Our Past President and current Board Chair, Dr. Nichelle Desilets, appeared before a legislative committee Tuesday evening to share physicians’ perspectives on two pieces of proposed legislation: Bill 27, which codifies patient expectations in health care, and Bill 50, which would expand pharmacist prescribing authority to include therapeutic substitutions. 

Why it matters: Two proposed provincial bills could affect both patient expectations and physician workflows across Manitoba’s health system. 

Bill 27: Patient Expectations

We expressed support for Bill 27, which would require health facilities and physician offices to post a notice outlining what patients should expect when accessing health care. 

• “Many of the expectations outlined in this legislation will sound familiar to physicians, because they’re already embedded in our professional Code of Ethics,” explained Dr. Desilets. 
• “Treating patients with dignity, supporting informed decision-making, protecting privacy — these are standards we’ve been held to for years.” 

The bigger picture: We emphasized the importance of these principles extending beyond individual physician encounters to the health system as a whole. 

• Patients should expect the same respect and quality of care whether they’re seeing their doctor, visiting an ER, or navigating between services. 

The catch: One of the requirements in the legislation, and that would be posted in physicians’ offices, is the expectation of timely care. 

• While physicians are fully committed to that principle, most wait times in emergency departments, diagnostic imaging, and surgical queues are driven by system-level factors outside physician control. 
• “We support posting these expectations,” said Dr. Desilets, ​“but if we are going to tell patients they should expect timely care, we must also ensure the system has the capacity to deliver it.” She then outlined lengthy wait times in ERs and for testing and surgery, all outside of physicians’ control. 

Bill 50: Therapeutic Substitution

On Bill 50, Doctors Manitoba expressed support in principle for enabling pharmacists to substitute therapeutically equivalent medications, while raising two important qualifications. 

Staying in the loop: Dr. Desilets called for clear, streamlined notification to prescribers when substitutions occur. 

• “Physicians remain responsible for a patient’s overall care and need an accurate, current medication record,” said Dr. Desilets. 
• However, this must be done in an efficient way. ​“Removing the fax authorization on the front end shouldn’t mean we’re left out of the loop entirely on the back end.” 

Patients, not profits: We urged the government to explicitly define acceptable reasons for substitution — such as drug shortages or cost savings to the patient — and to prohibit profit-driven substitutions. 

• Dr. Desilets cited a 2024 Ontario College of Pharmacists investigation in which 85% of pharmacy professionals reported pressure to meet corporate targets. 
• “This isn’t about questioning pharmacists’ integrity, it’s about protecting it, and maintaining public trust in health care decisions.” 

Doctors Manitoba’s positions were informed by consultation with physicians across the province.