TWO-TIER RADIOLOGY: QUEBEC’S CREEPING PUBLIC-PRIVATE SYSTEM

TWO-TIER RADIOLOGY: QUEBEC’S CREEPINGPUBLIC-PRIVATE SYSTEM

"The report shows (below - recap via email):

“While it has more material and human resources, Quebec is less effective than Canada as a whole in providing accessible medical imaging services. The exclusion from public coverage of CAT scan, MRI and ultrasound tests performed outside a hospital leads to joint public-private practice that has the effect of draining resources from the public to the private sector. This damaging distortion leads to problems of access to medical imaging for most patients…”

The report documents the inequitable, inefficient, costly and potentially unsafe utilization of medical imaging technology in Quebec’s unique and highly privatized system.  One aspect, the relatively effective use of technology in hospitals compared to private clinics (which would be better yet if the system were entirely public), is clearly not limited to Quebec."

Contents

Privatization is underway: The case of joint public-private practice in radiology...............4

1. A historic achievement, and then a retreat........................................................................5
Medical imaging...............................................................................................................6
2. On the ground: The impact of exclusion from public coverage .......................................8
The exodus of personnel ..................................................................................................8
Wait times: Interminable and inequitable ........................................................................8
Waiting list confusion ......................................................................................................9
Hours wasted by doctors, support personnel and patients................................................9
Tests that aren’t optimal..................................................................................................10
Conflict of interest, marketing….....................................................................................10
… and risks .....................................................................................................................10
Private tests with no quality control ...............................................................................10
3. An overview: Misuse of resources ..................................................................................12
The Quebec exception ....................................................................................................12
Radiology in Quebec : Doing more with less .................................................................15
The public-private gap ....................................................................................................16
Interregional distortions ..................................................................................................17
A distortion that damages the system .............................................................................18
Workers’ compensation: A special case .........................................................................19
4. The lead actors: Medical Imaging Laboratories ..............................................................21
5. What is to be done?: MQRP’s positions and demands..............................................23
6. What others say.................................................................................................................26
Once bitten, twice shy: The false option of joint public-private practice..............................30