All family physicians practising under Quebec’s public health insurance plan are subject to the commitment to devote part of their practice to specific medical activities (AMPs).

The number of hours of AMPs for which physicians have to sign on depends on their number of years of practice. In some cases, the number of hours is established on the basis of yearly pay if the doctor’s hours are very low.

The list of activities eligible for AMPs is set out in the AMP Special Arrangement (Entente particulière AMP), while the list of AMPs available in a given region is determined by the DRMGs. This list can change over time. To obtain a copy, you must get in touch with the DRMG of the region where you hold your PREM compliance notice.

Physicians with less than 15 years’ practice have to commit to 12 hours of AMPs per week, or the equivalent. In the event of non-compliance with the AMP Special Arrangement, the physician is subject to a 30% cutback on all his billings to the Quebec Health Insurance Board (RAMQ).

The DRMG of the region where you hold your PREM compliance notice is responsible for your AMP file. To sign up or to modify your commitment, or in the event of illness or pregnancy, you also have to contact the head of the DRMG of your main practice region.

Modifying AMPs

At the end of the 2-year commitment period, a physician may modify his AMPs. He will then have to choose new AMPs from among the list of AMPs available at the time of the change. Unless the activities requested do not appear on the list of AMPs available in the region, any request for modification should be approved by the DRMG.

In the course of the commitment, it is also possible for a doctor to request a modification in his AMPs. The physician must first discuss it and reach an agreement with his DRMG. In principle, unless the DRMG is able to justify its decision, it will try to accommodate the doctor while taking the priority needs of its region’s population into account.