Quebec faces doctor shortage, Alberta overreaches

A recent survey from Abacus Data and the CMA offers a sober snapshot of how physicians are feeling about recent political changes. Almost half of physicians nationwide (43%) say they do not feel trusted or respected by their provincial government. In Alberta and Quebec — the two provinces now reshaping the rules of medical practice — that number spikes to 76% and 84%, respectively. Two-thirds expect quality of care in their province to get worse.

Quebec pushed through Bill 2 at the end of last month, giving itself the power to surveil and directly manage many aspects of physicians’ work. As of mid-November, nearly 400 doctors have applied to work in other provinces. This doesn’t count anyone who took the legislation as a sign to retire early.

The government has since promised not to enforce some of the bill’s surveillance provisions. A government promising not to use a power implicitly advertises that it now possesses it.

Quebec’s approach to the medical workforce mirrors a broader trend seen in other public sectors where state control expands to monitor professional activities. In those instances, the initial imposition of monitoring tools is often followed by a gradual normalization of surveillance, even if the initial scope is limited. The pattern suggests that once a government establishes the infrastructure to watch a profession, the temptation to expand that oversight grows.

Alberta’s three-pronged approach to medical reform

Alberta’s project is qualitatively different. It goes further.

Bill 11 lets physicians toggle between parallel public and private systems, despite clear evidence that Alberta’s for-profit surgical facilities are already pulling scarce anesthesiologists and surgical staff out of the public tier and increasing wait-times for multiple high-acuity surgeries.

Bill 13 accomplishes Premier Smith’s long-standing promise to restrict the power of regulatory colleges to discipline members. Except for the bill’s narrowly defined exceptions, clinicians could no longer be reprimanded for statements made outside working hours, including health claims professional regulators have previously treated as sanctionable misinformation.

Smith’s disputes with medical regulators predate her premiership. In 2021, she publicly raised money to fund what she described as a legal challenge against Alberta’s College of Physicians and Surgeons, seeking a court ruling on whether Alberta doctors could offer early, unproven COVID treatments without jeopardizing their professional standing.

The bill also bars colleges from imposing mandatory cultural-competence and bias-training requirements unless the government deems them essential to professional competence.

Finally, with Bill 9, the government has invoked the notwithstanding clause, and asserts final say over which medical services physicians may and may not provide.

Families shoulder the mounting costs of Canada’s failing care economy. The exodus of medical professionals from Quebec and Alberta exacerbates these financial pressures.