Supervision of Restricted Activities

Dina Baras Are You Up to Standard?, CPSA, Messenger

Physicians are responsible for restricted activities performed by those they supervise.

As the physician with overall responsibility for care and management of your patient, you are responsible for restricted activities performed under your supervision. [i] You must be satisfied that the person performing those activities has the skill to perform them competently. You must also be authorized to perform the activity yourself. See the Standard of Practice on Supervision of Restricted Activities.

What are restricted activities?

Many activities are considered “restricted” when performed as part of providing a health service. Review the full list in Section 2 of Schedule 7.1 of the Government Organization Act. If you oversee any of these activities, you must be readily available for consultation.

Level of supervision – use your judgment

Base your level of supervision on the activity being performed, the risk to the patient and the supervisee’s experience. Depending on those factors, being “readily available” can mean you are:

  • Personally present at the patient’s bedside,
  • In the facility but not at the bedside or
  • Off-site but available to attend in a timely manner if needed

Supervising other healthcare professionals

Only supervise another healthcare professional performing a restricted activity if they have their regulator’s approval to perform the activity. Do not supervise them if they are eligible for a practice permit with their own regulator, but have not applied or have been denied (see section 46 of the Health Professions Act).

Supervising unregulated healthcare providers

You may supervise an unregulated healthcare provider only if:

  • You have given them a direct order to perform the activity,
  • The activity is performed according to an established protocol and
  • There is minimal additional risk to the patient

Questions or comments? Email

[i] From CMPA’s “The most responsible physician: A key link in the coordination of care,” published December 2012.