Les médecins québécois étudieront les économies dans les pratiques médicales

The Quebec government has signed agreements with two of the province's medical federations which aim to lower health care costs over the next 20 months without reducing insured services. The government hopes to save more than $60 million by measures such as reducing specialists' billings by 1%, instituting more efficient medical practices, and limiting complete medical examinations to one per patient per year.     

La potomanie: réévaluation des epreuves d'investigation et présentation inhabituelle avec hydronéphrose et méqavessie

Three cases of compulsive polydipsia previously diagnosed as diabetes insipidus are presented. Abnormally dilated bladder and pyelocalyceal systems were accompanying features, as previously described for diabetes insipidus, particularly of renal orign. Results of the hypertonic saline (Hickey-Hare) test were positive in only one case. Results of restriction of liquids followed by intravenous injection of vasopressin (Miller test) favoured a diagnosis of complete diabetes insipidus. These two tests cannot, therefore, exclude compulsive polydipsia. The features suggesting a diagnosis of compulsive water drinking are low plasma osmolality, a decrease in 24-hour urine output following water restriction, and abnormal behaviour. The diagnosis is confirmed by an 18-hour dehydration test done after gradual fluid restriction, which favours partial restoration of the papillary osmotic gradient.     

Les médecins du Québec: majoritairement pour l''avortement

Over 80% of Quebec's doctors recognize serious mental health dangers, the probability of fetal damage, or pregnancy due to rape as sufficient grounds for abortion. The most liberal 19% also accept pregnancy out of wedlock, or lack of economic support as a sufficient reason, but another 14% reject any basis for abortion, though among those some would accept a few criteria if the abortion were performed by another doctor. These results come from a random sample of the 12,000 doctors registered with the Quebec Medical Association. The high response rate of 45.4% gave ultimate representation to 10% of the medical population of Quebec. 90% of the doctors wanted a uniform set of criteria for hospital abortion committees, which now vary greatly. Protestant and Jewish hospitals being more liberal than Catholic ones. They also stressed sex education, access to contraceptives and services of birth regulation as necessary to stem overuse of abortions. The doctors were unsure of their legal position regarding abortion and tended to consider the law more restrictive than it is. Over 60% do want abortion removed from the Criminal Code. The number of referrals to hospital committees has increased between 1971-1975 though even in 1975 less than 132 doctors made more than half the demand. In 1975 doctors sent 30.1% of abortion demands to a committee, 20.7% to a clinic in the U.S., 14.8% to another doctor, 13.4% to a reference center, 10.4% to a Quebec clinic, 1.9% to a clinic elsewhere in Canada, and 8.7% of the cases were neither referred nor granted an abortion by the doctor. Most doctors agree that necessary action on the abortion issue includes discussions and conferences on the subject for medical personnel and the development of public awareness of the problem.