In this issue: July 2016

• Update on Medical Assistance in Dying
• Updated policy “Physician Behaviour in the Professional Environment”
• New Video Answers Your Questions About Sexual Abuse Investigations
• New Public Consultation on Continuity of Care
• The Council Award: Honouring Outstanding Ontario Physicians
• Happy Birthday, CPSO
• Your Health Confidentiality Matters

Update on Medical Assistance in Dying

CPSO updates policy to match new federal legislation

As a result of the June passage of the federal government’s legislation on medical assistance in dying, the College has updated its own policy to reflect the final language in the federal law.

One of the most significant differences between the College’s final Medical Assistance in Dying (MAiD) policy and our former Interim Guidance document is the inclusion of the federal government’s definition of a grievous and irremediable medical condition.  This definition requires, in part, that to access medical assistance in dying, the individual’s natural death must have become reasonably foreseeable, taking into account all of the individual’s medical circumstances.

In the doctor-patient relationship, doctors must put the patient’s interest before their own. In keeping with this principle, a key feature of our MAiD policy requires that where a physician declines to provide medical assistance in dying for reasons of conscience or religion, the patient must not be abandoned and an effective referral to another physician, nurse practitioner or agency must be provided.

You can read our final policy online along with some Frequently Asked Questions.

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Updated College Policy: Physician Behaviour in the Professional Environment

Last February, we asked for your input as we undertook to update our Physician Behaviour in the Professional Environment policy. The policy is an important one as we all expect our doctors to act with respect and courtesy when treating us and family members, or when interacting with other health care professionals. Unprofessional physician behaviour can have a negative impact on patient safety, health outcomes, and on workplace environments.

After reviewing all the consultation feedback, our policy has now been updated and is posted on our website. The updated policy reinforces that physicians are expected to act in a respectful, courteous and civil manner towards their patients, colleagues, and others involved in the provision of health care. The policy also identifies examples of unprofessional or disruptive behaviour and how it can impact good patient care. Thank you to everyone who took the time to participate in the consultation and tell us their thoughts.

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New Video Answers Questions About Sexual Abuse Investigations

As part of our ongoing efforts to provide effective support to individuals making a sexual abuse complaint about a physician, the College has produced a video that answers some common questions about our process for investigating doctors in these cases.

In the video, viewers are introduced to Pam Greenberg, our Sexual Abuse Intake Coordinator. Pam is the first point of contact for anyone wanting to make or thinking about making a sexual abuse complaint. In addition to outlining the investigation process, Pam also explains her role in providing complainant and witness support during the investigation.

This video is the most recent step in our ongoing efforts to enhance the support we give and the resources available to those making a sexual abuse complaint. If you have any questions about the sexual abuse complaints process, please go to our website which has information on the investigation process as well as other educational and support resources.

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New Public Consultation on Continuity of Care 

The College is in the early stages of developing a new policy on continuity of care and we want to hear from you.

Continuity of care is about patients enjoying a coordinated and continuous level of medical care that is consistent with their medical needs. Delays in receiving important tests, difficulties contacting your treating physicians, confusion regarding how to book appointments or where to seek care outside of normal operating hours, and poor communication between your treating physicians, patients, or other healthcare providers are just some of the issues in continuity of care that may negatively impact your safety or the quality of care you receive.

As we begin the work to develop this new policy, we would like to hear your thoughts and suggestions. In particular we are asking physicians, the public, and other health care stakeholders:

• What does continuity of care mean to you?
• What are the problems currently faced in ensuring continuity of care for patients?
• How can we overcome these problems?
• What role can the College play in overcoming these problems?

Please visit our Continuity of Care consultation page for more information and to provide your feedback. You can share your stories or comments on the discussion forum, send your comments via email, complete the online survey, or send your comments via regular mail. The deadline to share your point of view is August 12, 2016.

And please do take the time to visit our general consultation page to find out about all the public consultations currently under way.

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Call for Nominations: The CPSO Council Award

Do you know an outstanding physician in your community?

The College of Physicians and Surgeons (CPSO) is now accepting nominations for the 2017 Council Award. The Council Award honours outstanding Ontario physicians who have demonstrated excellence and embody society’s vision of an “ideal physician”.

The criteria for selecting a physician for the Council Award is based on the eight “physician roles” identified by Educating Future Physicians of Ontario. The eight point selection criteria are outlined in the award brochure.

Through the award, the College honours Ontario physicians whose performance in each of these roles is outstanding, recognizing that individual physicians will demonstrate more extensive expertise in some roles than in others. Four awards are presented each year, one in each of the following categories: Academic Specialty, Community Specialty, Academic Family Practice and Community Family Practice. You can read about our most recent Council Award recipient online.

If you know of a physician who meets the selection criteria, please nominate him or her for the Council Award. The deadline for receipt of nominations is October 3, 2016.

For further information, please contact Tracey Sobers at 416-967-2600 or 1-800-268-7096 extension 402.

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Happy 150^th Birthday, CPSO!

We’re very excited that 2016 marks the College’s 150^th birthday. Many of you will not know that the CPSO — which held its first meeting on May 2, 1866 – actually predates Confederation. Back then, we were known as the General Council of Medical Education and Registration, and it was our responsibility to regulate the handful of doctors spread across the province of Ontario.

Of course, our mandate and focus have changed a lot since those days. For much of the 20^th century, the College operated with the view that a medical degree from a recognized institution was sufficient to practise medicine dependably. We licensed qualified doctors, prosecuted unlicensed individuals, and disciplined members who had violated professional standards. That mandate began to expand starting in the 1970s and 80s, when the focus shifted towards ongoing competence of Ontario’s physicians through continuing professional education, assessment, and remediation.

To celebrate our birthday, we created a special section of our website about the College’s history. On May 28 and 29, we participated in Open Doors Toronto where members of the public were welcomed into our headquarters at 80 College St. to see an exhibit that traced the history of the CPSO and a display of historic artefacts related to the College’s beginnings and place in Ontario.

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Your Health Confidentiality Matters

Your personal health information is just that — it’s personal and by law belongs to you. It shouldn’t be known by anyone who is not involved in your care. When dealing with your physician, you can trust that he or she will treat the information, and you, with great care and respect.

Personal health information includes anything that identifies you: your health history, past care, test results, health number, payment or eligibility details, long-term care plans, and the name of a substitute decision-maker. This covers information collected in written or electronic form, or orally.

Maintaining confidentiality and privacy is a legal and professional obligation for physicians and all health care providers — and it’s also part of being an effective caregiver. When patients know their information is secure, they are likelier to be more open and supply what’s needed to obtain the best advice from their health care professionals.

Confidentiality and privacy are among the standards all health care providers are expected to meet and maintain. Our care providers are health information ‘custodians’ and they need the consent of patients before sharing that information.

Sometimes consent is implied as your doctor can assume it’s okay to share your information with additional members of your care team, for the purposes of providing care. Other times, you have to give express consent to share your personal health information beyond your circle of care.

Only in specific circumstances can health information custodians provide that information to a third party without consent. This includes situations where disclosure is mandatory, like managing risk (such as reporting a concern about child endangerment to the Children’s Aid Society) or legal proceedings (when a summons, subpoena or court order requests patient records).

Health care professionals should also ensure that other staff, patients, or clients don’t overhear conversations that involve your information and they must never look at the personal health information of patients who are not in their care.

Protecting confidentiality is important outside the walls of care too. For instance, your doctor should never talk about your personal health information in public areas and must exercise caution when leaving a message or sending an email since others might be able to access it. Relationships with health care professionals are based on trust — and ensuring privacy with respect adds to that trust.

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We want to hear from you!