Article – The doors at the Clinique Médicale Les Enfants closed for the last time on Friday afternoon, leaving hundreds of LaSalle families searching for new healthcare providers amid Quebec’s ongoing physician shortage. For 32-year-old mother Nadia Beaulieu, the closure represents more than just an administrative change.
“We’ve been coming here since my daughter was born,” she told me as we sat in the clinic’s waiting room, its walls still decorated with fading animal stickers. “Dr. Moreno knew all her allergies, her history. Now we’re starting from zero again.”
The west-end Montreal pediatric clinic has served the community for over 15 years, providing care to approximately 2,000 children. Its closure is the latest in a string of family medicine disruptions linked to Bill 15, Quebec Health Minister Christian Dubé’s sweeping healthcare reform legislation passed in December.
Dr. Elena Moreno, the clinic’s founder and one of three physicians there, explained the decision came after months of uncertainty about how the new reform would affect small, independent practices. “We simply couldn’t plan for the future. The administrative burden was becoming impossible for a clinic our size,” she said, her voice betraying frustration as she packed medical textbooks into cardboard boxes.
According to the Quebec Federation of General Practitioners (FMOQ), at least seven primary care clinics have announced closures in the first quarter of 2024 alone. Dr. Marc-André Amyot, president of the FMOQ, points directly to the uncertainty created by Bill 15’s implementation.
“Small clinics are being squeezed out while they wait for clear guidelines on how the new healthcare structures will function,” Dr. Amyot explained during our phone interview. “It’s creating a dangerous gap in services, especially for vulnerable populations like children.”
The reform aims to create a more centralized healthcare system through Santé Québec, a new agency that will handle healthcare operations while the Ministry of Health focuses on overall policy. But the transition period has created confusion among healthcare providers about everything from funding formulas to patient assignment systems.
For LaSalle resident Miguel Fuentes, whose two children have received care at the clinic since infancy, the closure feels personal. I watched as he tried to secure copies of his children’s medical records before the clinic shut permanently.
“They’re telling us to register with the Family Doctor Finder website, but the waiting list is already years long,” Fuentes said. “My son has asthma. We can’t just wait and hope for an appointment at the emergency room when he has an attack.”
When I visited the Clinique Médicale Les Enfants last Tuesday, the administrative staff were overwhelmed with requests from parents seeking guidance on transferring medical records and finding new physicians. Office manager Diane Lapointe had created handwritten lists of nearby walk-in clinics and hospital resources.
“We’re trying our best to help families transition,” Lapointe told me, “but many of these children have complex needs that require consistent care, not fragmented visits to different providers.”
The Quebec Ministry of Health responded to my inquiries with a statement indicating that patients from closing clinics would be “prioritized in the centralized access system.” However, they couldn’t provide specific timelines or guarantees for when families might secure new regular care providers.
Community health advocate Catherine Tremblay from the LaSalle Community Coalition notes this pattern disproportionately affects lower-income areas and immigrant communities. “LaSalle has a high percentage of newcomers to Canada who already face language barriers in healthcare. Losing a trusted pediatrician makes accessing care even more difficult,” Tremblay explained when we met at a local community center.
The Coalition has documented that since Bill 15 passed, clinic closures have occurred at higher rates in neighborhoods with below-average household incomes, suggesting structural inequities in how healthcare reforms impact different communities.
Dr. Moreno’s voice cracked when describing her final appointments. “Yesterday, I saw a child I’ve treated since she was born. She’s twelve now. These aren’t just patient files – these are relationships built on trust over years.”
While larger medical groups and hospital-affiliated clinics have more resources to navigate the transitional regulations, smaller independent practices face overwhelming administrative burdens under the new system. Many physicians from closing clinics are either retiring early or joining hospital departments rather than continuing in community practice.
Dr. Rajiv Sharma, a health policy researcher at McGill University, suggests this trend contradicts the reform’s stated goals. “If we lose community-based pediatric care, more families will rely on emergency departments for routine issues. That’s exactly what Bill 15 claimed it would prevent,” he noted in our conversation at his campus office.
As the afternoon sun streamed through the clinic’s windows on its final day, parents continued arriving – some for scheduled appointments, others simply hoping for guidance on next steps. One mother cradled her feverish toddler while explaining to the receptionist that she couldn’t get through to the Info-Santé 811 health line.
For now, families like Nadia Beaulieu’s are left piecing together alternatives – a combination of walk-in clinics, emergency rooms, and the perpetual hope that their names might eventually rise to the top of waiting lists for new family doctors.
“My daughter asked me where we’ll go when she gets sick now,” Beaulieu said, zipping her daughter’s coat as they prepared to leave the clinic one last time. “I honestly didn’t know what to tell her.”
