Two young emergency physicians, raised and trained in Montreal, quit their jobs after just two years to return to Toronto – and they say the Quebec health care model and Bill 96 are to blame.
The doctors, who work at the Jewish General Hospital, are returning to Ontario, a move they’ve made before – but this time they say they don’t expect to return home any time soon.
The married couple say they see no future in Quebec for themselves and their two boys, aged three and one.
So two different Toronto emergency rooms are preparing for their arrival, with jobs waiting for them.
“It was a really tough decision,” said Dr Daria Denisova, 34. Her husband, Dr Philip Stasiak, 37, said they took her “with a heavy heart”.
“I love Montreal. It’s the city I grew up in, and leaving it a second time is disappointing,” Stasiak said.
They are leaving at a time when the Quebec health system is being strongly criticized for its fragility.
Montreal alone is short by 18,399 health care workers, according to the government’s July 4 health system dashboard.
But after all their angst, it’s become clear to the doctors that compared to the hospital system they remember in Toronto, Montreal’s working conditions, which they find harsh and inflexible, are incompatible with raising a family. in good health. They say these conditions are a natural consequence of government rules limiting hiring.
And if they still had any doubts about the move, Quebec’s new language law, commonly known as Law 96, sealed the deal for them.
Physicians have no trouble communicating with patients in French or English. They are trilingual: Denissova also speaks Russian, Stasiak speaks Polish.
But they are somewhat concerned that the law to protect the French language will affect patient care and make an already difficult work environment all the more cumbersome.
“It’s very vague. What are the real implications of this going to be? Is this a political posturing? How are the laws going to be enforced?” said Stasiak. “No one really knows.”
He expects that at the English-designated hospital he works in he can continue to use his best judgment, but the unknowns still apply.
Will it be felt in “my interactions with patients, is it my interactions with my colleagues, when I talk to a consultant or a nurse or someone else in an allied health profession? is it in my file?” he said.
“We’re fully bilingual, but the fact is there are so many acronyms in medicine…and describing that to someone else who needs to pass that information on…wouldn’t it be better to continue like this? said Stasiak.
“I don’t like, on principle, that you dictate who I should speak to in English or in French,” Denisova said, when what matters most is communicating effectively with patients.
“It’s infuriating that this is even a conversation to be had,” she added. “Are people going to have to show their certificates of eligibility when you go to the hospital for treatment?”
They are not alone in their concerns. Other medical groups, including the College of Physicians of Quebec, have been sounding the alarm about Bill 96 for months.
In an email to CTV News on Monday, the Ordre des médecins du Québec reiterated that the organization “will remain vigilant” regarding Bill 96 because “the reform could impact the doctor-patient relationship.”
“I just didn’t want to live in a place where I no longer felt like I represented my views and values,” Denisova said.
THREE PRIORITIES: THE FAMILY, FRENCH MASTERY AND FREEDOM OF CHOICE
The much bigger issue looming over young parents, however, is how Bill 96 might limit their children’s school choices when they reach CEGEP age and after they’ve attended elementary schools. and French secondary schools, as their parents did when they were children.
“We would like them to have the freedom to choose between, ‘You know what? I want to go to an English CEGEP or a French CEGEP,” that’s the choice we made,” Stasiak said.
But they fear that changes to the language law will make this impossible.
Bill 96 caps enrollment levels in English-language CEGEPs and is expected to make college access increasingly difficult for French-speaking and allophone students as their growth will be halted at 2019 levels.
Given the restrictions, the couple want to make sure their children don’t spend all of their early years studying in French in a province that could later slam the door on their future success.
“They’re freezing English CEGEP enrollment and prioritizing students coming from English schools – and that’s now,” Denisova said. “What’s it going to be like in 10 to 15 years?”
The only feasible solution would be to send the boys to private English schools in Montreal that offer a Grade 12 option, so they can bypass CEGEP altogether and earn an Ontario Secondary School Diploma.
But then their fluency in French could take a hit, the two men noted. They say they are in a trap unless they leave Quebec.
“I think the biggest irony is that now we’re going to go back to Toronto, we’re going to send them to a French private school,” Denissova said.
“We want them to be fluent in French…but not at the expense of their future freedom, future choices and career opportunities,” she said.
Dr. Philip Stasiak and Dr. Daria Denissova, seen with their eldest son, are leaving Quebec to ensure their children have more freedom in their studies.
EMERGENCY ROOM COLLEAGUES UNDERSTAND
The couple say it’s hard to believe they’ve come full circle and are leaving home again.
They left for Ontario the first time because they could not get a license to practice in Montreal after completing their residencies at McGill University teaching hospitals.
The government determines how many doctors a region or hospital can hire, using a licensing system known as PREM/PEM (Regional Medical Workforce Plan) – and there was none at their disposal.
So for five years they worked in emergency rooms in Toronto.
“Then once we had our first child, we decided, you know, it would be really nice to go back. I miss the French. I miss Montreal as a city. We’re going to get closer to our parents.” , said Stasiak. said.
These Montreal elements were great for them: the grandparents, the house, the neighborhood. After about a year, however, reality set in, they said.
“It hit me that, oh my god, it’s such a tougher work environment and there was also Bill 96 making headlines, so all these things started coming to me. in mind,” Denisova said.
She wondered if they could handle the workload — many shifts, and shifts 30-50% longer than in Toronto, she calculated — and stay healthy. over the next 20+ years if they continue on the same path.
The environment, they said, has nothing to do with how their hospital is run, something Denissova observed when she took a few ER shifts at another Montreal hospital for the to help understand the issues she was facing.
The two young doctors believe the “onerous” workload has a lot to do with the province’s licensing system.
“Because of the PREM system, the working conditions are much more difficult. The work is much less flexible in terms of hours, in terms of shifts,” Denisova said.
When it comes to that assessment, she has an ally in a veteran Montreal GP who just sued the Department of Health over the PREM system and how it’s being used to distribute — or not — doctors. family in Montreal.
“It makes no sense that we have restrictions on recruitment,” said Dr Mark Roper, “when we have such a shortage of staff, a shortage of emergency doctors. It makes no sense, n ‘is this not?”
He believes having more family doctors in Montreal would relieve pressure on overwhelmed emergency rooms because family doctors would see more patients in their offices and rotate through emergency rooms.
“We would certainly welcome and benefit from more doctors,” Denisova said. She added that she was disheartened that the doctors decades her senior were still working as hard as she and her husband.
Nor does she anticipate that they will ever have a flexible work schedule that would allow them to better care for their children and get them to daycare and school, unless various aspects of the system change. radically.
“It’s true,” Roper said. “The PREM system and the PEM system, which are more of a labor check for hospitals, force department heads to use only full-time doctors, and part-timers have a hard time.”
They are so understaffed, Denisova said, that it would put too much pressure on the rest of the team if she were allowed to reduce her hours for a few years – something she will now be able to do in Toronto.
“Almost as soon as I spoke to the Toronto department where I used to work, they said, ‘Yeah, sure, we’ll gladly take you on however many shifts you want to do. “”
The hospital told her that “‘if you want to work less hard for a few years of your life because you have younger children, we can accommodate whatever you want,'” she said. so striking. “
Informing his colleagues at Jewish General Emergencies of their decision was “difficult,” Stasiak said.
“These are people we’ve trained with, who we know, who are our friends – I feel like we’re maybe even letting them down a bit, and they’re also disappointed,” he said. he declares.
“But everyone is very understanding. They understand because they see the conditions,” he said.
“We have to do what is best for us, for our family,” even if that means leaving others behind.
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