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When the doctor is on holiday: Who cares for the patient?

When planning a vacation, physicians are obligated to make arrangements so their patients have adequate medical care and are not forced to rely on emergency departments, argues an editorial in CMAJ (Canadian Medical Association Journal).

Doctors need to take vacations, but assuming that their patients will receive adequate care from emergency departments or walk-in clinics can leave patients adrift. This practice needs to be changed. Although some physicians work in group practices or make arrangements for coverage in their absences, others do not.

“Leaving a medical practice unattended is not acceptable,” writes Dr. Diane Kelsall, Deputy Editor, CMAJ. “Professional bodies stress that a physician’s obligation to ensure that his or her patients have access to care when he or she is not personally available is central to the patient – physician relationship.”

In the absence of their regular physician, patients may visit emergency departments for nonurgent conditions, which is inefficient or they may delay seeking care, which could compromise their health.

“What is still missing … are doctors who will take responsibility for specific patients in the absence of their physicians, and who will follow up on test results, facilitate consultations and fulfill the many obligations that the physician-patient relationship entails,” writes Dr. Kelsall.

“Individual physicians have a professional obligation to make specific arrangements for coverage during their absences, whether brief or longer term.”

For doctors who are not in group medical practices, locums may be an option for providing continuity of care.

Approximately 18% of family doctors and 30% of specialists in Canada are in solo practices.


When the doctor’s away, who pays the price? Diane Kelsall MD MEd, CMAJ (2014) DOI:10.1503/cmaj.140247.