In a dramatic act of defiance, the leaders of all of Quebec's regional family medicine departments have declared they will not implement key components of the provincial government's controversial Bill 2. The move sets up a direct confrontation with Premier François Legault's administration over its sweeping health-care reform law.
Open Refusal of Core Mandates
The medical directors of Quebec's 18 Départements territoriaux de médecine de famille (DTMF) outlined their position in a strongly worded letter sent on Monday, December 2, 2025. Addressed directly to Premier Legault, Health Minister Christian Dubé, and top health officials, the letter states they will refuse to distribute 1.5 million so-called "orphan" patients to doctors and clinics they say are already stretched beyond capacity.
This patient assignment is a central pillar of the new law, which aims to ensure every Quebecer has access to a primary care provider. However, the directors argue the government's approach is fundamentally flawed. "Making a formal commitment to assign patients to teams that have neither the time, nor the staff, nor the required interdisciplinary access, would be misleading for the population and contrary to our professional responsibilities," they wrote.
Rejecting a "Surveillance" Role
Beyond patient assignment, the DTMF heads are pushing back against a new role imposed on them by Bill 2: monitoring and policing physician performance. The law tasks them with reporting on and potentially sanctioning doctors who do not meet government-set targets for patient loads and care objectives.
The directors categorically refuse this shift in their function. "We refuse that the DTMFs be instrumentalized as tools of surveillance and coercion toward doctors and their teams," the letter states. They emphasize that their legitimacy comes from clinical expertise and collaboration, not from enforcing sanctions. Consequently, they will not establish internal mechanisms to monitor or punish doctors for failing to meet rigid qualitative targets.
Calls for Suspension and Dialogue
The letter calls for the immediate suspension of major parts of Bill 2 to address what they describe as its "major flaws." The directors propose a three-point plan for remedy:
- Remove articles that cast DTMFs in a surveillance and control role.
- Amend patient redistribution timelines to reflect the real, on-the-ground capacity of medical teams, not theoretical projections.
- Build a governance model based on trust, transparency, and listening, rather than coercion.
The signatories, who also copied the Collège des médecins du Québec, express a willingness to engage in constructive dialogue with the government. This act of collective defiance comes despite steep sanctions outlined in Bill 2 for concerted opposition to the law.
A System Under Strain
This rebellion from within the health system's management structure underscores the deep crisis in Quebec primary care. The letter arrives as hundreds of doctors consider leaving the province and numerous clinics warn of imminent closure due to plummeting funding under the new model.
The medical community has repeatedly warned that Bill 2 is unworkable and could cause irreparable harm to primary care when it comes into force on January 1, 2026. The DTMF directors now stand with front-line doctors, stating they felt compelled to take a stand after physicians reached out to them pleading for help in conveying their concerns to the government.
The Gazette has sought comment from the Quebec government regarding this direct challenge to its health-care reform agenda. The coming weeks will test whether the government chooses to enforce its law against the very administrators tasked with implementing it, or opts for the negotiated solution the medical directors are proposing.
