Quebec’s Family Medicine Groups: Innovation and Compromise in the Reform of Front-Line Care

Abstract

At their origin, public healthcare systems were designed mainly for the treatment of acute illnesses. For many years, therefore, public health care focused on services offered in healthcare establishments and primary care was allowed to evolve on the periphery of hospitals, with doctors free to follow their own conception of how best to provide and follow up on care. As hospital costs grew, however, and new challenges regarding the provision of care began to emerge, governments felt increasingly responsible for organizing the front line (Nolte and McKee 2008). How doctors would be called upon to participate in the new configuration of services—particularly in Canada, where physicians function as independent entrepreneurs—is the subject of this article, which investigates the decision to introduce family medicine groups (FMGs) to the province of Quebec.