Temporary leave for physicians

1. Evaluate the situation 

• Determine your leave duration and your intended involvement level during the absence
• Review your business, financial and regulatory obligations, e.g., after-hours scheduling, cost sharing/operational expense agreements 
• Health-related leave: Consult your health-care provider about your work options. Consider having a contingency plan in case your return is delayed due to ongoing illness

2. Review your financial situation

• Establish a financial plan to ensure peace of mind during your leave
• You may qualify for employment insurance, parental leave benefits or insurance payments (e.g., professional liability, critical illness, disability) depending on your circumstances
• Consult your financial advisor for tailored guidance

3. Leave plan

• Share your intentions, leave duration, and absence plan with your group or employer and staff

4. Patient care during leave 

The College of Physicians and Surgeons of Ontario requires physicians to maintain continuity of care during temporary absences, including vacations, parental leave, or unplanned events like illness. You must: 

• Arrange specific coverage arrangements with another healthcare provider(s) to manage patient care and all outstanding test results and consultation reports are received, reviewed, and acted upon if immediate intervention is required
• Have a plan or coverage arrangement that allows other health-care providers to communicate or request information pertaining to patients under their care during temporary absences from practice
• Make reasonable efforts to arrange for another health-care provider(s) to provide care to patients during planned temporary absences from practice
• Communicate coverage arrangements to patients
  • If specific arrangements are made, physicians must inform patients of these arrangements
  • If after reasonable efforts are made it is not possible to make specific arrangements, physicians must inform patients seeking care during the temporary absence about appropriate alternative access points of care (e.g., Telehealth, local walk-in clinics, emergency department, etc.). 

IMPORTANT: Review CPSO’s Availability and Coverage Guideline to understand your professional obligations.  

5. Prepare your clinic  

Office management 

• Ensure your points of communication with patients, such as phone or secure messaging, provide information relating to temporary coverage arrangements and points of care (e.g. telehealth walk-in clinics, emergency department, coverage arrangements that have been made, etc.)
• Delegate responsibilities to your employees to oversee daily operations and handle patient inquiries during your absence, including directing patients to alternative access points of care.  Clearly communicate expectations and ensure they have the necessary tools and training
• Empower your staff to address any potential unexpected event that may arise and specify your availability and the parameters, to minimize unnecessary contact during your leave

Staff 

• It is imperative to discuss any changes to your employees’ role or employment status (e.g. reduced hours, temporary lay-off) with your legal counsel to ensure it abides by Ontario’s Employment Standards Act and any contractual obligations you may have under their employment contracts
• Generally, it is not possible to temporarily lay off employees without specific contractual language within a valid employment contract. Similarly, employment contracts must specifically permit reducing hours or altering working conditions, or there is a risk of constructive dismissal. While employers can require employees to take vacation at specific times, such as during office closures, these must be established in advance to ensure that the employee receives proper notice and vacation pay

EMRs and connected services 

If you have found coverage, ensure the new physician has access to the necessary tools. If you are unable to find coverage, ensure patient results are monitored/stopped in the EMR (e.g. notify sending facilities). 

Depending on your involvement level, you may want to set up remote access to certain tools.

6. Notification 

Depending on the length and type of your leave, you will need to notify the following:

• Laboratory and healthcare facilities, with pending patient results
• The hospital, if you have hospital privileges
• Your professional associations, such as OMA, CPSO, CMPA, OHIP, CFPC and RCPS. Some associations may reduce/pause your fees, depending on the length and type of leave

The reason for taking leave (e.g., medical, parental, caregiver) may influence your return-to-work plan. Ease back into work with a phased return or reduced hours.  

Return to work plan

• Communicate your return with your lead physician/HR administrator
  • Confirm your return date and upcoming schedule. Review your contract for your return notice obligations, if applicable
  • Discuss any accommodations or schedule changes required, if applicable
  • Clarify expectations for reintegration
  • Health-related leave: Ensure you have documented medical clearance
• Confirm your return date, schedule, and expectations with the office staff

Re-onboarding

• Confirm access to necessary tools, such as reinstated privileges, clinic ID, EMR logins, mask fitting, updated vaccinations (e.g., TB), and any required HR training modules
• Get informed about any policy, procedural changes, OHIP updates or regulatory requirements that occurred during your absence
• Arrange a handover if another physician provided coverage
• Ensure business insurance is reinstated, if applicable

Notifications

• Relevant health-care providers
• Professional associations. Note: You must notify CPSO and CMPA before returning to work