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Nearly a year and a half after Quebec banned medical accessory fees in the public system, the number of doctors opting out of medicare continues to rise, the latest provincial statistics show.

The cumulative total number of doctors who no longer practise in the public system — and who have the legal right to bill patients directly for medical services — stood at 413 in April, up from 377 during the same month last year. That’s an increase of 9.5 per cent — and a dramatic 159 per cent since 2008, according to a review of data compiled by the Régie de l’assurance-maladie du Québec (RAMQ), which administers medicare.

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Experts suggest that the ban on accessory fees — which was a source of additional income for doctors — might have had the unintended consequence of pushing some physicians toward going fully private. When doctors become “non-participants” of the public system, they can bill patients for any medical service.