The Health Professions and Occupations Act makes a health care system built on trust, respect, and collaboration less achievable

I’m a physician practising in British Columbia, and, for the first time in my career, I find myself questioning whether this profession is still worth it.

When I chose medicine, I believed it was a calling. I grew up watching my father (also a physician) dedicate himself to our community. He worked long hours helping people through the most difficult moments of their lives, sacrificing his sleep, his weekends, and time with our family. Yet he was valued, trusted, and respected for it. This example shaped my life. I have spent over a decade in university and put my family into hundreds of thousands of dollars of debt to serve my community in the same way.

Today, however, the relationship between physicians and the health care system is eroding. The Health Professions and Occupations Act (HPOA) reinforces the message that physicians are adversaries who must be controlled and punished, rather than professionals who should be trusted and supported. Many of the changes imposed by the HPOA weren’t openly discussed with physicians, or even patients. Among other things, the HPOA replaces elected College of Physicians and Surgeons of British Columbia representatives with government appointees. It then allows these appointees to impose fines or even seek imprisonment for infractions. It removes meaningful appeal processes and expands bureaucratic oversight. It allows appointees to access medical records without a court order. It seems to suggest that individual physicians, rather than overburdened and mismanaged systems, are the problem with our health care system. To many physicians, this does not feel like reform; it feels like mistrust.

This sentiment is particularly painful given what we have been asked to endure in recent years. During the pandemic, physicians stepped forward when our communities needed us most. We accepted reassignments to high-risk environments, jeopardizing our personal safety to protect the public. I contracted COVID-19 while reassigned to a critical-care ward and passed it on to my family before vaccines were available.

We accepted these risks because we believed that medicine was a calling, and we honored the trust placed in us. Now it feels like that trust has been eroded.

The reality is that practising medicine in BC is already difficult. Physicians are not employees, but independent contractors. We are responsible for our clinic rent, staff salaries, medical equipment, and supplies. We have no paid vacation, sick leave, or health care benefits. Furthermore, we are not protected by the Employment Standards Act or WorkSafeBC. We may work 28 to 72 hours at a time without protected breaks to eat or sleep.

Despite this, many of us stay in medicine, because the work matters. However, legislation like the HPOA threatens to break our commitment. When the system treats physicians like potential offenders rather than partners in care, it creates moral injury. It signals that dedication, sacrifice, and expertise are not valued.

At a time when BC is facing physician shortages, discouraging physicians seems counterproductive. If the work becomes riskier and less valued, many physicians will leave. Speaking as both a physician and a patient, I want a health care system built on trust, respect, and collaboration. But I believe that legislation like the HPOA makes this less achievable.
—A. Vallee, MA, MD
Victoria