Montreal’s Tiny Tots Clinic to Close Due to Doctor Salary Reform

The Tiny Tots pediatric clinic in Montreal has announced its impending closure, attributing the decision partly to the controversial doctor salary reform implemented by the Quebec government. The clinic, located inside Decarie Square, will begin phasing out operations in early January 2026. A notice on the door reassures patients that the clinic is exploring relocation options to maintain continuity of care for its more than 20,000 patients.

The clinic is part of the ELNA Médical Group, which operates one of the largest networks of medical clinics in Quebec. Oren Sebag, a city councillor in Côte Saint-Luc and manager of the ELNA clinics, revealed that the medical group has been grappling with financial difficulties over the past year. An ongoing “exodus” of doctors has compounded these challenges. Following a period of creditor protection, the company was sold to a group of investors last summer. Currently, the clinic operates with a reduced staff of approximately nine to ten doctors.

Recent changes to physician remuneration, particularly through a law known as Bill 2, have intensified the clinic’s struggles. Sebag stated that the legislation was “the nail in the coffin” for the clinic. Passed in October 2023 under closure to expedite its implementation, Bill 2 links 10 percent of a doctor’s salary to specific performance indicators established by the province. Failure to meet these objectives, which include seeing a greater number of patients, may result in salary reductions. The law also imposes severe penalties on physicians who resist the new regulations through collective actions.

The impact of Bill 2 extends beyond Tiny Tots. Other clinics have already closed or indicated they might shut down due to the financial pressures stemming from the law. For instance, Dr. Rachel Tessier, co-owner of the Centre médical pour enfants Lasalle, informed her patients in late November that her clinic would cease operations in the spring, citing Bill 2 as the primary reason. Similarly, GMF Hudson Medicentre, located west of Montreal, announced its closure effective April 1, 2026.

Physicians have raised concerns about the law, particularly regarding provisions that allow inspectors to access sensitive patient files to ensure compliance. The Quebec government is currently in negotiations with the leaders of the two main federations representing family physicians and medical specialists as it seeks to address the controversy surrounding the law before it takes effect in the new year. Both federations have voiced that the law is unsustainable, putting additional pressure on the government led by François Legault to reach a consensus quickly. The last sitting day of the Quebec legislature before the holiday break is scheduled for Friday.