Background
On March 4, 2026, the Alberta Court of King’s Bench (Court) released its written decision in the case of College of Physicians and Surgeons of Alberta v. Makis (Makis). The Court clarified what constitutes the unauthorized practice of medicine in Alberta, as well as the jurisdiction of the College of Physicians and Surgeons of Alberta (CPSA) over non-members.[1]
This case involved breaches of an Interim Interlocutory Injunction (Injunction), which required a physician formerly licensed by the CPSA, Mr. Makis, to refrain from providing medical services or using titles reserved for regulated members while he remained unlicensed in Alberta.[2] In 2019, the CPSA cancelled Mr. Makis’ practice permit due to his failure to renew it and pay the associated fees.[3] The CPSA alleged that he continued to practice medicine while unlicensed, which resulted in the Injunction being ordered on August 15, 2025.[4]
Some months later, the CPSA applied to have Mr. Makis cited in contempt for his alleged breaches of the Injunction.[5] The alleged breaches consisted of various online posts and interactions where Mr. Makis provided cancer patients with treatment information and referred to himself using titles reserved for regulated members of the CPSA.[6] The Alberta Court of King’s Bench found Mr. Makis to be in contempt of court and ordered a permanent injunction with the same terms as the previous Injunction, as well as imprisonment if his contempt was not purged within 72 hours.[7]
Unauthorized practice of medicine in Alberta
Whether Mr. Makis could be cited in contempt of court hinged on whether he engaged in the unauthorized practice of medicine contrary to the Injunction order. This, in turn, hinged on whether his conduct constituted the practice of medicine. The Court summarized Mr. Makis’ characterization of his services as follows:
“Mr. Makis asserts that he does not practice medicine. Rather, he shares his interest and research in cancer treatment with the public as a Substack author and helps people with cancer as an International Cancer Coach. He derives a living from doing so.”
Despite Mr. Makis labelling his work as “health coaching services,” where he said he shared information and research rather than medical advice, the Court viewed his actions as substantively within the scope of the practice of medicine.[8] The Court viewed Mr. Makis’ conduct, which included reviewing test results and providing customized treatment protocols, as falling under Schedule 21, s 3(1) of the Health Professions Act, which outlines the scope of the practice of medicine.[9]
The Court provided a clear message that calling something a non-medical practice does not make it so; it is the substance of the conduct that is determinative.[10]
Additionally, the Court clarified the principles that underlie judicial action against unauthorized professional services. Despite assertions from Mr. Makis that many people benefited from his work, the Court emphasized that the unauthorized services do not need to yield actual harm to warrant judicial intervention.[11] Rather, the risk to the public that is inherent to the unauthorized practice of medicine is sufficient.[12] Whether the individual’s services were effective, or may have resulted in health improvements, was seen as beyond the Court’s purview and not a necessary determination to justify the Court’s intervention.[13]
The jurisdiction of the CPSA
The issue of the CPSA’s jurisdiction was raised by Mr. Makis, who argued that as he was not a member of the CPSA, the CPSA had no jurisdiction over him.[14] The Court clarified that although Mr. Makis could not be regulated by the CPSA as a non-member, the CPSA was not attempting to regulate him. Rather, the Court explained, the CPSA was acting as a private litigant who sought the enforcement of the court-issued Injunction that Mr. Makis was contravening.[15]
Being a non-member of a professional college or society does not prevent that regulatory body from seeking the enforcement of an injunction against that individual, in order to protect the public from unlicensed professional services.[16]
Another jurisdictional issue raised by Mr. Makis, who was in the process of obtaining a medical license in Florida at the time this case was heard, was whether the Court could enforce an injunction in relation to his extra-territorial conduct.[17] As Mr. Makis’ activities were conducted online, he asserted that they were in relation to his developing practice in Florida, rendering the Alberta-based injunction inapplicable.[18] The Court clarified that Mr. Makis’ own status as a resident of Alberta, despite the recipients of his activities being located outside of Alberta, was sufficient to render his conduct within the jurisdiction of Alberta’s courts.[19]
Takeaway
Although each case will turn on its own facts, regulatory bodies who govern regulated health professionals can seek remedies from the Courts against individuals who are not members of those regulatory bodies, in order to ensure that unlicensed individuals do not engage in the regulated practice of medicine.
For more information, please contact the author, Tari M. Hiebert.
The author would like to thank Abhay Agnihotri, law student, for their valuable contribution to this article.
[1] College of Physicians and Surgeons of Alberta v. Makis, 2026 ABKB 159. Leave to appeal to the Alberta Court of Appeal denied. See College of Physicians and Surgeons of Alberta v. Makis, 2026 ABCA 198.
[2] Ibid.
[3] Ibid at para 13.
[4] Ibid at para 22.
[5] Ibid at para 1.
[6] Ibid at para 15.
[7] Ibid at paras 108-110, 115.
[8] Ibid at paras 49, 99.
[9] Ibid at paras 8, 97, citing Health Professions Act, RSA 2000, c H-7, Schedule 21, s 3(1).
[10] Ibid at para 106.
[11] Ibid at paras 45, 102.
[12] Ibid at para 102.
[13] Ibid at para 103.
[14] Ibid at para 33.
[15] Ibid at paras 74-76.
[16] Ibid.
[17] Ibid at paras 45-46.
[18] Ibid at para 46.
[19] Ibid at paras 78-79.
