Alberta doctors often fail to provide after-hours care, college says
Alberta's college of physician and surgeons plans to crack down on family doctors who don't see patients after hours.
Only one-third of the province’s doctors currently arrange for or provide after-hours care for their patients, according to a survey done by the College of Physicians & Surgeons of Alberta, a problem the registrar says may be worsening already overcrowded conditions in emergency rooms.
Based on a random telephone survey of 117 doctors, conducted over the Christmas holidays, the college found that most doctors were not complying with a long-standing directive that they provide their patients with care outside of office hours, or arrange for that care.
"They [doctors] see it as a burden,” said college registrar Dr. Trevor Theman. “And it is, undoubtedly. But there are ways to manage that."
“Patients have problems that happen after five o’clock. And the physician who has cared for the patient is the person in the best position to understand what the issue might be, and to provide advice.”
Theman said good medical practice means being available after hours to patients, to other doctors or to pass on critical test results.
The college's governing body, made up of members of the public and practising doctors, has recommended that a new rule be drafted to clarify the expectations for after-hours care.
“Our council, 11 of whom are practising physicians, have said this is what we think members can do," he said. "They can do it, so they think members should be able to do this as well.”
Theman said he sees a generational gap among physicians; when he was in practice, doctors commonly found ways to care for their patients after hours.
The college has been seeking feedback from members since January about a draft standard of practice called Continuity of Access to Care.
The draft outlines responsibilities physicians have in caring for their patients.
According to the draft, physicians must have systems in place to:
- “personally provide or arrange for continuous after-hours care to be provided through an appropriate health-care provider(s)
- “ensure handover of relevant patient information to the after-hours health care provider(s) or service when a patient’s need for after-hours care is reasonably foreseeable; and, inform patients how to access the after-hours care.”
"Every time we raise the issue, we get feedback that is mixed,” Theman said.
Theman said after-hours care could be as simple as a group of physicians banding together, formally or informally, to make sure someone is always available by telephone.
The issue will be discussed when the college's governing body meets on May 28-29.
