Council Update

September 8-9, 2016

100th Physician Honoured with Council Award; Council responds to Sexual Abuse Task Force recommendations; CPSO Consultations; By-law Amendments Approved; Safeguarding our Communities Act (Patch for Patch Return Policy)

Sep 14, 2016

100th Physician Honoured with Council Award

Dr. Martin White of Carleton Place

At its September meeting, the College presented its 100th Council Award. The deserving recipient was Dr. Martin White, a general practitioner from Carleton Place, Ontario.

Dr. White has practised medicine in Carleton Place for more than 40 years, and whether he is treating patients in his private practice, working as the hospital chief of staff, supporting colleagues in the operating theatre or investigating deaths as the local coroner, Dr. White serves his rural community with compassion, humour, sincerity and dependability.

Over the past 40 years, much has changed in how health care is delivered in Carleton Place, and in the neighboring town of Almonte, due in no small measure to Dr. White's efforts. He was instrumental in the development of a partnership between Carleton Place and Almonte that saw the communities combine resources and expertise, and improve clinical services in chronic care. He led the joint steering committee to improve regional wait times and adopt new provincial standards for access to care. He has also led, supported or guided numerous quality improvement and research initiatives with a view to ensuring any initiative measured up to providing the best care for patients and added value to patient care in the rural environment.

As Chief of Staff at the Carleton Place and District Memorial Hospital, Dr. White was commended for his focus and passion for physician education, coaching and mentoring which enhanced a learning culture among the medical staff.

"His honesty, integrity, caring and provision of excellent medical care in over 40 years of his medical career is and has been an inspiration to all his colleagues," said Dr. Roger Drake. "He is regarded by those who work with him with much love and affection. He has managed to balance family life, a busy family practice and many night calls as the local coroner with incredible skill. He is a wonderful teacher and mentor not only to medical students and residents but also to colleagues who continue to seek his counsel with challenging patients."

An interview with Dr. White appears in the upcoming Dialogue.

Council responds to Sexual Abuse Task Force recommendations

At its meeting, Council discussed some of the key recommendations from the Minister of Health and Long-term Care's Sexual Abuse and Task Force report, which had been just released several hours earlier.

The task force was given the mandate to "examine the existing legislative scheme under the RHPA and provide advice and recommendations with respect to modernizing and reinforcing the province's ongoing commitment to a zero tolerance policy for the sexual abuse of patients by regulated health professionals".

The report contains 34 recommendations, and while Council fully supported or supported in principle many of the recommendations, it did oppose one key recommendation.

Specifically, Council opposes the report's recommendation to remove from all health regulatory colleges their jurisdiction over all responses to sexual abuse of their members and move to a new centralized agency/independent body for public education and complaints investigations. Council believes that the College's extensive experience, grounded in many years of investigating and holding hearings into physician sexual abuse, is too valuable to be abandoned. The College has a specialized team of investigators and prosecutors; it investigates sexual abuse complaints thoroughly, and prosecutes these cases vigorously. It is the College's goal to have the most effective investigative and discipline system in place to empower patients and protect them from sexual abuse.

"We will work with government and our health-care partners to build on and improve the existing legislative and regulatory system to ensure patients are protected from sexual abuse by physicians," said Dr. Joel Kirsh, College President. "We do not believe that the creation of a new agency will result in a better experience for patients or in better outcomes for the public," he said.

There are several recommendations where the College's position is to "support in principle". For these recommendations, the principle behind the task force's recommendation is consistent with the College's objectives regarding the issue of sexual abuse, such as enhanced protection of patients, zero tolerance of sexual abuse, but the College doesn't believe the mechanism proposed by the Task Force is the best way to achieve the objective.

We will continue to review the Minister's Task Force report carefully and we will work with government and our health-care partners to build on and evolve the existing legislative and regulatory system to ensure patient protection. For more information, please see the CPSO news release; backgrounder; and MOHLTC news release.

CPSO Consultations

College Oversight of Fertility Services - Regulation Change Proposal

Last year, the Ministry requested the College's participation in establishing a quality and inspections framework for the fertility services sector.

At its meeting, Council reviewed draft amendments that would allow the College to enter and inspect premises where fertility services are performed. The draft regulation is now circulated for external consultation.

In December 2015, the government launched its newly expanded government-funded fertility program. This program funds one cycle of in vitro fertilization (IVF) per patient under age 43, per lifetime for all forms of infertility. Funding for unlimited cycles of intra-uterine insemination (IUI) and one fertility preservation (FP) cycle for medical reasons are also being provided. Currently, there are 52 clinics in the province that have received funding for the government's program through a Transfer Payment Agreement (TPA).

The College's oversight, however, will apply to all facilities that offer fertility services, regardless of whether they are receiving funding under a TPA.

As with other College inspection programs, this will operate on a cost-recovery program.

The Ministry is hopeful that the quality and inspections framework for fertility services could be in place by early 2017.

Physician and Health Emergencies - Preliminary Consultation

The College's Physician and Health Emergencies policy is currently under review and we would like to hear what you think about its current expectations as part of our preliminary consultation. The purpose of this policy is to reaffirm the profession's commitment to the public in times of health emergencies. Provide your thoughts on the existing policy.

By-law Amendments Approved

Register Content

Following external consultation, Council approved a number of proposed amendments to the register provisions in the General By-law. The amendments fell into two main categories: revisions intended to better reflect current College practices, and corrections and minor improvements of a housekeeping nature.

These amendments did not propose new information to be posted; they reflect information that is already included on the register.

Safeguarding our Communities Act (Patch for Patch Return Policy)

Council considered several elements of work related to the Safeguarding our Communities Act, 2015. This Act establishes a "patch-for-patch" fentanyl return program for Ontario which will require patients who receive prescriptions for fentanyl to return their used patches to a pharmacy in order to receive new ones. It sets out specific requirements for both physicians and pharmacists when prescribing and/or dispensing fentanyl.

Council approved a Fact Sheet, drafted in collaboration between the CPSO and the Ontario College of Pharmacists, which articulates both colleges' general support for the patch-for-patch legislation, and which describes the new requirements for physicians and pharmacists under the Act.

Earlier, the College provided to the Ministry a response in relation to a draft regulation developed under the Act. The CPSO expressed support for the draft regulation, but emphasized that the proposed regulation alone may have a limited effect on the overall incidence of opioid abuse and overdose. The submission recommended specific, proactive strategies to promote a more co-ordinated, system-wide approach to mitigating opioid abuse, including giving physicians greater access to provincial narcotics monitoring data that will help them confirm the patient's prescription history.

Council also approved several housekeeping amendments to the Prescribing Drugs policy which reflect the new legislation, as well as several other recent changes on the opioid front: the release of the CDC's guideline for prescribing opioids, and Health Canada's decision to make naloxone available without a prescription.

An article about the legislation will appear in the upcoming Dialogue.