Health professionals and patient advocates in Quebec say the system of issuing permits for family doctors is making it hard for physicians of colour to work in their communities.
The result, they argue, is that patients in some neighbourhoods, like Parc-Extension in Montreal, don’t get care that takes their cultural needs into consideration.
They point out that not allocating enough permits, known by the French acronym PREM – plans régionaux d’effectifs médicaux, puts sociocultural barriers to health care and is an example of systemic discrimination.
“You know, I love Canada, I love Quebec, but when it comes to not giving PREM to Parc-Ex,… there has to be somewhere systemic racism,” said pharmacist Victor Sumbly who has a pharmacy on Jean-Talon Boulevard, in the heart of Parc-Extension. It’s right next to Clinic Parc-X that was opened by his daughter Pia Sumbly, a nurse, and Dr. Jhanzaib Sherwani, a general practitioner.
Sherwani pointed out that because many patients don’t speak English or French and can’t express themselves to a doctor, many fall through the cracks.
“Illnesses that are very easily treated by family doctors such as diabetes, iron deficiency, anemia hypothyroidism, often go unchecked or undiagnosed in this population,” he told Global News, adding that treatable illnesses get worse.
He also said the family doctor shortage also drives people to hospital emergency rooms, “leading to long wait times for other people,” he noted. “They’re often consulting for issues that are not emergencies.”
According to patient advocates Seeta Ramdass, a board member with the patients’ advocacy group Conseil pour la protection des malades, another important cultural aspect is diet.
“Their dietary needs may be different because they are vegetarians according to their beliefs and cultures, often deficient in vitamin and nutrients,” she explained.
She stressed that a family doctor who understands the culture can build a health-care model that respects cultural and nutritional needs.
In a statement, the CIUSSS West-Central Montreal that oversees health services in the area said, “we offer medical and social services in the community in more than 10 languages, we offer cultural and religious accommodations whenever possible and we have a close working relationship with community partners.”
Those who work in the community say while those efforts are laudable, they fall short.
Sherwani said he helped opened Clinic Parc-X, where services are offered in nine languages, to help bridge some of the gaps he says are present. He speaks four languages: French English, Urdu and Hindi, but he blames the Quebec government for not giving him a PREM to work at the clinic full time.
He does have a permit to practice but only in the Ahuntsic-Montreal North jurisdiction. Under the rules, he has to spend most of his time in the area which his permit covers — 55 per cent of his time minimum. It means, therefore, that he is at the Parc-Ex. clinic only two days, weekly.
Ramdass believes sociocultural needs must be taken more seriously.
“We can’t ask patients to conform to very Western and very North American paradigms of care,” she stressed. “We have to, as clinicians, adjust the care to the patient.”
According to Sherwani, doing so will save taxpayers money, too.