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

A doctor wears a lab coat and stethoscope in an exam room on Friday, July 14, 2023. THE CANADIAN PRESS/Jeff McIntosh

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 an 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. Adil Shamji, a Toronto Liberal MPP and an emergency physician, said it is “embarrassing” 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 placed the blame for the change squarely on Ontario’s Progressive Conservative government, saying they were “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.”

With files from Allison Jones

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

Nicole Ireland, The Canadian Press