Peer review and complaints

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What can you expect?

Under the Health Professions Act, CPSA has an obligation to respond to all complaint submissions. If you are the subject of a complaint, you will be asked by our Professional Conduct team to provide a response in writing, along with applicable medical documentation. If early resolution is not an option based on the information gathered, the next steps may include a review by a peer expert.

CPSA’S Expert Peer Review program was established in 2023 as an impartial way to carry out our obligations of fairness and transparency in the resolution of complaints—an important part of self-regulation.

Many complaints submitted to CPSA contain concerns about quality of care. When such a complaint is made, a medical expert can objectively review the care provided and give CPSA an informed perspective from which to move forward. This ensures physicians are being held to a consistent standard of care by their peers, which supports the delivery of high-quality care for patients.

The expert peer reviewer’s role

A peer in the same specialty of practice as the physician for whom we’ve received a complaint will review the complaint submission, the response and the corresponding records. Drawing from their own expertise and experience, the peer physician determines whether the care and treatment provided met the standard for a physician in their specialty.

The expert peer reviewer provides a report to CPSA, with analysis of the facts in relation to CPSA’s Standards of Practice and the Canadian Medical Association’s Code of Ethics and Professionalism.

An expert peer review is most suitable for complaints that are about diagnosis, treatment, prescribing and physical examinations. An expert peer reviewer does not:

• Contact the parties of the complaint.
• Provide opinions on subjective matters.
• Review unrelated medical records that are not within the scope of the care provided.
• Advocate for either the physician or the complainant.

A peer review is essential to supporting the mission and integrity of CPSA’s complaints process. Decisions with an objective opinion based on professional expertise are credible and fair to all parties involved.

What’s next?

Once the Complaints Director has reviewed the expert’s report and made a decision on how to proceed, the physician is notified of next steps. On average, 50-70 per cent of complaints directed to an expert peer review under Section 55 of the HPA are dismissed, with the rest going through resolution and adopting a learning approach. Very few quality-of-care complaints are referred to a hearing as they often present an opportunity for learning and competency building, which improves the care provided by the physician to future patients.

As a complaint moves through our process, your assistance is greatly appreciated and lends to an efficient and timely resolution. You and your Canadian Medical Protective Association (CMPA) legal counsel will receive regular status updates throughout.

We understand complaints can be difficult, but holding each other accountable and ensuring all patients in Alberta receive high-quality care is a responsibility we all share. If you have received a complaint and need support, there are resources available through the Alberta Medical Association’s Physician and Family Support Program.

To find out more about CPSA’s complaints process, visit our website.