Thank you for all of your hard work to maintain a standard of excellence for physicians in Alberta!  I have read through the draft policy and am concerned about the term "effective referral" used in 1f. Part of the brilliance I have admired in our system is the ability for patient's to access types of care that perhaps not 100% of physicians are comfortable providing and/or referring for. This has led to physicians being able to practice according to their conscience, while all patients maintain access to the full suite of legal services available in Alberta. In conversations I have had over the years with physicians who do conscientiously object, they have always noted their willingness to provide information about where patients can access and self-refer for the things they seek. This seems to be the perfect balance of patients and physicians rights. In other provinces, where similar wording has been enacted, we have seen physicians close their practice or leave the province. At a time when, as you are certainly aware, there is a real crisis in family medicine fomenting, it would seem a real shame to give primary care physicians another reason to give up their practice or move out of general family practice into a more niche area. Medicine is hard work, and the demands feel like they have increased very significantly over the last few years. To increase that burden on physicians who are doing their best to serve those in their care seems a great shame - particularly at this moment. It is not an uncommon thing for patients and physicians to disagree about what the best course of action is - that is just the nature of humans in relationship. But medicine is the dance we do while working with patients from a place of deep mutual respect for often differing values to navigate these issues. Physicians who conscientiously object are very rarely barriers. And if they are barriers, they violate the policies already in existence. I do not think that this policy change will serve patients better, and it will not serve physicians better. At a time where patients are increasingly facing inappropriately long wait times and suboptimal care because of the impossibly heavy burdens physicians are being expected to bear, this policy feels out of step with the good work of the College. Remove the words "effective referral" and maintain the morale of Alberta physicians.