by bringing together family doctors and nurses and offering a wide range of services that are finely tuned to each patient’s needs.

But how do FMGs differ from traditional medical practices, and how will they impact your healthcare experience? Even more crucially, what are your rights and responsibilities within this new system? Our health lawyers are here to answer these questions.

How family medicine groups (FMGs) work

A family medicine group (FMG) is a collaboration between doctors, nurses and other healthcare professionals to offer accessible primary care to registered patients. FMG objectives include:

  • Improving access to care
  • Reducing waiting times
  • Better coordination between providers
  • Reducing overcrowding in emergency departments.

Based on agreements with the Integrated Health and Social Services Centres (CISSS), FMGs operate according to general standards for professionals in private practice. These agreements govern the relationships and responsibilities between FMGs, CISSSs and patients, and enable FMGs to receive government subsidies if they achieve their objectives.

FMG patients

To benefit from the services of an FMG, it is mandatory to register with a family physician within the group. This registration enables the FMG to manage care efficiently, and to correctly apply government subsidies.

Patients who are registered with an FMG must:

  • Have a valid health insurance card.
  • Consult only your family physician or other FMG physicians, except in the case of emergencies or when outside your region.
  • Inform your FMG of any change of address or telephone number.
  • Sign a form authorizing the sharing of medical information with other FMG professionals.

FMG membership is awarded on an annual basis and is automatically renewed.

If a patient decides to unregister, they must notify their family physician in writing. Even after unregistering, the patient can still see their doctor, but they will lose all FMG benefits.

Conditions for cancellation

A user’s registration may be cancelled under the following conditions:

  • Upon written request
  • If the user loses their valid health insurance card
  • If the family physician leaves the FMG
  • If the FMG dissolves.

By registering, the user benefits from the FMG’s promise to provide care and access to services, and follow-up according to the commitments made in the FMG’s contract with the CISSS.

Obligations of family medicine groups (FMGs)

In exchange for support from Integrated Health and Social Services Centres (CISSS), FMGs have a number of obligations towards their users. They must provide adequate services, do effective follow-up, manage registered patients, and provide easy access to these services.

1. Patient care and follow-up

FMGs are required to provide full patient care and follow-up for anywhere from 9,000 to 30,000 users, depending on their agreement with the CISSS. Each patient has a unique clinical file, which will be managed by the FMG even if their physician leaves the group, unless the patient specifically requests a transfer. Files will be transferred at no additional cost.

Services offered by FMGs include:

  • Health assessment
  • Diagnosis
  • Treatment of acute and chronic health problems
  • Prevention and health promotion.

Services also cover mental health such as psychiatry, in addition to home care and prenatal and postnatal care.

Each FMG has committed to providing these services in a timely manner, and to collaborating with the local community service centers (CLSCs) of the CISSS for coordinated follow-up.

In addition, FMGs coordinate with CISSS hospitals to ensure continued access to care, including after hospitalization or emergency room visits.

2. Accessibility to FMG services and collaboration with the CISSS

FMGs must offer family medicine consultations, with or without an appointment, according to a minimum opening schedule of 12 hours on weekdays and 4 hours on weekends and holidays. An info-santé phone service is also available 24/7 by calling 8-1-1, for patients with special needs.

In addition, FMGs are responsible for establishing partnerships with other healthcare professionals to offer a range of services by specialists and other doctors.

FMGs also have responsibilities towards the CISSS. They must notify them when physicians join or leave the group, with six months’ notice required for group departures. They must also report the use of financial and technical resources provided by the CISSS.

Meeting objectives

FMGs must meet the enrolment targets set out in their CISSS contract, with a deadline of three years to reach 80% of these targets, and five years to achieve them in full.

They must also provide budget reports to their CISSS to demonstrate progress. Supported by the Ministry, each CISSS allocates funds to FMGs so they can guarantee the delivery of services. Challenges such as maternity leave, the recruitment of new physicians and retirements are often cited by FMGs as obstacles to achieving these objectives.

How do FMGs and the CISSS work together?

FMGs work closely with the CISSS to consistently deliver healthcare services. All FMGs must:

  • Register their patients in the CISSS nursing on-call system and update clinical records within 48 hours.
  • Provide CISSS with the list and schedules of all on-call professionals, informing them promptly of any changes.
  • Participate in the CISSS homecare program and other programs that could benefit patients.
  • Respect the working conditions of nurses assigned to the FMG.

These commitments help achieve quality care and the effective integration of health services within the community.

User rights and recourse in the event of non-compliance by FMGs

By joining an FMG, users accept certain changes to their legal rights, such as a limited choice of healthcare professional and changes to how they can access their medical records. However, in return, users are entitled to the benefits promised in the contract between the FMG and the CISSS.

For medical complaints toward an FMG, existing procedures continue to apply. Complaints against a professional in a healthcare institution are handled by the corresponding disciplinary committee, while those concerning a physician in a private clinic must be communicated to the Collège des médecins du Québec.

An FMG member physician is chosen by the group to act as internal manager, and will be responsible for managing administration and ensuring contractual compliance. Although they are responsible for organizing services, the internal manager is not able to address legal complaints. If an FMG fails to meet its commitments to a user, that individual will need to file complaint with the regional CISSS by following established procedures.

Protect your rights with MedLégal

Family Medicine Groups (FMGs) play a crucial role in providing accessible, coordinated health care in Quebec, but to benefit from these services, you need to understand your rights and responsibilities as a user. If you are encountering difficulties or have concerns about the services offered by an FMG, you can file a complaint. Trust the expertise of a health law firm like MedLégal to help you find a solution.

Contact MedLégal now to uphold your rights as a healthcare user.

Recommended Posts