In this issue: July 2017

• Announcing the New Ontario Health Regulators Website!
• New National Opioid Guideline
• Naloxone Kits Available in Pharmacies
• Public Consultation: Confidentiality of Personal Health Information
• Two New CPSO Policies You Should Know About

Announcing the New Ontario Health Regulators Website!

The Federation of Health Regulatory Colleges of Ontario (OHR) has launched www.ontariohealthregulators.ca, a one-stop gateway to the websites of all the health regulators in Ontario. From the website, you can find the most trustworthy, relevant, and up-to-date information about the health colleges and the professionals they regulate.

This new website provides easy-to-access information and resources on regulated health professionals, all in a single place. From this site, visitors can access the registers of all 26 colleges, find a health professional, and see important information about a health professional’s registration and discipline history.

The site also contains a variety of articles to help health care consumers make the most of their care and time with regulated health professionals. The information on this site is available in 10 languages.

Please visit the site and let interested friends or colleagues know about the useful information and resources it contains.

Back to top

New National Opioid Guideline

Updated standards to help your doctor prescribe opioids safely

In response to the public health crisis surrounding the use of opioids, governments and health professions worldwide are re-evaluating the role and limitations of opioids in the management of chronic non cancer pain.

The recently released 2017 Canadian Guideline for Opioid for Chronic Pain urges doctors to take a more conservative approach to prescribing opioids. Patients who are prescribed opioids for non-cancer pain should speak to their doctor to discuss how the new guideline may affect their treatment. Evidence points to the fact that opioids should not be the first line of therapy in chronic pain, and many of the recommendations in the guideline focus on optimizing other non-opioid therapies and significantly restricting the daily limit of opioids to a dosage much lower than in the previous guideline.

As we now know that high doses of opioids over long periods may in fact worsen patients’ symptoms and can sometimes lead to addiction, the guideline also includes some information for patients about tapering to help you understand why and how your physician may choose to begin gradually reducing your dosage.

If you have any concerns about your opioid therapy, please talk to your doctor. The Institute for Safe Medication Practices (ISMP) Canada also has a lot of information for patients who want to better understand the risks associated with opioid therapy.

It’s important that you know the CPSO is not asking physicians to stop prescribing opioids, but instead to prescribe safely. We believe that prescribing opioids under the right conditions is critical for good patient care.

The College is committed to working with the public and our health care partners to help tackle the opioid crisis. Recently we launched a wide ranging opioid strategy with the goal of (a) facilitating safe and appropriate opioid prescribing by physicians to patients; (b) protecting patient access to care; and (c) reducing risk to patients and the public. You can read more about our opioid strategy in the most recent issue of Dialogue.

Naloxone Kits Available in Pharmacies

Patients at high risk of overdose are encouraged to obtain a naloxone kit and speak to their loved ones about signs of overdose.

Naloxone is a drug that can temporarily reverse the dangerous effects of an opioid overdose. When someone overdoes on opioids, injecting naloxone can help to restore consciousness and normal breathing, as well as reduce other symptoms like hypertension to allow time to transfer to the hospital.

Naloxone kits are available free of charge and without a prescription from pharmacies across the province. You can find more information about naloxone and the location of pharmacies in your community that carry the kits by visiting the Ontario government’s website.

If you, a friend or a loved one is on opioid therapy, talk to a doctor about overdose risk and the benefits of having a naloxone kit. 

Back to top

Public Consultation: Confidentiality of Personal Health Information

We want to hear from you!

When we visit the doctor, we talk about our most private and intimate details, and we trust that what we share will remain confidential. The CPSO policy Confidentiality of Personal Health Information sets out physicians’ legal and professional obligations in maintaining patient confidentiality. It emphasizes that physicians need your consent to disclose your private information and it outlines those limited circumstances where a physician is allowed or required by law to disclose personal health information.

The College is reviewing our policy in light of recent changes to the provincial Personal Health Information Protection Act 2004. We also want to ensure the policy is clear, informative, and reflective of the privacy and confidentiality issues that often arise in medical practice. As part of that review, we are conducting a public consultation to hear feedback on the current policy and suggestions for improvement.

We would welcome your input. Patient confidentiality is a crucial part of the doctor-patient relationship, and your feedback will help ensure that our policies continue to meet your needs and expectations.

Please visit the consultation page and tell us your thoughts. The consultation closes on July 31, 2017.

The College regularly conducts public consultations to obtain feedback from the public and physicians on new and revised policies, as well as existing policies that are under review. You can keep up with all current consultations, submit your comments and review all the feedback received by visiting our consultations page.

Back to top

Two New CPSO Policies You Should Know About

Accepting New Patients

Finding a new doctor can be a challenge and you may wonder how doctors decide when to accept new patients into their practice. The CPSO’s updated Accepting New Patients policy tells doctors they must use the first-come, first-served approach when accepting new patients into their practices. Exceptions to the rule include prioritizing higher needs/complex patients and the family members of current patients. Some doctors use “meet and greet’ appointments and medical questionnaires to better understand a patient’s needs, however, the policy clarifies that these tools can only be used after a patient is accepted into the practice and not as a way to vet prospective patients. You can find out more details about physicians’ responsibilities when accepting new patients by reading the complete policy.

Ending the Physician-Patient Relationship

There are many reasons why you or your doctor may decide that you can no longer be his/her patient. Sometimes the reason is as simple as the doctor’s retirement. However, for other circumstances, the CPSO’s updated Ending the Physician-Patient Relationship provides guidance to physicians on when it is and is not appropriate to end the relationship, and the actions they must take when making this decision.

Discontinuing a physician-patient relationship can have serious consequences for the patient by, for example, limiting their access to care. For this reason, the policy requires physicians to use good clinical judgment and compassion when considering this option and to first make reasonable efforts to resolve the situation that is affecting their ability to provide care in the best interests of their patient.

Examples of situations that may cause a doctor to consider discontinuing the relationship are listed in the policy and include, (a) a significant breakdown in the physician-patient relationship (e.g., disruptive or inappropriate behaviour); (b) the physician wishes to decrease his/her practice size, and (c) the patient being absent from the practice for significant amount of time.

While providing these and other examples, the policy says that each case is ultimately fact-specific and physicians must use their own judgment to determine whether discontinuing the relationship is appropriate. Once the decision to end the relationship is made, physicians are expected to follow several steps including formally notifying the patient of the decision and being as helpful as possible to the patient in finding a new physician or care provider. For more complete details on physicians’ responsibilities, please take the time to read the full policy.

Find a New Doctor
Are you looking for a new doctor? Go to the Doctor Search on out public register to find doctors in your community. Health Care Connect, an Ontario Ministry of Health and Long-Term care (MOHLTC) program, helps Ontarians without a family health care provider find one by referring people to physicians and nurse practitioners who are accepting new patients in their community.

Back to top

We want to hear from you!