Quebec Doctors Revolt Against Bill 2 Over Pay, Patient Load Changes

Quebec’s healthcare system has been thrust into a state of crisis as hundreds of doctors threaten to leave the province—or even the profession—over a controversial new law known as Bill 2. The reform, passed by Premier François Legault’s government, fundamentally changes how doctors are paid and what is expected of them.

Bill 2 introduces a new payment model that shifts from the traditional fee-for-service system to a capitation model. Under this model, doctors are paid based on the number of patients they enroll, especially those from vulnerable populations. Payments are linked to performance indicators such as shorter wait times and improved continuity of care. The reform aims to increase the number of patients registered with family doctors and promote collaboration among healthcare professionals.

Many specialist and family physicians argue that the new system could lead to dramatic reductions in their income and overwhelming patient loads. They say the government did not provide necessary support or consultation before implementing the law. “The Quebec government is asking us to do more for less and they’re not giving us the tools to practice medicine better,” said Dr. Craig McCullough, family physician and assistant professor at McGill University.

Doctors fear being forced to rush through appointments without sufficient support from allied healthcare workers, such as nurse practitioners or psychologists. This, they say, will ultimately harm patient care rather than improve it.

Over 1.5 million Quebec residents currently do not have a family doctor. The passage of Bill 2 has triggered a wave of doctors seeking to move out of Quebec, particularly to Ontario. Reports indicate that some physicians have directly contacted Ontario Premier Doug Ford after he publicly suggested that Quebec doctors could find work in his province.

Faced with mounting pressure, Quebec’s ruling party invoked closure, a parliamentary tool to cut off debate and push the bill through, despite weeks of protests and even refusals by physician groups to train medical students. The bill’s passage triggered the resignation of Social Services Minister Lionel Carmant, himself a neurologist, whose family members are reportedly opposed to the law. His departure highlighted deep divides even within the government’s ranks. Bill 2 also includes harsh penalties—up to $20,000 per day—for doctors who engage in coordinated resistance, such as work slowdowns or service delays.

While the backlash is intense, some experts argue that moving toward a capitation model is a necessary modernization. Olivier Jacques, a public policy professor at Université de Montréal, noted that Quebec doctors are among the highest paid in Canada, even after taxes, and the capitation model is already used in many other parts of the country. However, Jacques warns that the confrontational manner in which the government has pushed the reform could overshadow its intended benefits and widen the rift between policymakers and physicians.

With the doctor shortage already critical and growing discontent, health services in Quebec may see further strain if the government and medical community cannot find common ground. For now, the province stands at a crossroads, with the future of its healthcare workforce hanging in the balance.