In this issue: March 2017

• Patient Notebook
• Looking at Bill 87 – The Protecting Patients Act
• New CPSO public information video
• Public Consultation: Uninsured Services - Billing and Block Fees
• Just so you know: Medical Marijuana update 

Patient Notebook 

You and Your Medical Records

From time to time, patients call us with questions about their medical records. The most common questions are about who owns the medical record — you or your doctor — and whether or not patients are entitled to a copy of their record.

So, who owns your medical record? Well, the physician is the “custodian” of your medical record and he or she has a legal obligation to keep it for a specified period of time — generally 10 years from the date of the last entry. While this in essence does make the physician the ‘owner’ of your record, he or she is not allowed to share the information in your medical record with a third party without your consent or unless the physician has a legal obligation to share the information.

As the patient, however, you are entitled to ask for and receive a copy of your medical record. The most frequent reason why you might want to have a copy is when you leave the care of one physician and want to provide the new physician with your medical history.

Doctors are allowed to charge a reasonable fee for copying and providing you with the record, as this service is not covered by OHIP, but the physician must advise you of the fee in advance. Asking you to pre-pay the fee is allowed as long as withholding the chart does not impact your health and safety.

When you need a copy of your medical record, submit your request in writing to your physician. He or she has 30 days in which to respond. Your doctor will let you know if he or she is having any difficulty facilitating your request and, if this is the case, another 30 days is permitted to complete the task.

There are a few limited circumstances where a doctor may refuse your request, as outlined in s. 52 of the Personal Health Information Protection Act . In such circumstances your doctor is expected to clearly explain the reasons to you.

You can learn more about accessing your medical records by reviewing our Medical Records policy. If you have any questions about your medical record or any other aspect of your medical care, call or email our Advisory Services Department at feedback@cpso.on.ca or 416-967-2600 ext. 603. We will be pleased to talk to you.

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Looking at Bill 87 – The Protecting Patients Act

In December, the provincial government introduced  Bill 87, the Protecting Patients Act. The Bill is an important piece of legislation that proposes changes to the Regulated Health Professions Act, the legislation that provides health colleges with the authority to regulate health professions in the public interest.

Bill 87 contains amendments to strengthen the legislative provisions relating to sexual abuse and transparency as well as changes to enhance the complaints, investigation and discipline processes. The Bill also contains significant new ministerial powers via new regulation-making authority.

The College is generally supportive of the intent and overall objectives in Bill 87 as many of the proposed changes we previously recommended as a way to strengthen the protection of patients from sexual abuse. As well, the Bill’s provisions regarding transparency are consistent with action the College has already taken.

As with any new government legislation, there are some aspects of the Bill that we think can be improved in order to better achieve the goal of improved patient protection. You can read more about Bill 87 and our analysis in the March issue of Dialogue. In addition, our recent submission to the Minister of Health and Long-Term Care outlines our concerns and makes recommendations designed to ensure the amendments contained in the Bill will achieve the government’s desired outcome and avoid unintended negative consequences.

We believe strongly that any sexual contact between a doctor and a patient is abuse. Doctor-patient sexual contact is never okay. Supporting patients and protecting them from physician sexual abuse is a priority for the College, and over the past few years, we have taken steps to create more avenues of support for patients. You can read more about the steps we have taken to protect patients and other resources on the Preventing and Dealing with Sexual Abuse pages of our website.

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New CPSO public information video

The Anatomy of a Complaint

A new College video, The Anatomy of a Complaint, reviews the College’s complaints process and how we can help when you have a concern about your doctor.

In the video, our Deputy Registrar, Dan Faulkner, explains what happens when you call us with a complaint or concern, and the different outcomes or solutions that can occur. We hope the information in the video will make it easier for you and your families to understand how the College can help, and make you feel more comfortable about calling us when you have a concern.

Please take a moment to view the video and feel free to share it within your personal network of friends, family and colleagues. We hope you find it useful.

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Public Consultation: Uninsured Services - Billing and Block Fees

We want to hear from you!

Did you know some physicians’ services are not covered by OHIP? What rules and guidelines should doctors follow when deciding to bill patients directly for uninsured services? And should a physician notify you before charging a fee? If you have an opinion on these issues, we want to hear from you!

The College is reviewing our policy concerning physicians’ responsibilities when charging patients for uninsured services. As part of that review, we are conducting a public consultation to get your feedback on our draft, updated policy, Uninsured Services: Billing and Block Fees.

Uninsured services include items such as sick notes for work, the copy and transfer of medical records, medical advice over the phone, and the completion of insurance and/or medical forms. Our current policy requires that physicians charge ‘reasonable fees’ for uninsured services, that, when offering patients a ‘block fee’ (i.e., a lump sum charge to cover a range of uninsured services), patients have the option of paying for services individually at the time they are provided. The current policy also requires that patient decisions regarding how to pay for uninsured services must not affect the patient’s ability to access care.

The draft policy includes changes to strengthen existing expectations, address issues not previously covered and places more emphasis on the importance of clear communication to patients about the fees. The changes are based on feedback from our preliminary consultation and research, as well as recent decisions following complaint investigations that highlight frequent or persistent problems.

Please visit our consultation page to review our draft policy and provide your feedback. You can share your stories or comments on our discussion board, or complete a brief online survey on our draft policy. Remember, the deadline to share your perspective is May 1, 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.

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Just so you know: Medical Marijuana update 

We’ve updated our Marijuana for Medical Purposes policy to match recent changes made to the federal government’s regulations governing the use of medical marijuana.

Under the updated federal regulations, patients needing marijuana for medical purposes can now access marijuana in forms other than dried, including fresh buds and leaves, and cannabis oil. You can also now apply to Health Canada for authorization to grow your own supply of medical marijuana plants, or to designate someone to grow plants for you. As a result of these changes, we revised our policy so that it no longer includes specific references to ‘dried’ marijuana and reflects the new application process.

The revision doesn’t change your physician’s responsibilities when authorizing your access to marijuana for medical purposes – he or she still has to complete a medical document which is effectively the same as a prescription.

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We want to hear from you!