Patient Safety Must Remain the Foundation of Scope of Practice Decisions in Canada

Thursday, April 16 2026 | 09 h 20 min | News

As scope of practice expansion is actively being considered across Canada, the Canadian Ophthalmological Society (COS) is emphasizing that patient safety must remain the central and non-negotiable principle guiding any changes to healthcare delivery.

While COS supports innovation and system modernization, it is deeply concerned that several proposed changes would expand independent clinical authority to non-physician providers without sufficient safeguards, standardized training equivalency, or mandatory review by relevant physician specialists.

“Patient safety is not negotiable, and it depends on ensuring that clinical responsibility matches the depth and breadth of medical training required to assume it,” said Dr. Mona Dagher, President of the Canadian Ophthalmological Society. “Diagnosis, treatment decisions, and procedural care require the full medical training of physicians, including the ability to integrate systemic disease, assess risk, and manage complications in real time.”

Ophthalmologists are medical doctors and surgeons trained to diagnose and manage eye disease within the context of overall health, including systemic conditions. This training is developed through medical school and years of residency within a structured, supervised, and accountable system, an approach that is fundamental to ensuring patient safety.

In eyecare, delayed or incorrect diagnosis can result in irreversible vision loss. Even routine-appearing assessments or procedures require the ability to recognize subtle but critical findings, escalate care appropriately, and manage complications when they arise.

From a primary care perspective, the College of Family Physicians of Canada (CFPC) reaffirms the importance of maintaining clear scope definitions grounded in training.

“We support the position of the Canadian Ophthalmological Society and the importance of appropriate scopes of practice based firmly on training and expertise,” said Sarah Cook, President of the College of Family Physicians of Canada. “We support collaboration—not substitution.”

COS and its physician partners are calling for mandatory, transparent, and medical expert-led review of any proposed scope of practice changes to ensure alignment between training, responsibility, and patient safety.

“At its core, this is about protecting patients,” added Dr. Dagher. “Different professionals contribute to care, but roles are not interchangeable. The level of care delivered must always match the level of training required to provide it safely.”

Source: Canadian Ophthalmological Society

Want to see more like this article? Click here to subscribe to our FREE print magazines and e-newsletters!