Council Update

March 7, 2014

Council Award to Dr. Keyna Bracken; Consultation Updates; New Consultation; Quality Management Partnership; Other News

Mar 12, 2014

Dr. Keyna Bracken

Council Award Recipient

Dr. Keyna Bracken, a Hamilton FP, is the most recent recipient of a Council Award.

Dr. Bracken is the medical director of the Maternity Centre in Hamilton, a collaborative group of nurse practitioners, family physicians, and a social worker who provide antepartum and postpartum care to pregnant women.

She is also deeply committed to issues of social justice and supporting immigrant and refugee health and has extensive medical experience in the developing world, having worked in Jamaica, Haiti and Tanzania.

Dr. Bracken is also a mentor and role model for family medicine residents during their maternal child rotation at St. Joseph’s Healthcare Hamilton.

“She’s an excellent mentor. She made me want to be a better doctor and also provided me with the guidance and knowledge to reach [higher],” said Dr. Farhan Asrar, who had nominated Dr. Bracken.

Consultation Updates

Providing Physician Services During Job Actions - Policy Approved

Council has approved a policy that specifies College expectations for physicians who may be contemplating and/or undertaking job actions. The policy was returned to Council after it was circulated for external consultation.

The policy, Providing Physician Services During Job Actions states that before embarking on any job action, physicians must consider whether a withdrawal of services is contrary to their professional responsibilities. If they decide that it is not contrary and proceed to a job action, physicians must mitigate the adverse impact of the withdrawal on patients and/or the public.  The policy specifies that during a job action, physicians are expected to provide medical care in instances that are urgent or otherwise necessary to prevent harm, suffering and/or deterioration. This will include ensuring health- care concerns are assessed and appropriately triaged so that urgent and/or necessary medical care can be obtained.

Council noted that the feedback provided during the consultation was thoughtful and contributed significantly to the final product. See revised policy.

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

Transparency Project Amendment – Reinstatement Applications

As part of our transparency initiative, information about Discipline Committee decisions regarding reinstatement applications has been on the public register since late last year. 

A by-law has been passed that will add information to the public register regarding applications for reinstatement that are made by Executive Committee or Council.

Where the application is made by a person whose certificate was revoked or suspended further to disciplinary proceedings, the by-law requires that the date the application will be considered together with the decision be included in the public register.

Where the application is made by a person whose certificate was revoked or suspended further to incapacity proceedings, the by-law requires  that the date the application will be considered together with a summary of the decision be included in the public register (unless the Registrar determines it is in the public interest for the full decision to be included).

Fee Increase of $20 Approved

Council ratified the budget for 2014 after circulating the proposed fee increase to the membership. The modest $20 increase brings the annual fee to $1,570 for most classes of certificates of registration. 

In a comparison of provincial medical regulatory colleges, the CPSO’s fee is in the mid-range. A number of other Colleges across the country have fees several hundred dollars more than the CPSO annual fee.

Colonoscopy Clinics and other Community-based Specialty Clinics

Council has approved an amendment to the College’s general regulation that will see some clinics become subject to oversight from both the Out-of-Hospital Premises Inspection Program (OHPIP) and the Independent Health Facilities (IHF) Program. Currently, the regulation exempts IHFs from the OHPIP. The decision follows a consultation with stakeholders.

The amendment is a response to the provincial government’s proposal to make changes that would see colonoscopy procedures moved out of hospitals into community specialty clinics and making them IHFs to allow them to receive facility-based funding. To date, colonoscopy clinics have fallen within the scope of the College’s OHPIP. Without this regulation amendment, the colonoscopy clinics will no longer be under the OHPIP’s jurisdiction if they become IHFs.

The College is of the view that patient safety would be best protected if there was a dual regulatory model, providing oversight by both the OHPIP and the IHF programs. It would like to see colonoscopy clinics continue to be regulated under the OHPIP.

Once the amendment is approved by government, it will allow facilities to be inspected and assessed under the OHPIP even if they are IHFs. Staff is already working on a process that will minimize any impact of this change on clinics, such as developing a single assessment and an associated fee that meets the needs of both programs.

New Consultation

Physicians’ Relationships with Industry: Practice, Education and Research

Council has approved the draft - Physicians’ Relationships with Industry: Practice, Education and Research – for circulation. We want to hear what you have to say about our draft policy which articulates our guidance in helping you manage your relationships with industry appropriately. 

“Receiving physician and public feedback on all draft policies is of enormous benefit to the final product,” said Dr. Marc Gabel, College President. “And on this particular issue, feedback is absolutely critical. Knowing your considered thoughts on what is reasonable, what is doable and what is in the best interests of our patients will help craft the best possible policy,” he said.

The draft provides guidance on the following topics:  clinical practice, continuing medical education/continuing professional development, consultation or advisory boards/investigator meetings; and industry-sponsored research.

In the draft, industry includes the full range of commercial enterprises associated with health care. These include, but are not restricted to, the pharmaceutical industry, the biotechnology industry, the medical device industry, and commercial providers of services related to clinical practice, research and education.

Industry has a valuable and legitimate role to play in the practice of medicine. The interests and responsibilities of industry, however, are not always aligned with the professional and legal obligations of physicians. As a result, physicians may find themselves facing ethical dilemmas or potential conflicts of interest stemming from their relationships with industry. Therefore, the expectations set out in the policy were developed to enable physicians to uphold their professional responsibilities and to ensure that a patient’s trust in his or her physician is maintained.

Please read the draft policy and provide your feedback. The draft policy is also the cover story for the next issue of Dialogue.

Quality Management Partnership

Phase One Report

Council reviewed and supported a preliminary draft report on the first phase of the work conducted by the Quality Management Partnership (QMP) of the College and Cancer Care Ontario.

The mandate of the QMP is to establish a framework that sets out an integrated set of performance standards and quality measures at the provider, facility and systems level in mammography, colonoscopy and pathology. The goal is to improve the safety of care, improve the consistency of the care regionally, ensure patient-centred care and improve access.

As part of this initiative, the partnership is working collaboratively with physicians, allied health-care professionals, patients, health-care facilities, and provincial organizations.

The report contains early quality initiatives that can begin this year and move Ontario toward quality management partnerships in each service area. The report also includes associated funding requests with each initiative.

The document will be submitted to government at the end of March for review.

We have an article about the early quality initiatives in the next issue of Dialogue. 

Other News

Release of CPSO Data

Council confirmed its support of having the College continue to share its data with external parties for the purpose of improving quality care, health systems and regulatory processes and outcomes. The College has a responsibility to contribute to health systems issues.

Currently, the College receives a number of requests from different agencies requesting on such matters as physician demographics, and complaint trends, for example. These requests may come from groups such as disease-based advocacy organizations, provincial research organizations, and municipalities wishing to recruit physicians.   

Dan Faulkner, Deputy Registrar, told Council that its current policies and approach to the release of data has addressed the concerns that were most prominent when the College developed its policies in 2002. However, the type of data requests that are now being received by the College are different, and the policies may not be the best means of addressing them. There is a strong belief that the College can make enhancements to current practices so that we are able to respond to such requests for data in a transparent, consistent and timely manner. The issues will be considered further at the next meeting of Council.   

Choosing Wisely Canada

Is there a test that you order simply because your patients expect it? 

Well, you are not alone.  And for that reason, an educational campaign will be launched next month to kick start conversations between physicians and patients with the goal of avoiding ordering tests and procedures that may be unnecessary and in some cases, even harmful.

Dr. Wendy Levinson, who is spearheading the Choosing Wisely Canada campaign with the Canadian Medical Association, provided Council with an overview of the campaign. Physicians and their professional societies have been enthusiastic about the initiative.  Each society is encouraged to come up with a list of five tests, treatments or procedures in their own discipline for which there is excellent evidence of overuse and harm.

Don’t miss our interview with Dr. Levinson in the next issue of Dialogue.