Provision of Care by Physicians after Hours or During Short-Term Absences

Guidelines on the Provision of Care by Physicians after Hours or During Short-Term Absences

Preamble

Physicians have an obligation to assist or direct patients to care when their offices are closed or when they are unavailable.  This obligation is ordinarily met by participating in on-call coverage, and/or providing information to patients on where care is available in their absence.  The College therefore encourages its members to be familiar with and to observe the following guidelines.

Guidelines

These guidelines apply to all physicians when accepting new patients at any point during their practice.

1. Physicians are strongly encouraged to participate in an after-hours call or coverage schedule, allowing for the provision of urgent care to their patients. This may be achieved by participating in a call group where possible.
2. Physicians are expected to make arrangements with their call group to deal with specific issues such as:
   1. Impending medical problems among patients.
   2. Impending test results.
   3. Unexpected calls from the laboratory or from homecare.
   4. Special needs, such as those involving patients who wish to die at home.
3. Physicians are expected to establish mechanisms to assure that patients are made aware of who to contact for help when the office is closed (either after hours or for other reasons). This may include a recorded phone message directing patients to an alternate physician or call group.
4. When physicians are unable to participate in after-hours coverage, or where after-hours coverage is provided for less than 24 hours per day, it is recognized they may have no option but to direct their patients to a local hospital, emergency department, walk-in clinic, or another local service such as a Collaborative Emergency Care Centre (CEC).
5. Notification of call coverage to DHAs and/or emergency departments or CECs may take the form of a call schedule that is submitted in advance. It is recommended that specific notice of absence be provided in exceptional situations such as illness or vacation.
6. If possible, physicians should make efforts to provide assistance with after-hours workload in that institution/District.