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Patient Compass

In this issue: October 2015

Our quarterly magazine contains important updates on policies, topics of interest, as well as a summary of recent disciplinary findings.
Read the latest issue here.

**Correction: An earlier version of this newsletter contained an error with regard to direction on “Do Not Resuscitate” orders under the Planning for and Providing Quality End-of-Life Care Policy.

End-of-life care policy gets green light

We believe providing quality care should encompass the entire span of patients’ lives, including at the very end of their lives. Quality end-of-life care aims to reduce suffering, respect the wishes of patients, and lessen conflict and distress.

To provide guidance to physicians in assisting patients to identify meaningful and realistic goals of care that are compassionate, respectful and aligns with their values and beliefs, our Council has approved the Planning for and Providing Quality End-of-Life Care Policy. It replaces the Decision-making for the End of Life Policy. The former policy was reviewed under the College’s regular policy review cycle and underwent an extensive public consultation.

In the draft version of the policy, there was a requirement that consent be obtained for a no-CPR order. This requirement has been revised. The final policy emphasizes good and effective communication and a robust conflict resolution process. In particular, physicians are required to engage patients or substitute decision-makers in a discussion before writing a no-CPR order and engage in conflict resolution if the patient or substitute decision-maker disagrees and insists that CPR be provided.

Should the patient arrest, while conflict resolution regarding a no-CPR order is underway, the policy requires physicians to provide CPR in good faith and using their professional judgment. In accordance with a recent Supreme Court of Canada decision, the policy requires physicians to obtain consent in order to withdraw life-sustaining treatment.

For more information on the College’s Planning for and Providing Quality End-of-Life Care Policy visit our Planning for and Providing Quality End-of-Life Care page and read the article in Dialogue.

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Council takes major steps on sex abuse 

Protecting patients from physician sexual abuse has always been a priority for us. Council made several decisions and recommendations to bolster our ability to protect victims of physician sexual abuse and ensure they are well supported during the College’s investigation and discipline process.

This includes a number of proposed changes to strengthen the Regulated Health Professions Act (RHPA), the legislation that gives us the authority to take action to protect patients.

For example, we have asked that the legislation be changed so a physician would be prevented from practising medicine when they have been found to have sexually abused a patient.  A doctor’s license in such a case would be automatically revoked. Currently under the legislative framework, mandatory revocation of is only for certain acts of sexual abuse. For sexual abuse that does not involve these acts, the penalty is at the discretion of the Discipline Committee.

Council also approved giving the Discipline Committee the discretion to specify a period between one and five years before a physician can reapply to the College for a license after being revoked for sexual abuse, sexual impropriety or other findings of professional misconduct. The current mandatory period is five years.

Other actions included:

For more information on the College’s sexual abuse initiative, visit our Preventing and Dealing with Sexual Abuse page and read the article in Dialogue.

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Spotlight on physician-assisted dying

A topic that has garnered a lot of media attention in recent months is the Supreme Court of Canada’s landmark ruling earlier this year on physician assisted death. In Carter v Canada the Court found that the Criminal Code provisions that prohibit physician-assisted death are constitutionally invalid, in circumstances where a competent adult:

  • Clearly consents to the termination of life; and
  • Has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

We support the establishment of the provincial-territorial expert advisory group and the launch of a broad public consultation on physician assisted dying and end of life care that was announced by Ontario’s Minister of Health. These issues are extremely important and we need to clearly understand public views and expectations.  The results of this work will inform our guidance to the medical profession and ensure patients and their families have the information they need to make decisions that are right for them at the end of life. 

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Have your say!

The College welcomes your feedback on several open policy consultations. Public feedback is extremely helpful in shaping policies that govern the delivery of quality care. The deadline to provide feedback is November 20.

  • Rights and Responsibilities: What to Expect During Medical Encounters

This is a draft Rights and Responsibilities document for patients to use as a resource.  It contains information regarding: what patients can expect from their physician during medical encounters, what rights they have as a patient, and how we can help if they have questions or concerns about something their doctor said or did. Visit the dedicated consultation page to view further information and provide your feedback.

  • Preliminary Consultation on Block Fees and Uninsured Services Policy

Did you know that we have a policy on what doctors can charge patients for services? We are inviting comments on the current Block Fees and Uninsured Services policy at this early stage of the review process to help determine what changes may be required. Once a revised draft policy has been developed, we will invite feedback on the draft before it is considered for final approval by our Council.

  • Revised Blood Borne Viruses Policy

This draft policy sets expectations for physicians who perform or assist in performing procedures that may expose them or patients to viruses in blood, such as Hepatitis B, Hepatitis C and HIV. The aim is to reduce the risk of acquiring or transmitting these viruses.

The most significant proposed change in the draft policy pertains to routine testing. The draft policy changes the requirement for HIV testing and HCV testing from every year to every three years.

It strongly recommends that physicians be immunized for HBV and tested to confirm the presence of an effective antibody response. Annual testing for HBV is only required for those physicians who have not been confirmed immune to HBV. Read more.

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Your College by the numbers

Did you know:

  • We licensed 4,667 doctors last year – a 5% increase over the previous year.
  • 40% of newly registered MDs are International medical Graduates representing 108 different countries.
  • 80% of physicians randomly chosen for an assessment were found to be satisfactory.
  • 94% of Independent Health Facilities (IHFs) passed their inspection.
  • We handed down 2,660 decisions following public complaints.
  • 37 Physicians were referred for a hearing before the Discipline Committee.
  • There 8 million visits to our website.
  • Our Public Advisory Services logged 60,850 calls.

You can read more interesting tidbits in the Infographic of our Annual Report which includes links to the dynamic PDF for further detail.

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We want to hear from you!

The College relies on feedback from the public, as well as the profession, to formulate policy. Please take a few moments to comment on our open consultations.
View our active consultations.
Learn more about the College’s consultation process here.
Join our mailing list and receive notification of all future policy consultations.

For general inquiries or to make a complaint, contact our Public Advisory Service:
Toll Free: 1-800-268-7096 Ext. 603
Copyright © 2015 College of Physicians and Surgeons of Ontario, All rights reserved.

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