Family medicine group implemented in Québec: potential and limits to improve healthcare performance

Summary A longstanding consensus among politicians, professionals, researchers and clinicians exists regarding the need to reform primary healthcare in order to improve the performance of healthcare systems. However, it is only recently that initiatives of renewal of primary healthcare have been undertaken in various Canadian provinces as well as in several other countries. In this regard, the model of Family Medicine Group (FMG) developed in Québec appears promising to improve the organization of primary health care. A FMG is a group of family physicians who work in close collaboration with nurses to provide services to registered clientele on a non geographical basis. The aim of this article is to analyze the potential of the FMG model to be a lever for improving the health system performance as well as to discuss potential improvement for this model. First, we present the history of the organization of primary health care in Québec. Second, we present the FMG model based on the four key functions of a healthcare system identified by WHO; 1) financing 2) resource generation 3) provision of individual and collective services and 4) governance. Then, we discuss potential improvements inspired by the Family Health Team implemented in Ontario. Finally, we conclude by formulating recommendations that could inspire other initiatives that are taking place such as Maison de santé which are gradually established in France. Prat Organ Soins. 2011;42(2):101-109