We encourage physicians, medical students and residents with health conditions to seek medical attention early in order to minimize the impact on their practice.
Physicians deserve the same high level of care and compassion that they provide to their patients. The impact of a physician’s health condition is evaluated in the context of each physician’s individual practice.
We may require additional information from your health providers to ensure that you are managing your health condition and able to provide care safely to your patients. We will seek consent from you to request this information if this is required.
In some circumstances, we may require ongoing monitoring of a health condition to ensure you remain healthy and are able to carry out your duties.
Our aim is to ensure that you have the support you require in order to balance your health needs with your clinical responsibilities.
Physician Health Scenarios
Colleague with Possible Cognitive Impairment
You have become increasingly concerned about your older colleague who you have recently noted to be more forgetful, less organized, and not following up with critical test results. This has also been noticed by other office staff who have brought this to your attention. This has been a noticeable change and you would like to know how to approach this.
You contact the Assistant Registrar of the Physician Health Monitoring Program non-nominally to seek advice. Upon review of the circumstances, it was determined this should be reported to the Physician Health Monitoring Program, and you spoke with your colleague and your colleague made the decision to self report.
What does this mean for your colleague?
- Your colleague would be asked to meet with the Assistant Registrar of the Physician Health Monitoring Program. Information would be gathered about your colleague’s health condition and on their scope of practice and work setting.
- With consent, we would request information from your colleague’s treating health professionals and possibly other colleagues.
- Your colleague may be required to have independent neuropsychological testing to determine fitness to practice and practice recommendations.
- Possible outcomes of this scenario depend on the reports received from the treating physician and/or an independent assessment and consideration of the context of the physician’s practice situation.
Related Standards of Practice:
Concern about a Colleague’s Potential Alcohol Abuse
You are a resident physician on call and your fellow resident appears to be impaired and you noticed the smell of alcohol. What should you do? You are aware of several situations where the resident has not been available while on call and is frequently late for rounds.
After taking steps to ensure patients were safe, you spoke with your program director about your concerns. The program director met with the resident who admitted they were struggling with alcohol use issues.There was also noted to be a decline in the resident’s performance over the past six months. The program director contacted the Assistant Registrar of the Physician Health Monitoring Program and also contacted the Alberta Medical Association Physician and Family Support Program (PFSP).
How does the CPSA address substance use issues?
- The Assistant Registrar would speak or meet with the resident on a priority basis.
- The resident would be encouraged to contact PFSP for support and potential treatment options. (Case Coordination through the PFSP is frequently involved in assisting physicians, residents and medical students with coordination of their treatment and support services).
- When the resident completes treatment, the treatment program makes recommendations for ongoing support and monitoring to ensure that the physician remains healthy and fit to practice.
- The resident would meet with the Assistant Registrar to review their work situation and recommendations from the treatment program.
- Ongoing monitoring is required to ensure that the resident remains healthy and is able to carry out their clinical duties.
Diagnosed with Bipolar Disorder
You have reported on your application for registration that you have been diagnosed with a bipolar disorder and you are under the care of a psychiatrist.
Following this report, what process will be followed at the College.
- The Assistant Registrar would arrange to speak with you by phone or in person to obtain further information about your medical condition and practice context.
- We would obtain your consent to gather information from your treating health professionals.
- We would seek advice from your treating physicians on any recommendations or modifications to practice.
- In some circumstances, we may require ongoing monitoring of a health condition to ensure you remain healthy and are able to carry out your duties.
Diagnosed with a blood borne infection
You are a physician who does exposure-prone procedures and you were recently diagnosed with a blood borne infection.
What does this mean and what should you do?
- Firstly, you are required to report your health condition to the Assistant Registrar of the Physician Health Monitoring Department.
- The Assistant Registrar would arrange to speak with you by phone to obtain further information about your medical status and scope of practice.
- Because you perform exposure-prone procedures, we may obtain your agreement to avoid all exposure-prone procedures until information is obtained from your treating physicians.
- We will request your consent to obtain additional information from your treating physicians, including viral loads, as well as a complete list of procedures that you perform in your practice and information regarding your work environment.
- Your anonymized information would then be sent to the Alberta Expert Review Panel for review and recommendations.
- The Alberta Expert Review Panel for Blood Borne Infections in Healthcare Workers reviews cases involving healthcare workers who have blood borne viral infections and provides them with advice and guidance.
Related Standards of Practice:
- Self Reporting to the College
- Duty to Report a Colleague
- Duty to Report: Physicians treating Physicians as Patients
Advice To The Profession:
Physicians are affected by the very same conditions as the general population and are entitled to the same high level of care and compassion as their patients.
Frequently Asked Questions
You can contact the Assistant Registrar with the Physician Health Monitoring Program in a confidential and non-nominal way. We often get phone calls where the caller does not give any identification, but requires information about their health condition or possible impact on their practice.
If you have a health condition that may impact the safety of your patients, you are required to self-report.
If you have concerns about a colleague who may have a health condition that could interfere with the safety of their patients, you can contact the Assistant Registrar with the Physician Health Monitoring Program in a confidential and non-nominal way.
A physician must report another physician to the College when the first physician believes, on reasonable grounds, that the conduct of the other physician places patients at risk or is considered unprofessional conduct under the Health Professions Act.
If you’re treating a physician who has a health condition that may impact the safety of their patients, you have a duty to report to the College.
The Assistant Registrar will contact you to discuss the next steps. We may refer you to the AMA Physician Family Support Program and suggest you obtain legal council.
Approximately 90 % of physicians involved the Physician Health Monitoring Program are currently practice.
We may request that a physician temporarily withdraw from practice until their health is stable and we have assurance from their treating physicians that the physician is fit to practice.
On rare occasions it may be necessary to refer the matter to the Complaints Director for consideration of the use of provisions in Section 118 of the Health Professions Act, if the physician will not voluntarily withdraw and there is reason to believe that there is a lack of capacity to care safely for patients.
Yes, if the physician’s assessment determines he or she can practise safely while receiving treatment.
There may be limitations placed on the practice of the physicians to ensure they remain healthy. If these limitations solely relate to the health of the physician they are kept confidential, but if they are solely related to practice, they can be included on the physician’s practice permit. These conditions could include such things as: limitations to night call, restriction on the type and number of patients seen, or restrictions of the practice type or location.
Most physicians can return to work with appropriate supports in place. The Physician Health Monitoring Program may enter into a treatment agreement with the physician to ensure that the physician remains healthy and able to carry out their clinical duties.