Some Ontario doctors can treat family members as regulatory college relaxes rules amid shortage

TORONTO — The College of Physicians and Surgeons of Ontario is relaxing its policy against doctors treating themselves, family members and others close to them amid the province’s primary care crisis.

Doctors were previously only allowed to treat relatives and other people close to them in emergencies or for minor conditions if no other qualified health-care professional was readily available.

Now, those practising in underserved areas can provide other medical care — including ordering tests and treating illnesses and injuries — if there isn’t another option, such as virtual care, or an alternate health-care provider within a reasonable distance, said a policy that was approved by the CPSO’s board in May and communicated to physicians in the June issue of its digital publication, “Dialogue.”

“The policy responds most directly to ongoing challenges in accessing timely care in Ontario, with particular recognition of the unique considerations of physicians working in smaller communities,” said Laura Zilke, spokesperson for the CPSO, in an emailed response to The Canadian Press on Friday.

“The updates enable physicians to provide care beyond emergency treatment and treatment of minor conditions to people close to them in communities with limited treatment options, including rural, remote and Indigenous communities.”

In some areas, the only doctor available to patients might be someone they’re related to or have a close relationship with, the policy notes.

Zilke said important safeguards remain in place “to ensure high-quality care and minimize risks to patient safety.”

“(The policy) continues to prohibit ongoing episodic care for family members or others close to the physician and requires care to be transferred to another provider as soon as practical when further treatment is needed,” she said.

Doctors also can’t do intimate examinations or prescribe narcotics to people close to them, except in an emergency. They are also not allowed to provide psychotherapy to family members.

In accompanying “advice to the profession” on its website, the college encourages doctors to be mindful that personal relationships with patients “can reasonably affect a physician’s professional judgment in a number of ways,” including feeling uncomfortable discussing sensitive issues, feeling pressured to treat conditions that are beyond their expertise or to prescribe drugs.

When asked for comment on the college’s policy as a way to address the primary-care shortage, a spokesperson for Ontario Minister of Health Sylvia Jones said the CPSO is “an independent regulatory body, which in Ontario is independently responsible for setting the rules and regulations that physicians need to follow.”

She also said the provincial government is “investing $2.1 billion to connect every single person in the province to primary care — and that will continue to be our focus.”

Dr. Robin Lennox, the NDP Opposition critic for primary care, said that while it’s “not an ideal situation,” the CPSO has taken a positive step for physicians who “might be the only health-care provider available to someone who might be a family member or someone that they know closely.”

Lennox, who is also a family physician in Hamilton, said the NDP agrees with the Ontario Progressive Conservative government’s “stated intention” to ensure everyone in the province has access to primary care.

However, she notes they have not seen enough action.

“Their response has been underwhelming in the sense that we’re still seeing many communities that don’t have access to a regular family doctor. We’re seeing many communities where their family doctor that is local is imminently going to retire and there’s going to be no one available to replace them,” she said.

“The investment of funds in primary care is of course extremely welcome and we agree that everyone should have access to team-based primary care in this province (but) we really need to see that outcome delivered rather than a promise.”

Dr. Adil Shamji, a Toronto Liberal MPP and an emergency physician, said it is “embarrassing” to the provincial government that the college had to change a policy that had been in place for a reason.

“Until recently, there’s been a prohibition on physicians providing care to themselves, family members, or others close to them, because when providing care to such individuals, for various reasons, it can be difficult to maintain the standard of care,” he said in an interview Friday afternoon.

“The CPSO has been forced to adjust its policy to meet the new reality of profound health-care and primary-care scarcity in this province,” he said.

Shamji said the government is “leaving regulatory bodies such as the CPSO with no choice but to resort to amending their policies in the interest of ultimately delivering at least some care to patients in our province.”

Physician regulatory bodies in other provinces say doctors should only treat themselves, family members and friends in emergencies or for minor conditions when no other health-care provider is readily available.

Like Ontario, the College of Physicians and Surgeons of British Columbia acknowledges there can be “unique circumstances” in rural or remote settings.

-With files from Allison Jones

This report by The Canadian Press was first published July 11, 2025.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

Nicole Ireland, The Canadian Press