Key Differences in Health Law for Physicians Moving from the US to Canada with Brooke Shekter

Written By Robert Beck

Navigating Health Law in Canada: What Every Doctor Needs to Know

By Dr. Rob Beck, Host of The Interesting MD Podcast

When I made the move to Canada, one thing quickly became clear: the legal landscape for doctors up here is a whole different world compared to what I was used to in the United States. Over the past five years practicing in British Columbia, I’ve found myself not just treating patients, but also puzzling over everything from malpractice insurance to hospital governance and—perhaps most daunting of all—the dreaded college complaint.

To help make sense of these complicated issues—not just for myself, but for the many Canadian and international doctors making the move north—I sat down with Brooke Shekter, a seasoned health law lawyer and managing partner at Lloyd Schekter Health Law. In this post, I’ll dive into what I learned from our conversation, share some key takeaways, and hopefully arm you with the knowledge you need to stay protected, prevent burnout, and thrive in practice.

What Is Health Law in Canada?

First, let’s get a quick sense of where things stand. In Canada, health law is a unique specialty. As Brooke Shekter explained, she spends her days defending physicians and regulated health professionals facing everything from college complaints to hospital disputes, registration trouble, and audit nightmares. And as she’s quick to point out, the regulatory system here fundamentally differs from the U.S.

Your Malpractice Insurance: Say Hello to the CMPA

Let’s talk malpractice insurance. In Canada, every physician is required to carry coverage through the Canadian Medical Protective Association (CMPA). For those of you comparing costs, mine clocks in at around $348 a month as an internist in BC. This coverage includes tail and lifetime coverage—it’s all rolled into one, and you don’t have to wrangle with private insurers like in the States. No system is perfect, but this one is fairly straightforward, and rates are generally much more predictable.

Understanding College Complaints

If you’re new to Canada, forget everything you know about medical boards in the U.S. Here, we have the College of Physicians and Surgeons in each province (think CPSO in Ontario, CPSBC in BC, and so on). These bodies regulate the profession and have significant power over every practicing doctor.

If a patient, hospital, or even another doctor has a concern, they lodge a “college complaint.” Brooke Shekter emphasized just how common these are—at some point, it’s virtually guaranteed you’ll face one. Complaints can range from professional misconduct and negligence, to more serious allegations like sexual assault, or (sometimes) even more frivolous concerns.

A critical point? When you get that dreaded letter, do not respond on your own. The first step is to call a health law lawyer—ideally before you say anything at all. What you say can—and will—be used as part of the investigation. Documentation matters: Always have chaperones for sensitive exams and meticulously record who was in the room, what was done, and why.

College Complaints: What Happens Next?

Here’s a quick rundown of the process:

  • A patient (or hospital, or other party) files the complaint, usually electronically.

  • The college notifies you—sometimes with a phone call, but always with a letter.

  • You (preferably with your lawyer) prepare a written response.

  • An initial panel (the ICRC in Ontario) reviews the case. Outcomes can include dismissal, recommendations for further education, agreed undertakings, or referral to a full discipline committee hearing for serious matters like misconduct or assault.

  • These hearings are no joke—they look like civil suits, but are administrative, internal to the college, and can have major consequences for your license.

Can You Face a Lawsuit Too?

Short answer: Yes. There are two completely separate tracks—a civil lawsuit (the one you’d expect as a malpractice action) and a college complaint. They can run in parallel, and you’ll need insurance coverage and often separate counsel for both.

Hospital Privileges: The Power of Leadership

One of the biggest shifts I had to wrap my head around in Canada was hospital governance. Unlike in the U.S., where your contract is with a health system or hospital group, Canadian doctors typically hold “privileges.” These are renewed annually, and whether you keep working—or get your privileges suspended or revoked—depends heavily on the hospital’s internal medical advisory committee (MAC) and board.

Here’s the kicker: the leadership has enormous power, and if there’s discontent, your privileges can be at risk. Brooke Shekter sees plenty of cases where conflict with leadership or department dynamics leads to trouble. It’s always best to approach these situations collectively, if possible. Lone-wolf challenges are difficult and require a different, often riskier, legal strategy.

Tips for Surviving Hospital Politics

  • Build strong relationships with department members, nurses, and allied health staff.

  • Avoid personality clashes—many complaints arise from disruption, not clinical care.

  • If you find yourself being labeled as “disruptive,” seek legal counsel right away.

  • Know that while it feels intimidating, there are procedural protections and appeal routes available. Know your rights!

Preventing Complaints and Legal Issues: Practical Tips

As much as we all want to believe our good intentions and skills are enough, every doctor is vulnerable to complaints. Here are a few practical strategies, right from my conversation with Brooke Shekter:

  • Meticulous documentation: Always. Your notes are your strongest defense.

  • Chaperones and transparency: Particularly for any sensitive exam, have a chaperone and record their name in the chart.

  • Handle communication with care: All written and verbal responses to an investigator should be routed through a lawyer.

  • Understand the process: Know where you stand in the complaint or hearing process, ask questions, and stay actively involved in your defense.

  • Respect and professionalism: Treat every team member, patient, and manager respectfully—even when tensions run high.

Burnout and the Toll of Complaints

Let’s be honest: facing a college complaint or legal battle is among the most exhausting, demoralizing events in a doctor’s career. It’s one of the fastest tracks to burnout, which is why it’s so important to address these issues early, understand the resources available, and never try to go it alone.

Final Thoughts: If You Need Help, Reach Out

If there’s one thing I hope you take away, it’s that you don’t have to navigate Canadian health law and physician regulation on your own. Whether you’re new to practice, new to Canada, or just facing your first (or fifth) complaint, connecting with an expert like Brooke Shekter can make all the difference.

Here’s how to get in touch with her:

And as always, if you have questions, topic ideas, or want to share your own practice experiences, drop me a line at rob@interestingmd.com or reach out on YouTube or any of my socials.

Stay safe out there, and keep up the amazing work. Medicine is tough enough—don’t let the legal and administrative side catch you off guard.

Dr. Rob Beck
Host, The Interesting MD

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Robert Beck
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