The Alberta government says a new dual practice model set to launch this fall will expand surgical capacity, reduce wait times and give patients more options by allowing eligible physicians to perform both publicly funded and privately paid surgeries.Beginning in September, approved physicians will be able to provide services through a framework that permits work in both the public and private systems, a model already used in several countries with universal health-care systems.The province says the initiative is aimed at tackling persistent surgical backlogs while helping recruit and retain specialists by offering greater flexibility in how they practise.“Doing more of the same will not reduce Alberta’s surgical wait times,” Premier Danielle Smith said in a statement. “Dual practice is one of several reforms that will help expand surgical capacity, improve access to care and ensure Albertans can get the procedures they need sooner.”The model will apply to a range of procedures already approved in accredited surgical facilities, including orthopedic operations, hip and knee replacements, cataract surgery, certain ear, nose and throat procedures, gynecological surgeries, dermatology, plastic surgery and minimally invasive general surgeries such as hernia repairs.Family physicians will generally be excluded, except for those with specialized training in anesthesia or surgical assistance.The province emphasized that emergency procedures, life-saving treatments and cancer care will remain exclusively within the publicly funded system.Hospital and Surgical Health Services Minister Adriana LaGrange said the government has built safeguards into the framework to ensure the public system is protected.“It’s important we get this right, which is why we have built strong safeguards and only allowed specified surgeries to protect access to the public system,” said LaGrange. “We will closely monitor dual practice and make changes if needed to ensure shorter waits, more choice and better access for Albertans.”.Among the measures announced are minimum public-service requirements for participating physicians, integrated electronic health records and mandatory reporting requirements.Acute Care Alberta will establish minimum public surgery hour requirements and conduct regular reviews to ensure public surgical volumes remain stable.Dr. Aaron Low, chief medical officer for Acute Care Alberta, said the goal is to improve access without weakening the public system.“Dual practice is designed to expand access for patients while maintaining a strong and reliable public surgical system,” said Low.The government argues Alberta already allows some access to private care through patients travelling elsewhere for treatment or through opted-out physicians, but says the new framework will bring greater oversight and accountability.“Albertans already access private care through travel loopholes and opted-out physicians,” said Dr. Sean Gregg, chief medical officer at Windflower Health. “What has been lacking is the thoughtful design and regulatory oversight to ensure public access and quality is protected.”Supporters of the change also say it will allow surgeons to perform more procedures overall.“Your proposal offers a tangible solution by creating a framework that better utilizes my skills and capacity, directly addressing the bottlenecks I face every day,” said Dr. Trevor Brooks, a plastic, hand and reconstructive surgeon.“This is not an abstract ideological debate; it is a practical mechanism to get my patients out of pain and back to their lives, sooner.”.The province noted that several highly ranked universal health-care systems, including those in Australia, the Netherlands, the United Kingdom, France, Sweden, Germany, Spain and Denmark, permit some form of dual practice.According to the Commonwealth Fund’s 2024 rankings, Canada placed seventh among 10 countries studied, while the six higher-ranked countries all allowed physicians to practise in both public and private systems.An expression of interest process for physicians will open June 22, with a formal application process expected later this summer.The Alberta government said the province remains fully compliant with the Canada Health Act and reiterated its commitment that no Albertan will be required to pay out of pocket for medically necessary care.
