Physician

A physician is a licensed medical doctor who diagnoses, treats, and helps prevent illness, injury, and disease. Physicians play a central role in healthcare by providing medical assessments, prescribing medications, ordering diagnostic tests, and coordinating patient care with specialists or allied health professionals. In Canada, physicians are regulated by provincial colleges of physicians and surgeons to ensure professional standards and ethical medical practice.

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In health and travel insurance, the term “physician” is specifically defined to mean a doctor of medicine (MD) or doctor of osteopathic medicine (DO) who is licensed and practicing within the jurisdiction where the service is provided. Insurance policies often require that diagnoses, prescriptions, and treatment plans be provided by a physician to qualify for reimbursement. For travel insurance, claims for emergency medical care must generally be supported by a physician’s report or treatment record.

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Example:

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If you experience severe stomach pain and visit a physician who orders an ultrasound and prescribes medication, your insurance plan may reimburse both the diagnostic test and the prescription costs, provided they meet the plan’s eligibility rules.

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What to Watch For:

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Ensure that the healthcare provider you see is recognized as a physician under your plan’s definition. Services provided by naturopaths or alternative practitioners are typically classified separately under paramedical benefits. For claims, retain documentation such as physician notes, referrals, and test results, as insurers may require proof that treatment was medically necessary and prescribed by a qualified doctor.