December 5-6, 2019

Hamilton FP New CPSO President

At Council in December, we said goodbye and thank you to Dr. Peeter Poldre for an excellent year under his leadership. We also welcomed Dr. Brenda Copps, a Hamilton-based family physician, to the President’s chair. Dr. Copps is just the sixth woman to be President of the College.

A passionate advocate for family medicine, Dr. Copps has held leadership positions at various levels of the Hamilton health-care system. This includes a term as chief of the Department of Family Medicine at St. Joseph’s Hospital, and as a board member and Chairperson of the Hamilton Family Health Team. She currently holds appointments at St. Joseph's Healthcare System and Hamilton Health Sciences and is an adjunct professor with the Department of Family Medicine in The Michael G. Degroote School of Medicine.

Read more about Dr. Copps in the upcoming issue of Dialogue

Council Award Recipient: Dr. Michelle Hladunewich

Council presented the final 2019 Council Award to Dr. Michelle Hladunewich. Through her consultative practice, research and training of new nephrologists, Dr. Hladunewich has helped many women with serious kidney disease carry babies to term. Her work has become a model for others across the country looking to provide women with similar help.

Dr. Hladunewich is currently the Physician-in-Chief at Sunnybrook Health Sciences Centre in Toronto. She is also the Medical Lead, glomerulonephritis and specialty clinics, with the Ontario Renal Network, and a professor at the University of Toronto.

At Sunnybrook, she is the founder and lead at Sunnybrook’s Pregnancy and Kidney Disease Clinic (PreKid), the largest specialty renal clinic for high-risk pregnancies in Ontario, where she has helped hundreds of women living with renal disease have children. The clinic also serves as a training program for medical students and nephrology specialists, many of whom travel from around the globe to learn how to set up similar programs in their communities.

Watch the CityTV Toronto story on Dr. Hladunewich, and read more about Dr. Hladunewich in the upcoming issue of Dialogue.

Registrar/CEO’s Report

Dr. Nancy Whitmore reported on a number of highlights from the 2019 year, including Right-Touch Regulation, and, how adopting the approach has seen efficiencies realized in the College’s complaints process. The changes include: the number of early resolution cases has increased by 88%; Complaint investigations opened in the first six months are being completed 44% faster than during the same period last year; the number of closed complaints has outnumbered new complaints in the past five quarters; the number of ongoing cases has dropped by half since the start of 2018; the time it takes to write an ICRC decision has dropped by 85% since June 2018; and the time it takes to release a discipline decision has dropped by 51%.

Dr. Whitmore also updated Council on the successful completion of the Quality Improvement pilot and described how the College significantly increased public and patient engagement.

Strategic Plan KPIs

Council discussed and approved draft Key Performance Indicators (KPIs) for the 2020-2025 Strategic Plan. The KPIs are designed to demonstrate progress against the following strategic priorities: Right-Touch Regulation; Quality Care; System Collaboration; Meaningful Engagement; and Continuous Improvement.

No fee increase

Council voted to approve the 2020 Budget and maintain the current fee of $1,725 for a Certificate of Registration for the 2020 year (for the second year in a row).

Council also agreed to a proposal to no longer charge fees for certificates of professional conduct ($75); wall diplomas ($75); or for making name changes on the College register ($25). This proposed by-law is not in effect until the by-law is ratified at the March Council meeting.

The Council of the College of Physicians and Surgeons of Ontario proposes to make the following By-law No. 132, after circulation to stakeholders:

By-law No. 132 (1) 
Sections 14, 15 and 16 of By-Law No. 2 (the Fees and Remuneration By-Law) are revoked.

Council Elections

In an effort to improve the elections process and enhance member engagement, Council approved two by-law changes.

Council voted to move the elections from October to late spring. It is believed that this change in timing would result in a number of anticipated benefits. Significantly, it would enable the incoming Council member(s) to have more time to arrange their schedules to accommodate the four Council meetings and Committee schedules for the upcoming year. It would also provide more opportunity for orientation of incoming Council member(s) and for their participation on Council and on committees. This by-law is now in effect.

Council also approved circulating a by-law that proposes the the 14-day recount period be shortened to three business days. With electronic elections, a long recount period is not necessary. This will enable earlier communication of the results to members after election day.

The Council of the College of Physicians and Surgeons of Ontario proposes to make the following By-law No. 134, after circulation to stakeholders: 

By-law No. 134 
(1) Section 21 of the General By-law is revoked and the following is substituted:

Recounts

21. 
    (1) A candidate may require a recount by giving a written request to the registrar no more than three business days after the date of an election and paying a fee of $500. 
    (2) The registrar shall hold the recount no more than thirty days after receiving the request.

Boundary Violations

Council has approved the Boundary Violations policy, which sets out the College’s expectations for physicians related to establishing and maintaining appropriate boundaries with patients, including both sexual and non-sexual boundaries.

The policy generally maintains the expectations set out in the consultation draft; however, some revisions have been made. For example, an expectation was added which requires physicians to obtain consent before proceeding with an examination of a patient. The companion Advice to the Profession document provides additional information about how this expectation can be discharged. In particular, it explains that the process is not meant to be burdensome and can include a concise explanation of what the exam will entail in order to promote patient understanding. Several changes were also made regarding the presence of third parties during examinations.

Many of the changes requested during the consultation are now reflected in the policy’s Advice to the Profession document, including clarifications about non-sexual boundary violations.

We have two articles about the policy in the upcoming issue of Dialogue.

Prescribing Drugs

Council approved the Prescribing Drugs policy, which sets out the College’s expectations for physicians when prescribing drugs or providing drug samples to patients.

The expectations were generally well received by external stakeholders during the consultation.

Among the updates made to the revised policy, physicians are now required to include their CPSO number on all new prescriptions.

In addition, an Advice to the Profession document has been drafted to accompany the policy This advice documents includes content to support physicians in meeting their professional obligations in key practice areas, including:

• “safer supply” opioid prescribing,
• accessing patients’ electronic prescription histories,
• considering prescription drug costs,
• the use of prescribing contracts (also known as “treatment agreements”),
• reporting adverse drug reactions or medication incidents, and
• prescription drug

We have an article about the policy in the upcoming issue of Dialogue.

Disclosure of Harm

Council approved the Disclosure of Harm policy, which articulates the College’s expectations of physicians for informing patients when harm – or potential harm - is sustained in the course of receiving health care.

The policy retains the spirit and intention of the expectations that were circulated for consultation. The changes made in response to feedback were primarily aimed at enhancing the clarity and specificity of the policy’s expectations.

Additionally, the Advice document includes content as requested through the consultation, including:

• clearer and more examples of harmful, no-harm, and near miss incidents;
• additional guidance about how to identify no-harm incidents; and
• clarification about the relationship between the policy’s expectations and the critical incident regime under the Public Hospitals Act

We have an article about the policy in the upcoming issue of Dialogue.

Preliminary consultations

The College’s Third Party Reports and Medical Expert: Reports and Testimony polices are currently being reviewed. These policies set out expectations for physicians who complete or prepare third party reports, conduct independent medical examinations and provide medical expert reports and testimony. Please visit the dedicated consultation page for additional information and provide your feedback by February 9, 2020.

The College’s Professional Responsibilities in Undergraduate Medical Education and Professional Responsibilities in Postgraduate Medical Education policies are also currently being reviewed. These policies set out expectations for physicians who are supervisors for medical students and/or postgraduate trainees, postgraduate trainees, and the most responsible physician in environments where there are medical students and/or postgraduate trainees. Please visit the dedicated consultation page for additional information and provide your feedback by February 9, 2020.

Check out e-Dialogue!

Our first online Dialogue will soon be live. The digital version is for those of you who prefer to read your regulatory news on your computer screen at home or on your mobile devices, while on the go. Our goal is to make e-Dialogue a compelling interactive experience for you.

For those of you who prefer to receive a print version of Dialogue in your mailbox, no worries. The print version is being done in parallel with the online version. Eventually, we will be able to provide you with the opportunity to choose which version you would prefer to receive.

We are excited about this change and we hope you are too!