A change that health groups are calling historic, and the Alberta government is calling more choice, just took effect. Either way, it is the biggest shift in how Canadian doctors can practise in decades, and the rest of the country is watching closely.
As of this week, Alberta's Bill 11, formally the Health Statutes Amendment Act, 2025 (No. 2), is in effect, allowing physicians to apply for dual practice, meaning work in both the public system and private practice at the same time. This is what the new model actually involves, what each side is saying, and what it could mean for patients.
What do the new rules say, and what the new rules do in practice
Bill 11 passed in Alberta's legislature in the fall 2025 sitting. Under the model, doctors can apply for permission to practise in both the public and private spheres, but there are conditions. Physicians must work a prescribed number of hours in the public system to be eligible, and family doctors are not permitted to take part at this time. The rules mainly open the door for specialists, with surgeries under the model not expected to begin until later in the fall, since doctors must first be approved. Applications open in mid-September.
The province spent the summer collecting expressions of interest from physicians. Maddison McKee, press secretary for Alberta's Hospital and Surgical Health Services Minister Adriana LaGrange, told CBC News those submissions are being reviewed to prepare the formal application process, which will include public surgery hour requirements, monitoring and new reporting requirements.
Why is this contested, and why it has become a national fight
Opposition groups argue dual practice will pull resources out of the public system. Jason MacLean, chair of the Canadian Health Coalition, called Bill 11 the biggest threat to health care since the Canada Health Act passed in 1984, and said that when physicians can work in both systems, resources tend to migrate toward the private side, making access unequal. His group is holding rallies in 30 locations across Canada and has 50 town halls planned this fall. That worry lands against a system already stretched thin, the same pressure behind reporting on why specialist wait times feel endless.
The Alberta government rejects that framing. McKee dismissed comparisons to a U.S.-style system as fear mongering, said dual practice does not violate the Canada Health Act, and pointed to the province's Public Health Care Guarantee, a commitment that Albertans will never pay out of pocket for medically necessary care. The federal government, so far, is somewhere in between. Ottawa sent a letter to the province on July 24 confirming it had reviewed the regulations, and a spokesperson for the federal health minister said the two governments are collaborating, with discussions focused on protecting access to medically necessary care, similar concerns to those raised amid strain in the country's emergency rooms.
What does it mean for patients, and what this means for you
For most patients, the arrival of dual practice changes nothing right now. If you live in Alberta, nothing changes at your family doctor's office, since family physicians are excluded from the model for now. The first visible effects will come later this fall as approved specialists begin offering privately paid procedures alongside their public work, and the practical question will be how the public surgery hour requirements and monitoring play out.
If you live anywhere else in Canada, this is worth watching, because both supporters and critics agree on one thing: other provinces will be studying what happens next. The pressures driving the debate, especially long waits, are already national, an issue that also shows up in coverage of long psychiatric bed wait times. Wherever you are, and whichever system you use, finding available care is the first step.
Frequently asked questions
What is dual practice under Alberta's Bill 11
Dual practice lets a physician apply for permission to work in both the public health system and private practice at the same time. Under Alberta's Bill 11, doctors must work a set number of public hours to be eligible, and the model is subject to monitoring and reporting. It took effect this week, with applications opening in mid-September.
Can family doctors take part in dual practice in Alberta
No. Family physicians are not permitted to take part in the dual-practice model at this time. The rules mainly open the door for specialists. For most patients, nothing changes at their family doctor's office, and the first visible effects will come later in the fall as approved specialists begin private procedures alongside their public work.
Does dual practice violate the Canada Health Act
That is contested. The Alberta government says dual practice does not violate the Act and points to its Public Health Care Guarantee that Albertans will not pay out of pocket for medically necessary care. Critics argue it will draw resources toward private care. The federal government says it is reviewing the changes to ensure they comply.
Will dual practice affect patients outside Alberta
Not directly, for now. The change applies in Alberta. But both supporters and critics expect other provinces to study the results closely, so it may shape future decisions elsewhere. The underlying pressures, especially long waits for specialists and surgery, are already national issues that other provinces are grappling with.
Finding care wherever you are
Wherever you are, and whichever system you use, finding available care is the first step. You can find clinics and specialists near you with current availability, or follow more Canadian health-system coverage on the Medimap Health Hub, so you can spend less time searching and more time being seen.
This article is general information and reporting, not medical or legal advice. For an emergency, call 911. For a non-urgent concern, see a doctor.
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