Rajesh Sood

Regarding Section 1b, does the College seriously expect a doctor to be available 24/7 to address any possible patient concern that could arise ? Does the CPSA therefore expect primary care clinics to be open 24 /7 and for doctors to never have any time away from work because they have treated a patient at some point ? We have services such as 811 and hospitals that already provide 24/7 triage and appropriate care. Patients are freely able to access virtual care providers such as Babylon or see other doctors without permission from their regular doctors. Why should a doctor be expected to enter into a formal agreement with Hospitals and 811 when these services are freely available to all Albertans ? The presence of Netcare allows doctors to obtain a significant amount of information about most patients they are likely to encounter. Is it realistic or even necessary to expect their primary doctor to be available 24/7 to provide information from medical records ? Surely there has to be a place in the standard for common sense ? If a patient falls at 2 am on a Sunday morning, does the CPSA seriously expect the patient to be able to phone any doctor that they have ever seen (Gp or specialist) to ask whether they need to go to hospital for an Xray to exclude a broken leg ? With respect to section 2, patients are often looked after buy multiple doctors who may order tests. Some specialist tests and their interpretations are beyond the scope of General Practitioners. Surely the responsibility for following up tests should lie with the ordering physician unless another doctor has accepted this responsibility formally. Again common sense needs to apply. The radiologist who does a Biopsy on request from a GP should not be expected to follow up the result and manage the patient even though their name will be on the requisition as the ordering physician. The standard does not clearly define what constitutes a physician patient relationship (i.e. one visit per year or once every three months?) as their is no end to expectations and entitlement. What happens if a patient has seen multiple doctors at your clinic because you were unavailable at times in the past ? Technically, according to the proposed standard the patient could expect that every doctor that they have seen should be available 24/7 to them. While I can accept that a doctor managing an acute problem should hand over to colleagues during a period of absence if possible (but if not possible, the patient should also assume some responsibility for seeking care if the need arises). However, it is unreasonable to expect a doctor to "place" every patient with another physician prior to their absence incase a healthcare need arises. It is also unrealistic to expect a doctor to document in every patient chart that they will be away for "x days" and Dr Y is available to cover or that tonight doctor P is in ER and will deal with urgent results. The standard does not define what constitutes an extended absence ? If I go overseas on holiday for a month can I just leave my patients "in the lurch", but for six weeks I need to find cover ? It seems unreasonable to place the sole burden for patients healthcare needs exclusively on a doctor. The reality is that most patients manage to find an alternative healthcare provider when their doctor is unavailable.

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