Scarcity of resources and delays in care

Updated: May 2023

There is no perfect solution to address resource dilemmas, but you can take steps to reduce patient harm and minimize medico-legal risk.

Article

• Scarce resources: Caring for patients during COVID-19 (4 min)
• Deferred care during the pandemic (6 min)

Podcast

• COVID-19: Reasonable care (15 min)

FAQ

• Due to the significant shortage of health care workers and overcapacity in some hospital departments, I have been asked to provide care outside my usual scope (e.g. non-physician or physician duties). What are the medico-legal risks and will the CMPA assist me if I perform duties outside my usual scope?

Due to the significant shortage of health care workers and overcapacity in some hospital departments, I have been asked to provide care outside my usual scope (e.g. non-physician or physician duties). What are the medico-legal risks and will the CMPA assist me if I perform duties outside my usual scope?

The CMPA recognizes the immense strain on the health care system due to the pandemic and surges in other infectious diseases. Physicians are being called upon to take on new roles to support their colleagues and the larger system due to the lasting effects of the health emergency. It is challenging to predict all the types of medico-legal difficulty that physicians may face arising from the provision of care in these circumstances. Physicians asked to perform duties outside their usual scope – whether medical duties or non-physician duties – will want to ensure they have the necessary skills to perform the requested duties or obtain the appropriate support or training to do so. Physicians who do not feel they are sufficiently qualified or competent to perform the requested duties can try to seek guidance from another health professional who is competent and/or has the requisite information to perform these duties or even redirect care where that is possible. Role clarity is also important where physicians are performing non-physician duties. It is expected that hospitals and health authorities will provide guidance for the health care team to delineate the expectations for performing non-physician duties or those outside a physician’s usual scope of practice, and how this will work operationally.

The Colleges generally recognize that in exceptional circumstances, such as a public health emergency, it may be necessary for physicians to temporarily practise outside their scope of practice. It will therefore be important for physicians to carefully document the circumstances that led to providing care outside their scope of practice or performing non-physician duties. Keeping such records will be helpful to demonstrate the clinical judgment exercised in the circumstances of scarce resources, should there be any medico-legal difficulties that arise at a later time.

Members who are called upon during the pandemic to provide care not typically falling within their normal scope of practice or the usual scope of practice of medicine remain eligible for CMPA assistance. Members who have specific questions about their eligibility for assistance are encouraged to discuss their concerns with the CMPA before providing care.