Alberta physicians get new rules for leaving practice, job actions

Requirement to `stagger' resignations with colleagues is officially off the table

As of Jan. 1, Alberta doctors have a new set of rules to follow if they want to leave their practice or take job action.

The new policies, approved in December by the College of Physicians and Surgeons of Alberta, do not include a requirement that doctors stagger resignations, something that was a part of the original consultation document.

College spokeswoman Jessica Mcphee said the requirement to stagger was not included in the final policy because the college didn't want to limit doctors' mobility.

“Physicians are still definitely required to notify if they leave, but there are some situations where staggering might not be possible, and in those circumstances we don't want to limit a physician's freedom of mobility,” she said.

A total of 395 physicians commented on the proposals between Sept. 15 and Oct. 15, Mcphee said.

That's the second-highest engagement the college has ever seen, surpassed only by the consultation for the standards of practice for medical assistance in dying, she said.

Mcphee said the college had already begun looking at updating its policies when Health Minister Tyler Shandro directed it in June to change its standards of practice to prevent physicians from leaving communities en masse.

The new rules clarify that a replacement does not have to be in place before a physician leaves but say that doctors must take “reasonable steps” to place patients under their care with another health-care provider.

Concerns over doctors leaving came up repeatedly in 2020 as Shandro and Alberta doctors were in conflict over his decision to rip up the province's contract with doctors in February and roll out a new funding framework.

Some of the billing changes were scrapped before they were to take effect March 31, while others have been postponed until the end of the pandemic. But some doctors have either left or said they plan to leave the province as a result of the changes.

The new standards of practice also offer a more detailed explanation of what it means for a doctor to take “job action.”

“A regulated member's decision to close or leave a medical practice or to change their pattern of practice based on personal or financial considerations does not constitute job action unless these actions

It's a difficult issue ... it is trying to strike a balance between the protection of patients and the rights of physicians.

are intended to compromise access to physician services to further a negotiating position,” the updated rules say, adding that doctors can still advocate for their patients' interests, their own interests or the interests of the healthcare system as a whole.

Job action is not forbidden but can only be done in “extremely controlled circumstances” as a last resort where a doctor has made certain all their responsibilities are met and patients are not at risk.

It remains to be seen exactly how these new rules will be interpreted. Mcphee said a complaint would have to be filed with the CPSA before officials would look into specific circumstances. Right now there isn't any precedence for what the consequences of taking an illegal “job action” might be, she said.

Dr. Paul Boucher, president of the Alberta Medical Association, said it will be up to those investigating a complaint to interpret a doctor's intent but that he thinks the college did a nice job of distinguishing between closing or changing a practice and job action. “It's a difficult issue for them, which I can completely appreciate because it's not black and white, and it is trying to strike a balance between the protection of patients and the rights of physicians,” he said.