The Quebec government is considering implementing a fee for patients who miss their doctor’s appointments without canceling in advance.
The move aims to address the growing issue of no-shows in the province’s health sector.
However, some experts argue that the real problem isn’t patients—it’s the healthcare system itself.
Paul Brunet, president of the Quebec Council for Patients’ Rights, strongly opposed the idea of punishing people.
“[The government] needs to stop penalizing and picking on patients—they have no right to do that,” Brunet said. “The real issue isn’t with patients, it’s with the disorganized systems, and people are paying the price.”
According to the Collège des médecins du Québec (CMQ), more than 30,000 medical appointments go unattended each month.
While this number is significant, Brunet argued that patients are rarely at fault.
“Only about 20 per cent of no-shows are due to patients not showing up,” he explained.
“The other 80 per cent can be traced back to hospitals, doctors, and administrative issues—year after year, there are reports that prove this.”
Instead of introducing fines, Brunet believes the province should focus on improving organization within the healthcare network.
“There’s a lack of coordination between health providers,” he said. “We need better staffing and better organization.”
David Levine, a former healthcare administrator, echoed Brunet’s concerns. He pointed out that many industries have efficient appointment management systems—something he believes healthcare should adopt.
“If restaurants can handle reservations and cancellations, the healthcare system should be able to do it, too,” Levine said.
Beyond technology, Levine stressed the importance of raising public awareness about the impact of no-shows.
“If you want to increase civic responsibility, you have to make the population aware of how missing an appointment affects the system as a whole,” he said.
Last month, the CMQ announced a campaign to promote social responsibility, emphasizing the strain that missed appointments place on an already overwhelmed system.
The organization said that, currently, 1.4 million Quebecers do not have access to a family doctor, making every appointment slot crucial.
Beyond routine check-ups
The issue of no-shows impacts the entire healthcare system, according to Quebec’s Ministry of Health. In a statement to CTV News, it reported that nearly 650,000 medical appointments and over 10,000 surgeries were missed each year in the province.
“These numbers are of great concern to us,” reads the statement.
Health Minister Christian Dubé said that all possible measures to reduce no-shows remain on the table.
Levine believes that while improving the system is key, small fines could help prevent further strain on the system, including unnecessary emergency room visits for issues that could have been addressed in a doctor’s office.
“A no-show fee doesn’t have to be harsh,” Levine said. “You could start very small with five dollars, for example, and if the same person repeatedly misses appointments, the fine could increase.”
Brunet, however, made it clear that he was prepared to fight against any financial penalties.
“Before you start punishing people, clean up your own system,” he said.
“Hospitals and clinics are responsible for 80 per cent of these missed appointments. They need to take accountability before shifting the blame onto patients.”
