The Quebec health care system: its implication for medical education

Since November 1, 1970, doctors in Quebec have been operating under a government-controlled compulsory and universal "fee-for-service" insurance plan. After a review of some characteristics of the new system, the author describes the impact of this social legislation on physicians' lives, control of health delivery costs, and various policy issues. He examines the implications of these changes for medical education. A qualitatively different kind of physician must be able to deal comfortably and effectively with a reality which includes: (a) the concept of "global medicine" and its social implications, (b) greater external control of costs and increased public concern with quality, (c) a new concept of the role of the hospital and its integration within the system, and (d) the concept of team care. Possible changes associated with the new system include a reevaluation of the criteria for a good clerkship, an acquisition of a new perspective on community health ecology, and a need to become an efficient team-worker.