Doctor group warns B.C.’s regulatory changes could lead to fewer physicians, longer wait times

Changes to regulatory oversight for health-care professionals that come into effect Wednesday could cause doctors to retire early or leave the province, a group representing medical professionals has warned.

The new regulations, part of the Health Professions and Occupations Act passed in 2022, will create a new independent oversight office and discipline tribunal for health professionals accused of wrongdoing, overseen by officials appointed by the province.

It’s a change that will impact a wide range of previously self-regulated professions, including doctors, dentists, pharmacists and psychologists.

The legislation came as a result of a 2018 review that found health professional colleges in B.C. showed “a lack of relentless focus on the safety of patients,” and recommended revising the regulatory process to increase its independence and accountability. 

It’s sparked backlash from some groups and officials representing health-care workers.

Doctors of B.C. president and family physician Adam Thompson said doctors have expressed wide-ranging fears about the legislation, including that decisions can no longer be appealed to the B.C. Supreme Court and that health-care regulations could be politicized by future governments due to the number of government appointees.

There are aspects of the regulations that he supports – including stronger consequences for discrimination – but he worries how provincial appointees could change the regulatory process.

He said he’s heard from late-career doctors who are weighing this in their decision to potentially retire early, and worries it could lead others to leave the province.

“The risk to patients is that it’s going to become harder to get a family doctor, or the waitlist with specialists is going to get longer, or the access to specialty care is going to become worse,” Thompson said.

When asked about the potential for the regulations to cause health-care workers to retire early or leave the province – as Quebec saw in the wake of changes to its health-care system – B.C. Health Minister Josie Osborne said the changes were in the best interest of the public and health-care professionals.

She says added oversight and accountability will improve the current systems.

“I recognize that this new act is a major overhaul of the regulatory system. It is the first in 30 years,” she said.

“For people in B.C., this means stronger protections, clearer processes, and greater confidence in the care that they receive.”

As for health-care professionals, Osborne said the changes would mean clearer expectations and support.

In accordance with the changes starting on April 1, the 15 professional colleges in B.C. will be reduced to six, and college board members will no longer be elected, but appointed by the ministry. 

Previously, most board members were required to be licensed professionals from the fields being regulated. Now half of board members will be licensed professionals, with the rest being members of the public.

A 2018 independent review, along with a 2003 ombudsperson report, expressed concern that elected board members could feel a responsibility to protect the interest of the colleges’ members, instead of the public.

All disciplinary decisions and agreements concerning health professionals will be posted publicly. They can no longer be appealed to the B.C. Supreme Court, only contested in internal reassessments or a judicial review.

Other changes in the legislation include that discrimination will now be treated as a form of professional misconduct, and all colleges will have to implement anti-discrimination measures.

Eric Kuelker, a Kelowna-based psychologist, says the challenge of having these professional groups no longer govern themselves is that disciplinary decisions could be made by people with no expertise in the field.

“There wasn’t a single psychologist put on the board of governors for the new regulatory body,” he said.

B.C. Conservative health critic Anna Kindy is concerned about the potential for political interference due to ending the practice of electing representatives to college boards.

“Every position, including the superintendent and the director of discipline, is appointed by government,” she said.

“It’s basically government overreach.”

Alix Lavertu, executive director of the B.C. Chiropractic Association, said there’s been confusion among chiropractors about what’s expected of them under the act, and any other changes.

“There are members and health providers in the province that do have some concerns,” she said. 

“I think it’s primarily because not enough information is out there for them to fully understand the impacts of this act.”

For example, she says health-care workers are required to be proactive in knowing how to be culturally sensitive and safe in their approach to patient care. However, Lavertu says there isn’t enough clarity from the province yet to ensure people are fully prepared and equipped to do that.

Osborne says the Office of the Superintendent of Professional Governance will publish more information about the changes to its website by the end of day Tuesday, and encouraged anyone with further questions to reach out to their colleges for clarity.