Know Your Rights and Responsibilities: A Guide for International Physicians in Clinic Partnerships
Working Together: Fostering Positive Clinic Partnerships
Across Canada, clinics often partner with pharmacies, landlords, or third-party operators to bring much-needed healthcare services to local communities. Many of these clinics offer shared infrastructure, administrative support, or low-cost space to help physicians establish practices—particularly in areas with high patient need.
When structured well, these partnerships benefit everyone: patients receive timely care, physicians are supported in their work, and communities continue to access essential services. That said, it’s important for all parties to understand how to operate within professional boundaries that respect clinical independence, privacy, and regulatory requirements.
Shared Spaces: Key Considerations
If you are practicing in a clinic that involves a partnership with another entity (including pharmacies), here are a few foundational points to clarify:
- Are you free to refer patients to any pharmacy based on their choice?
- Are expectations around collaboration, space, and shared services clearly outlined in writing?
- Is your medical judgment fully independent?
- Do you have full access to the patient records for those under your care?
Professional Boundaries and Patient Choice
Physicians in Canada are expected to maintain autonomy in clinical decision-making. This includes the ability to:
- Refer or prescribe based on what is best for the patient
- Allow patients to choose where they fill prescriptions
- Avoid relationships that could create real or perceived conflicts of interest
Clinic partnerships can absolutely support these goals when built on trust and clear communication.
Collaborative Agreements that Build Trust
It’s not uncommon for clinics to offer low-cost or shared space to physicians as part of a broader commitment to community care. These arrangements can be positive and sustainable if they:
- Reflect fair market value in rental agreements
- Avoid tying referrals or prescribing behavior to financial incentives
- Support patient transparency and freedom of choice
Clarifying roles, expectations, and ethical boundaries from the outset helps prevent misunderstandings and supports long-term success.
Ensuring Clinical Access: Medical Records and EMR Governance
In any collaborative clinic setting, especially where infrastructure is shared, it’s important to clarify who has access to what—and why. One of the most critical areas where this applies is electronic medical records (EMRs).
Physicians must have reliable, uninterrupted access to the records of patients under their care. Even when an EMR system is managed or hosted by a clinic partner, that access must align with legal privacy frameworks and professional expectations.
- Physicians are typically considered Health Information Custodians (HIC) under provincial privacy law, making them responsible for how patient information is documented and used.
- Clinics or third-party partners may act as supportive agents or facilitators of the system, but they cannot block a physician’s access to their patients’ charts.
A clear, cooperative EMR structure ensures quality care, safeguards compliance, and protects the trust between healthcare providers and the communities they serve.
What Happens to Patient Records When a Physician Leaves?
If a physician transitions out of a clinic partnership, all parties share a responsibility to ensure continuity of care and privacy compliance.
- Patients should be informed and supported in transferring records if they wish to follow the physician
- Physicians should retain access to necessary records for ongoing clinical, legal, or regulatory responsibilities
- Clinics should work cooperatively to facilitate secure, transparent record transfer procedures
Open dialogue and mutual respect can make this process seamless and support a strong reputation for everyone involved.
For International Physicians
With community physician recruiters, we recognize that most clinic partnerships are rooted in collaboration and community service. Many international physicians are welcomed into supportive work environments where their skills are valued and respected.
However, we also understand that starting a medical career in a new country, especially while navigating closed work permits or unfamiliar employment terms, can sometimes lead to confusion or unmet expectations. In rare cases, physicians may encounter situations where the role they accepted differs from what was originally described, or where their professional autonomy feels constrained.
OPRA is here to help. Our role is to support international physicians with the resources, referrals, and guidance needed to practice safely, ethically, and confidently within the Canadian healthcare system.
If you were promised certain hours, supervision, pay, or autonomy, and the reality is different, you’re not alone. Some physicians arrive to find that:
- Their clinical independence feels limited
- They are pressured to refer only to a particular pharmacy or service provider
- Their EMR access is restricted
- Leaving the clinic feels difficult because of their immigration status
The Vulnerable Worker Open Work Permit
Canada offers a special open work permit for workers who experience abuse, coercion, or exploitation under a closed work permit.
You may qualify if:
- You hold a closed (employer-specific) work permit
- You are in Canada
- You are experiencing workplace mistreatment that affects your safety or autonomy
This permit allows you to seek other employment while staying legally in Canada.
Working With Recruiters
If you’re working with a recruiter or third-party agency, be sure:
- They are licensed in the province they operate in
- They do not charge you placement fees (this is illegal in Canada)
- All agreements are written and transparent
Avoid recruiters who pressure you, promise things not in writing, or tell you not to consult a lawyer.
Shared Goal, Shared Responsibility
Clinic partnerships are a vital part of Canada’s healthcare delivery network. With the right foundations—respect, transparency, and regulatory awareness—these relationships can support sustainable, ethical care for everyone involved.
If you’re ever unsure about your rights or responsibilities, reach out to:
- Your provincial medical regulatory college
- A qualified immigration lawyer
- The Ontario Physician Recruitment Alliance (OPRA)
- A community recruiter or newcomer support agency
This guide is intended for general awareness and does not replace legal or professional regulatory advice.
