Provincial borders won't be barriers for doctors if coronavirus hits some areas worse than others

If COVID-19 overwhelms hospitals in one province, could doctors from other parts of Canada rush in to help?

It's a scenario that critical care physician Dr. Rob Fowler predicts could emerge, because he says the virus will probably cause different rates of infection in different parts of the country.

"We can anticipate that when Canada gets a bump up in cases it's not going to happen across the country in a homogenous way," said Fowler, who is also director of clinical epidemiology at the University of Toronto's Dalla Lana School of Public Health. Fowler was honoured for his work treating Ebola patients in West Africa in 2014.

"There's gonna be this patchiness where some places are feeling stretched and other places are saying kind of business as usual," Fowler said.

COVID-19 is already showing regional differences in Canada, with Ontario and British Columbia having the greatest number of cases to date, and new cases showing up in Manitoba and Saskatchewan. (Already, B.C. is asking recently-retired doctors to come back and help out.) 

It raises the concern that one part of the country could be so overwhelmed that hospitals might have to triage patients, making life and death decisions in the intensive care unit based on who should get life-saving treatment if there are not enough resources to go around.

We can't get ourselves in a situation where one city or one town is overwhelmed and individuals inside a hospital feel they need to enact triage because they don't have the capacity or support.- Dr. Rob Fowler, of University of Toronto's Dalla Lana School of Public Health

"We can't get ourselves in a situation where one city or one town is overwhelmed and individuals inside a hospital feel they need to enact triage because they don't have the capacity or support," he said. 

'We will not be an obstacle'

Even though the virus might not respect provincial boundaries, Canada's health-care professionals are required to be licensed by individual provinces and territories before they can practise medicine.

The provincial licensing agencies each have the ability to issue emergency licences. And they're ready to do that if it becomes necessary. 

"Licensing will not be a barrier. I can assure you of that," said  Dr. Linda Inkpen, president of the Federation of Medical Regulatory Authorities of Canada (FMRAC). 

"That process may be a little different from one province to the other, but essentially we can all give emergency licences to physicians coming in from other provinces very quickly with minimal documentation."

Doctors would need to show that they have a certificate in good standing from their provincial college.

"It would differ depending on the physician and their backgrounds, but in some cases this could be as little as minutes and then some more cases that might be longer, hours or so. But we're not talking a week or a month or anything of that sort," Inkpen said.

They would also need medical liability insurance. Most doctors in Canada are covered by the Canadian Medical Protective Association (CMPA).

"We will not be an obstacle to portability or system surge capacity during this time of need," Dr. Todd Watkins, associate executive director and managing director of CMPA's Enterprise Services, told CBC News in an email. 

"As an essential component of the health-care system, the CMPA will do our part to ensure doctors have the medical legal support they need to provide care to Canadians."