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Cortisone infiltration | Patients caught between two chairs



Showdown between radiologists and Quebec

At the beginning of March, as he does occasionally for his osteoarthritis problem, Gaétan Nadeau went to his clinic to receive a cortisone infiltration in his right knee. And the appointment for the left knee? It won’t be possible, he was told. “You were the last one who could have any. »

Like thousands of other Quebecers, Gaétan Nadeau, who is a semi-retired emergency doctor, is currently the victim of a showdown between radiologists and the Legault government.

A total of 172 radiologists from 44 clinics are under billing control by the Régie de l’assurance maladie du Québec (RAMQ), which is also lowering billing for any cortisone infiltration.

In response, many radiologists are now refusing treatment to their patients.

Marie-Hélène Émond, media relations officer for the Ministry of Health and Social Services, points out that “the government must ensure that health professionals bill in accordance with negotiated agreements”.

For this issue, the Federation of Medical Specialists directed us to the Association des radiologistes du Québec.

This dispute, according to the Association, stems from the fact that the auditor general demanded that the RAMQ be more accountable for medical compensation two years ago.

In a technical sheet that it sent to us, the Association of radiologists indicates that the RAMQ “claims significant and retroactive sums from 172 radiologists” going back to 2017.

The RAMQ now refuses that radiologists use the billing code “which had been used for 50 years”, explains the DD Magalie Dubé, President of the Association of Radiologists of Quebec.

Now, she says, clinics no longer receive any money “to pay for equipment, technologists, supplies, rent, etc.” “.

The stake is “several million a year”, says the DD Dubé, without quantifying it precisely.

“It is not with lightness of heart” that radiologists stop doing treatments, but “the clinics that do not suspend this service while we negotiate, they do it at a loss”, estimates the DD Dube.

According to RAMQ data, 48 radiologists earned over $1 million in 2020 (76 in 2019).

A highly requested service

The Association des radiologistes points out that cortisone infiltrations are a service “greatly needed by the population, particularly the geriatric clientele”.

She notes that “without this service, these patients must turn to the public network, which currently does not have the capacity to guarantee this service within reasonable timeframes”.

Across Quebec, 12,821 people are waiting for knee surgery, including 6,706 who have been waiting for more than six months. For the hip, 7,196 Quebecers are waiting for an intervention and 3,240 have been on the list for more than six months (according to data from the Ministry of Health and Social Services).

Many of them have so far sought a cortisone infiltration to reduce their pain while waiting for their operation.

Others, who do not yet need an operation, also did so to reduce chronic suffering.

Gaétan Nadeau is in the latter case.


Gaetan Nadeau

In addition to Advil and painkillers, the occasional infiltration of cortisone provides enormous relief and makes people functional, almost painless.

Gaetan Nadeau

After two years of “sedentary confinement” due to the pandemic, the infiltration of cortisone allows many Quebecers to continue to move, observes Mr. Nadeau. And if they do, “they’ll be less depressed, less obese, and in better cardiovascular health.”

Learn more

  • 70,000
    Number of cortisone injections performed annually by radiologists


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