Dual practice

Overview

We have modernized physician practice rules to provide more flexibility, support innovation and improve access to care.

Dual practice allows eligible physicians to provide publicly funded surgeries in the public health system and privately paid surgeries in approved private settings.

What is changing

Dual practice gives you another way to access eligible surgeries while maintaining access to publicly funded care. Albertans can continue to receive care through the public health system, and may also choose to pay for eligible private surgeries if they do not want to wait.

This will help reduce pressure on the public system. When some patients choose private surgery, others can move up the public wait list and receive care sooner.

Dual practice also means Albertans and physicians can stay in Alberta. Patients who choose to pay for private surgery will not need to travel outside the province, and physicians who currently provide private care elsewhere can offer those services here.

This added flexibility can support physician recruitment and retention.

Physicians can still choose to practice entirely in the public health system or entirely in private settings.

Dual practice in other jurisdictions

We continue to look at innovative approaches and successful models in other jurisdictions to strengthen how surgical care is delivered. Several high-performing health care systems use dual practice, including:

• Denmark
• the Netherlands
• the United Kingdom
• France
• Germany
• Spain
• Sweden
• Australia

With dual practice now being implemented, Alberta joins other jurisdictions that use this model to expand patient choice and support access to care.

Safeguards for public care

Dual practice regulations were developed following careful consideration and consultation with stakeholders across the province. Strong safeguards are being put in place to protect access to the public health system. These safeguards include:

• Public system requirements: Physicians must complete a minimum number of hours in the public health system to be able to offer private surgeries.
• Family physician restrictions: Family physicians are not eligible for dual practice, except those with a subspecialty in anesthesia or surgical assistance.
• Life-threatening and emergency care excluded: Surgeries for life-threatening conditions, such as cancer and emergency or urgent procedures will remain entirely publicly funded.
• Integrated records: Private-service records must be uploaded to provincial health information systems to support follow-up care by other providers.
• Monitoring and reporting: Reporting requirements will allow the government to collect the information it needs on both public and private surgeries to help it monitor dual practice and protect Albertans’ access to the public health system.

Primary and Preventative Health Services and Hospital and Surgical Health Services will oversee the implementation of dual practice. Under their guidance, Acute Care Alberta will set minimum public surgery hour requirements, conduct regular reviews and report on system performance, with further adjustments made as needed to protect public system capacity. The exact hour requirements and processes will be determined in the coming months, based on level of interest and system need.

Eligible procedures and facilities

Dual practice physicians will enable surgeries in accredited chartered surgical facilities and hospitals. Hospital and Surgical Health Services and Acute Care Alberta are working to build a model that supports hospital-based dual practice to leverage underutilized operating rooms.

Eligible procedures will include those already approved by the College of Physicians & Surgeons of Alberta for these facilities. Eligible surgeries may include:

• orthopedic
• cataract
• gynecological
• ophthalmology
• select ear, nose and throat
• dermatology
• plastic surgery
• minimally invasive general surgery procedures

Surgeries for life-threatening conditions, including cancer and emergency or urgent procedures will remain entirely publicly funded.

Commitment to publicly funded care

We remain committed to a strong, publicly funded health care system and its public health guarantee.

Alberta’s dual practice model complies with the Canada Health Act, which allows provinces and territories to set conditions for private care offered by providers who are opted out of the public health insurance plan.

We will monitor dual practice closely and will make changes if needed to protect Albertans’ access to the public health system.

How to access a dual practice physician

Interested physicians can submit an expression of interest starting June 22. A formal application process will open later this summer.

Applications will be reviewed and approved on a rolling basis. Approved physicians are expected to begin dual practice this fall.