Council Update

March 6, 2015

Dr. Rosemary Moodie, Council Award Recipient; Two Policies Approved; Fees and Remuneration By-law; External Reviews of the College; Quality Management Partnership Report

Mar 11, 2015

Dr. Rosemary Moodie

Neonatologist presented with Council Award

Dr. Rosemary Moodie, who has cared for critically ill infants for two decades as a neonatologist and dedicated her life to alleviating poverty and empowering girls and women, was presented with the Council Award.

Dr. Moodie graduated from medical school at the University of the West Indies in Jamaica. She did an internship in the Caribbean, and then arrived at the Hospital for Sick Children in Toronto to do a residency in pediatrics in 1987. After completing a fellowship in neonatology there, she went on staff and was recognized for 25 years of outstanding service in 2012.

She has led multidisciplinary teams with evidence-based practice and is a passionate breastfeeding advocate and researcher because she understands its impact on future health, particularly for premature infants.

Dr. Moodie now divides her time between consulting for Sick Kids International and working in a community-based practice with six other pediatricians in Rexdale.

One of those pediatricians, Dr. Sylvie Bergeron, who has worked with Dr. Moodie for the past five years, nominated her for this award.

"Not only is she an exceptional doctor, but I find she is very charming and well-rounded. She truly believes in helping people who are less fortunate," Dr. Bergeron said.

Two Policies Approved

Professional Obligations and Human Rights

Council voted to approve a policy which articulates physicians' existing legal obligations under the Ontario Human Rights Code and the College's expectation that physicians will respect the fundamental rights of those who seek their services.  

The Professional Obligations and Human Rights policy underwent two extensive consultations. In total, close to 16,000 responses were received. Of particular interest among physicians, organizations, members of the public and media is the section of the policy that addresses the College's expectations in circumstances where physicians limit the services they provide for reasons of conscience or religion. Such objections are commonly referred to as conscientious objections.

The policy requires that physicians, who are unwilling to provide certain elements of care due to their conscience or religious beliefs, refer the patient to another health-care provider.  This referral must be an 'effective referral', meaning a referral that is made in good faith, to a non-objecting, available and accessible health-care provider.

In response to feedback received during the consultation, the referral requirement was expanded to allow physicians to also refer the patient to an agency that will coordinate and/or provide the treatment or service to which the physician objects.

Council was of the opinion that the referral requirement strikes an appropriate balance between physician and patient rights, while ensuring patient access to care is not impeded.

The policy is available online, and will be published with an article in the next issue of Dialogue.

Marijuana for Medical Purposes

Council has approved a policy that sets out expectations for those physicians who prescribe dried marijuana for medical purposes.

The policy was developed in light of new federal regulations that have significantly altered the legislative framework governing patient access to dried marijuana. Under these regulations, physicians have primary responsibility for the decision to authorize patient use of dried marijuana for medical purposes. Physicians enable patients to access a legal supply of dried marijuana by completing a medical document that functions like a conventional prescription.

In response to consultation feedback, key revisions were made to the policy. These include: adding references to provide physicians with the most current and reliable information on the medical use of dried marijuana; explicitly stating that physicians are not obligated to prescribe dried marijuana if they do not believe it is clinically appropriate for their patient; adding expectations for physicians who wish to prescribe dried marijuana to patients under the age of 25; and stating that physicians must discontinue prescribing if dried marijuana fails to meet the physician's therapeutic goals or the risks outweigh the benefits.

The policy is available online, and will be published with an article in the next issue of Dialogue.

Fees and Remuneration By-law

Amendment approved

Council has approved a by-law that will see members pay a fee when they apply to modify the terms, conditions or limitations of their certificate of registration imposed as a result of a registration proceeding.

A fee totaling 50% of the application fee will be charged to a member requesting such a change. This fee is equivalent to 25% of the annual membership fee. In 2015, the fee would be $392.50.

The College has not previously charged members for an application to modify the terms, conditions or limitations of a certificate of registration. However, the Registration Committee recommended this fee be implemented due to the increasing volume of requests and the amount of time involved in processing such requests. In 2013, the Registration Committee reviewed more than 450 requests from physicians for amendments to their certificates of registration. This is almost double 2012's annual total of 276 amendments. The time taken to prepare and review amendment requests is approximately 66% of the time that is involved in reviewing and processing a new application for a certificate of registration.

External Reviews of the College

Council was updated on the status of four different initiatives which have recently been established by the Ministry of Health and Long-Term Care that impact the CPSO.

The four initiatives are:

1. Transparency
In 2012, we began a multiphase initiative to review how the College could make more physician-specific and process information available to the public on our website. The consultation is ongoing and feedback can be provided until April 1, 2015. In early December, in response to a request from the Minister, we sent the Ministry a letter detailing our initiative and planned activity. The Minister has not responded to our letter. In the upcoming issue of Dialogue, there is an article that addresses the dominant themes arising from the ongoing consultation of Phase 2 of the initiative.

2. Sexual Abuse Review
A task force has been appointed to review of our governing legislation to ensure that existing legislative measures, designed to prevent and deal with the sexual abuse of patients by regulated health professionals, are appropriate and effective. Council has directed a review into our practices and processes relating to sexual abuse and an overview is provided in the upcoming issue of Dialogue.

3. Goudge Review of CMPA/CPSO processes
Hon. Stephen Goudge will develop recommendations by which the process used to deal with complaints about physicians to the CPSO can be streamlined to permit decisions to be made more efficiently and cost-effectively.

4. OHP/IHF Review by Health Quality Ontario (HQO)
An expert panel has been asked to provide advice to Health Quality Ontario (HQO) on the current quality oversight programs for non-hospital based premises. Given its longstanding role in facilities regulation and oversight, the CPSO was invited to provide a submission to the panel, expressing its thoughts and recommendations for the future of facilities regulation. In the upcoming issue of Dialogue, we discuss the submission that the College has provided to Health Quality Ontario for its review. The submission describes our experience regulating out-of-hospital facilities and puts forward a proposal for a single regulatory framework for oversight of these facilities.

Quality Management Partnership Report

Council approved the final report of the Quality Management Partnership. The report puts forward recommendations for the development of provincial quality management programs for colonoscopy, mammography and pathology services in Ontario.  
Working closely with physicians, other health-care professionals and organizations, the College and our partner in this initiative, Cancer Care Ontario, made recommendations for the design of quality management programs that rely on the collection of data and leverage existing quality initiatives where possible, remove duplication, address inconsistencies and fill gaps.

The report will now be submitted to the Ministry of Health and Long-Term Care.