Improving Access to Family Medicine in Quebec through Quotas and Numerical Targets
Bibliographic record
Abstract
Despite various health reforms over the last 20 years, access to primary care remained stagnant in Qubec, and in 2014 the province had the highest proportion of residents in Canada without a family physician. In November 2014, the Qubec Minister of Health and Social Services introduced Bill 20, An Act to promote access to family medicine and specialized medicine services and to amend various legislative provisions relating to assisted procreation. Bill 20 aimed to increase access to family medicine through a system of quotas of registered patients and penalties for family physicians. Health system user support groups and the governmental advisory group on women's rights supported Bill 20's approach to ensure the rights of system users to access family physicians. However, the union of general practitioners was strongly against the bill due to the clash between the minister's reliance on numbers and the realities of family practice. The union of general practitioners entered negotiations with the minister and while Bill 20 was legalized in 2015, it was agreed that family physicians would be excused from the bill as long as they reached two targets at the end of December 2017: 1) 85% of Qubecers must have a family doctor and 2) family doctors must ensure the patients registered to them see them, and not other doctors, 80% of the time. The targets were not met at the end of December 2017 but the quota system in Bill 20 has yet to be implemented.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".