Alberta · College of Physicians & Surgeons of Alberta

How to Respond to a CPSA Complaint

Alberta funnels every complaint about a physician through one person: the Complaints Director. What that officer decides in the first weeks determines almost everything that follows — because fewer than two per cent of complaints ever reach a hearing tribunal. The early stage is not a preliminary to the real process. For nearly all physicians, it is the whole process.

Who regulates you, and in what terms

Physicians in Alberta are regulated by the College of Physicians & Surgeons of Alberta (CPSA) under the Health Professions Act, RSA 2000, c H-7, together with the Physicians, Surgeons, Osteopaths and Physician Assistants Profession Regulation.

The language matters, because it differs from other provinces. You are a regulated member. What is at stake is your practice permit. And the thing you may be found to have committed is unprofessional conduct — a single statutory concept that covers everything from a lapse of clinical judgment to a failure to answer the College’s letters.

One person decides what happens next

Unlike Ontario, where a committee screens complaints, and unlike British Columbia, where an Investigation Committee does, Alberta routes every complaint through the Complaints Director — an individual with statutory powers under the HPA.

The Complaints Director reviews the complaint, your response and the relevant records, and then chooses among several routes:

• Dismiss — where there is insufficient evidence of unprofessional conduct, or the complaint is frivolous or vexatious.
• Expert peer review — where you and the complainant agree on what the issue is, an expert in the same specialty is asked to assess the care.
• Alternative complaint resolution (ACR) — a voluntary, mediation-like process to reach a negotiated resolution.
• Investigation — a formal investigation of the allegations.
• Referral to a hearing — where the evidence meets the charging standard and public safety requires it.

Very few complaints travel the whole distance. CPSA has said that fewer than two per cent of complaints end up before a hearing tribunal. That is not a reason to be casual; it is a reason to take the early stages seriously, because that is where almost everything is decided.

What “unprofessional conduct” actually covers

The HPA definition is deliberately broad. It includes a lack of knowledge, skill or judgment in providing professional services; contravening the Act, a code of ethics or a CPSA standard of practice; misrepresenting your registration or practice permit status; breaching conditions on a permit, a settlement agreement or a Tribunal order; and conduct that harms the integrity of the profession.

Your first week

1. Contact the CMPA before you write anything. Not after you have drafted a reply — before.
2. Diarise every deadline in the letter, and request an extension early if you need one.
3. Preserve the record exactly as it stands. Never alter, supplement or tidy a chart after a complaint arrives. Amendments are detectable, and they convert a question about your care into a question about your honesty.
4. Do not contact the complainant.

You may disclose health information to the College for the purposes of an investigation; Alberta’s Health Information Act permits disclosure to a regulatory body exercising its statutory function. Withholding or delaying is far more dangerous than disclosing.

Writing a response the Complaints Director can use

Set out the clinical context and your reasoning at the time, on the information you actually had. Deal with each concern the complainant raised individually. Anchor everything in the record. Where something did go wrong, say so plainly and say what you have already done about it.

Two routes available to the Complaints Director — expert peer review and alternative complaint resolution — both depend on a degree of common ground. A response that engages seriously with the patient’s experience keeps those doors open. A response that is dismissive tends to close them, and pushes the file towards investigation.

If the complaint is dismissed

A dismissal is not necessarily the end. The complainant has 30 days from notification to ask a Complaint Review Committee (CRC) to review the Complaints Director’s decision. The CRC is not a hearing and not an appeal: it decides whether the decision to dismiss was reasonable.

A CRC panel can confirm the dismissal, refer the matter back to the Complaints Director for further investigation, or refer it straight to a hearing. So a dismissal letter is worth reading carefully, and it is worth keeping your file in order until the review window has closed.

This article is general information for physicians regulated by the College of Physicians & Surgeons of Alberta and does not constitute legal advice. Regulatory processes and the law change, and every case turns on its own facts. If you are the subject of a complaint or investigation, contact the Canadian Medical Protective Association (CMPA) or a lawyer experienced in professional regulation before you respond. Last updated July 14, 2026.