Take your vacation or personal leave, keep your patients safe

Temporary leaves of absence by a physician may be planned (such as for vacation, parental leave, and educational leave), or unplanned (due to illness and family emergencies). Whatever the reason for the leave, the aim of planning it is to maintain continuity of care for patients who require ongoing treatment and follow-up. Of course, achieving this isn’t always easy, especially when alternative healthcare resources are scarce.

Many medical regulatory authorities (Colleges) have policies and guidelines on physician responsibilities and coverage during temporary absences. Physicians working on a contract basis at a clinic or hospital should also be familiar with their contractual obligations concerning leaves of absence.

While specific rules governing temporary absences differ among provincial or territorial Colleges, addressing the following questions will help give you and your patients peace of mind when you pause your practice:

• Have I made arrangements with a colleague to receive, review, triage, and act on incoming information (e.g. test results from labs and voicemail messages from patients, other healthcare providers, pharmacists, etc.)?
• Who will review and act on critical test results?
• If, after attempting to make coverage arrangements and no colleague is available, have I informed patients to access appropriate care through other providers (e.g. walk-in clinics, emergency department)?
• Have I communicated the coverage arrangements to patients who may reasonably expect to receive follow-up care during my absence?
• Have I updated my voicemail (and any other communication channels) with information about my absence, coverage details, and alternative contacts?
• Have I consulted my College’s policies and guidance on temporary absences and continuity of care?

The concept of “reasonableness” is important when planning coverage. According to the College of Physicians & Surgeons of Ontario’s Availability and Coverage Policy, what is reasonable will depend on such things as the length of the absence, individual patient needs, and availability of healthcare providers and system resources in the community. Meanwhile, the College of Physicians & Surgeons of Alberta’s Continuity of Care standard of practice requires physicians who will be unavailable to have an agreement with a healthcare provider or service to provide ongoing care during their absence, among other related requirements. It further advises physicians to create a contingency plan to help mitigate the risk of harm. Such a plan should consider access to patient records, clear messaging on office hours, and communications on alternative sources of care, and what patients should do in an emergency. The Collège des médecins du Québec offers guidance for physicians in Québec, which includes posting a notice on a publicly-accessible door during an absence.

More reading

• Your well-being matters: CMPA support available to members
• Limited healthcare resources: The difficult balancing act
• Closing or leaving a practice: Tips for physicians

DISCLAIMER: This content is for general informational purposes and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. These resources are offered in accordance with CMPA's Terms of Use. AI tools may be used in limited ways, but human subject matter experts always provide oversight and final approval for all CMPA content.