February 24, 2017

Dr. Shazia Ambreen Receives Council Award

Dr. Shazia Ambreen, a family physician and GP-Anesthetist at the Stevenson Memorial Hospital in Alliston, received a Council Award for her commitment to patient safety and continuous improvement.

Dr. Ambreen has many roles at Stevenson Memorial: she is an anesthetist, a hospitalist, the Chief of Family Medicine, and the President of the Professional Staff Association. Since joining Stevenson in 2012, she has won the praise and admiration of her colleagues for being a physician who goes above and beyond her commitment to patient care by demonstrating leadership in the development of a number of quality improvement initiatives. Some of the initiatives that she has been involved with include better transition of care for patients from acute care to the community; better patient experience; and medication reconciliation on discharge.

Dr. Richard Simms, an obstetrician at Stevenson Memorial, has worked with Dr. Ambreen for many years. He describes her as embodying the best of what being a family doctor and GP anesthetist is about: dedication to providing excellent quality of care to patients and making meaningful contributions to the hospital and its community.

Have Your Say on Uninsured Services Policy

Council is inviting feedback on a draft policy that addresses issues around uninsured services and block fees.

The draft policy — entitled Uninsured Services: Billing and Block Fees — is not intended to tell a physician how much to bill but, rather, it sets out general principles of professionalism and relevant legislative obligations.

The draft policy retains the central principles of the current Block Fees and Uninsured Services policy. However, changes have been made to enhance clarity and flow, strengthen existing expectations, and address issues not covered by the current policy. The importance of clear communication around fees is particularly emphasized. These proposed changes are a result of a review of public polling, research and feedback from a preliminary consultation. Moreover, decisions of the Inquiries, Complaints and Reports Committee were reviewed to identify frequent or persistent problems.

Please see the article about the policy consultation in the upcoming Dialogue and please provide your feedback.

Bill 87 — The Protecting Patients' Act

At its recent meeting, Council considered Bill 87, The Protecting Patients Act. The Bill is an important piece of legislation that proposes sweeping changes to the Regulated Health Professions Act, the legislation that provides health colleges with the authority to regulate health professions in the public interest.

The Bill 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.

Council voiced general support for the intent and the overall objectives contained in Bill 87, noting that several legislative proposals advanced by the College to strengthen the provisions to protect patients from sexual abuse are incorporated in the Bill. The provisions relating to transparency are generally consistent with action the College has already taken.

The Bill also contains significant new ministerial powers via new regulation-making authority. In some instances, however, the College believes that other methods should be used to better achieve the College and government's shared goal of improved patient protection and accountability.

Council has identified some substantive issues, as well as a number of other issues which could be addressed through amendments as the Bill moves through the legislative process. Our recommendations will be made in an upcoming submission to the government. The recommendations are designed to ensure that the amendments contained in the Bill will achieve the desired outcome and avoid unintended negative consequences.

Some of the more substantive issues that will form part of the College's response to the Bill include the following:

• Recommend that individuals who have not made complaints or who have not been named in mandatory reports be allowed to access counselling and therapy funding.
• Support notion of consistency, accountability and rigour for investigative processes but oppose putting detailed processes in regulation where it is difficult to make changes. Recommend that committee functions remain in the statute as opposed to regulation.
• Support change to enhance the independence of Discipline Committee processes, but suggest changes to governance should be made in the statute; regulation-making authority with respect to the structure of all statutory committees is too broad.
• Recommend that the Bill's definition of "patient" for the purposes of sexual abuse be more clearly defined, and note that the one-year time period included in the definition will pose challenges.

The College will participate in the government's consultation process as the Bill moves through the legislative process.

The upcoming issue of Dialogue features several articles on Bill 87.

Fertility Clinic Oversight 

The College has moved closer to having the authority to develop and implement a quality and inspections framework for the delivery of fertility services across the province, with Council's approval of a draft regulation.

The draft regulation proposes to bring premises, including hospital-based fertility clinics which perform fertility services, under the Out-of-Hospital Premises Inspection Program. The regulation will now be submitted to government for approval.

The most significant changes being proposed include:

• Adding three additional procedures - in vitro fertilization (IVF), artificial insemination, and sperm cryopreservation and oocyte cryopreservation - to the definition of procedure so that a premises performing any act in connection with the identified procedures would be subject to inspection-assessment under the OHPIP;
• Requiring premises to provide an inspector with requested information, such as BORN reports or data; and
• Making hospital-based fertility clinics subject to inspection-assessment under the OHPIP.

The regulation has been worded so that practice settings such as a family physician's office would not be inadvertently captured by the OHPIP.

A companion document entitled Applying the Out-of-Hospital Premises Inspection Program (OHPIP) Standards in Fertility Services Premises is being finalized and will help fertility services practitioners plan for and participate in their inspection-assessments.

Other News

Practice Ready Assessment Program

Council approved registration changes that will help support a Practice Ready Assessment (PRA) program for family medicine with a small number of eligible candidates.

The PRA Program is designed to identify international medical graduate candidates who are deemed ready to enter practice in Ontario based on meeting qualification requirements and successfully completing a 12-week clinical assessment. The PRA program is under development by the Ministry of Health and Long-Term Care and Touchstone Institute with extensive involvement by the College to ensure that it aligns with national standards and our registration requirements.

Following successful completion of the clinical assessment, the College will issue a restricted certificate of registration to practice medicine under supervision for 24 months, enabling the candidate to achieve certification by the College of Family Physicians of Canada with successful completion of the examination. Should the candidate not be successful, the certificate will automatically expire by the nature of its terms on the first failed attempt.

More information will be available in the Spring/Summer 2017 as the program development is completed.

Fee Increases Approved

The College has approved increases for several fees at the College, including the annual membership fee for the year beginning June 1, 2017.

The 1.88% increase would bring the fee that a physician pays to renew a certificate of registration for independent practice from $1,595 to $1,625.

Council also voted to increase the Certificate of Professional Conduct fee from $50 to $75 (this fee has not been increased since 2008); increase the fee for an application for a certificate of registration for a postgraduate licence from 10% of the membership fee to 25%; and increase the fee for an application for an independent practice certificate of registration from 50% of the membership fee to 60%.

Council also voted to establish an expedited review service fee for those registration applications that meet the regulation. Applicants who wish to expedite the initial assessment of such applications to less than three weeks will have the option to do so with the new fee.