Guideline: Physicians and Public Health Emergencies

Introduction

The ill have always turned to physicians in times of crisis.  Physicians have always provided care, often putting themselves at great risk in order to save their patients.Federal, provincial, and local responses to public health emergencies require extensive involvement of physicians.  This policy has been developed to reaffirm the profession’s commitment to the public in times of public health emergencies.

Definition

Public Health Emergency: A current or impending situation that constitutes a danger of major proportions with the potential to result in serious harm to the health of the public. They are usually caused by forces of nature, a disease or other health risk, an accident or an act whether intentional or otherwise. They are declared by government and public health authorities at the federal, provincial, and municipal levels.
 

Principles

  1. The practice of medicine is founded on the values of compassion, service, altruism and trustworthiness. These values form the basis of professionalism.

     

  2. Physicians have duties which reflect the profession’s values. Physicians have duties individually to their patients. As members of the medical profession, they have a duty collectively to the public. As well, physicians have duties to themselves and their colleagues.[1]
     

Providing Care

The College strongly encourages physicians to provide medical care during a public health emergency.  Medical care should be provided in accordance with any federal, provincial and local emergency plans.

There may be reasons related to the physicians’ own health, that of family members, or others close to them which may place limits on the physicians’ ability to provide direct medical care to people in need during a public health emergency. In those instances, the College strongly encourages physicians who have a personal health and/or ability limitation to engage in indirect activities that support the response effort during public health emergencies.

By providing care, or by supporting the response effort, physicians fulfill their individual commitments to patients, professional commitment to colleagues and collective commitment to the public.

Physicians should not be expected to shoulder the burden of providing care in a public health emergency without support from government and health care institutions/organizations. The responsibility of these entities is to minimize risks and burdens and to do whatever is possible to contain the public health emergency.
 

Practising Outside of Scope of Practice

In non-emergency situations, there are clear expectations around scope of practice.  A physician must practise only in areas of medicine in which the physician is educated and experienced.  Changes in a physician’s scope of practice must be done in accordance with the College’s bylaws.[2]

In a public health emergency, federal, provincial and local emergency plans may call upon physicians to practise in an area of medicine in which they are not educated and experienced.


A physician should only practise outside of their area of expertise during a public health emergency if:

  • the care needed is urgent;
  • a more skilled physician is not available; and,
  • ·not providing the care would lead to worse consequences than providing it.

Once the public health emergency is over, the physician should no longer practise in the new area.

In advance of a public health emergency, the College encourages physicians to take advantage of any training offered to them for the activities which they may be required to perform.  Physicians may also want to contact the Canadian Medical Protective Association for additional guidance.
 

Keeping Informed and Cooperating

Physicians are expected to keep informed of all pertinent federal, provincial and local emergency plans and public health communication systems, particularly regarding the role of physicians.

In order to provide the best possible care, physicians need to receive up-to-date and complete information both prior to and during a public health emergency.

Physicians should cooperate with any government and/or public health requirements and/or directives.

 

Acknowledgement

The College of Physicians and Surgeons of Saskatchewan has adapted this from a document prepared by the Ontario College of Physicians and Surgeons.  The Saskatchewan College gratefully acknowledges that work. 

 


[1] The Code of Ethics, part of College regulatory bylaw 7.1, addresses physicians’ responsibilities to colleagues and society at paragraphs 31 to 44.

[2] College Bylaw 4.1 requires a physician to meet certain conditions before changing their field of practice.

STATUS:

APPROVED

Approved by Council:

September 2009

Confirmed by Council:

January 2012

Confirmed by Council:

January 2017

Amended:

September 2022

To be reviewed:

September 2027