Alberta's Dual-Practice Experiment Raises National Alarm Bells
Alberta is moving toward a healthcare model that would let physicians split their time between the public system and private clinics — and the province's own doctors are urging the government to tread carefully.
The Alberta Medical Association (AMA) has formally called on Premier Danielle Smith's government to adopt a comprehensive set of protections as it drafts regulations for what's known as a "dual practice" model. The framework would allow physicians to see patients in both publicly funded hospitals and privately run clinics — a significant structural shift that critics worry could accelerate a two-tiered system across Canada.
What Is Dual Practice — and Why Does It Matter?
Under the current system, most Canadian physicians work predominantly within the public system. A dual practice model would formally permit doctors to divide their caseloads between public and private settings, potentially letting them charge patients directly for services in private clinics while also maintaining public caseloads.
Proponents argue it could reduce wait times and expand healthcare capacity. Opponents — including many within the medical community itself — warn it risks pulling doctors away from the public system, deepening shortages for patients who rely on OHIP-style coverage.
The AMA's stance is notably nuanced. The association isn't outright opposing the concept, but it's insisting the government get the rules right before flipping the switch.
Dozens of Safeguards Requested
The AMA is pushing for a robust regulatory framework that would include strict conflict-of-interest rules, transparent reporting requirements, and protections to ensure public patients aren't disadvantaged by a doctor's private practice commitments.
Among the association's priorities: clear limits on how much of a physician's time can be spent in private practice, safeguards to prevent queue-jumping or preferential access based on ability to pay, and accountability mechanisms that give regulators real teeth.
The association has stressed that any dual practice model must preserve the integrity of universally accessible healthcare — a foundational principle of Canadian medicare.
A National Conversation
What happens in Alberta rarely stays in Alberta when it comes to healthcare policy. Other provinces, including Ontario and British Columbia, are watching closely. Canada's publicly funded healthcare system is under significant strain — long emergency room wait times, family doctor shortages, and surgical backlogs have prompted provincial governments to explore private-sector solutions.
Healthcare advocates nationally have warned that without strong guardrails, a dual practice model could accelerate physician migration toward private practice, ultimately shrinking capacity in the public system.
Federal Health Minister Mark Holland has repeatedly signalled that Ottawa will scrutinize any provincial changes that appear to violate the Canada Health Act, which prohibits extra-billing for insured services.
What Comes Next
Alberta's government is expected to release draft regulations in the coming months. The AMA has indicated it will remain engaged in consultations, but is prepared to escalate its concerns publicly if the province moves forward without adequate protections.
The outcome could set a precedent — or a cautionary tale — for healthcare reform across the country.
Source: CBC News Calgary. Read the original story at CBC.ca.
