September 8, 2017

Dr. Michael Stephenson Honoured for Work with Refugees

Dr. Michael Stephenson, a family physician from Kitchener, was presented with the College’s Council Award in recognition of his commitment to and passion for serving the needs of refugees in his community.

Dr. Stephenson is the founder, director and chief physician of the Sanctuary Refugee Health Centre in Kitchener. Thanks to his dedicated work at the clinic, Dr. Stephenson has transformed the delivery of health care to the region’s most vulnerable patients – people who have arrived here seeking sanctuary from the turmoil and strife in their home countries. He has also helped develop the community’s understanding of ‘refugee health’ as a field of expertise.

“Dr. Stephenson is an outstanding physician and leader [with] a passion for refugee medicine. He saw an unmet need among refugee newcomers and set out to meet that need. He has garnered respect from patients, colleagues and the wider community, and Kitchener-Waterloo is considered a show piece in the welcome given the recent influx of refugees,” said Margaret Brockett, the clinic’s associate director.

CPSO Releases Interim Opioid Strategy Progress Update

The College has released an interim update containing actions taken in support of our opioid strategy. The College’s opioid strategy is grounded in our steadfast commitment to improved patient and public safety. It identifies and commits the CPSO to specific actions within our legislated area of responsibility, and we are committed to reporting on our progress.

The strategy, approved in the Spring by Council, comprises a four-pronged approach within our area of responsibility, namely to: Guide; Assess; Investigate; and Facilitate Education for Ontario’s doctors.

Below is more detailed information about our activities:

• Updated CPSO Prescribing Policy: The College has updated the Prescribing Drugs policy to reflect the release of the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain. Other updates made to the policy include: considering alternatives to opioid therapy; selecting appropriate doses; monitoring patients for signs of addiction; and tapering. A full review of the policy will begin later this year.
• Opioid Information for Patients and Physicians: Our new opioid web portal provides online access to a wide array of information for physicians and patients. It includes a Message to Patients Living with Chronic Non-Cancer Pain, and an FAQ for patients, as well as Fact Sheets about each element of our four-pronged opioid strategy.
• Opioid Position Statement: The CPSO’s Opioid Position Statement outlines the role of the College and key elements of our opioid strategy, namely to guide, assess, investigate and facilitate education for Ontario’s doctors. It also highlights the complementary roles of health-system partners.
• Opioid Investigations: In November 2016, based on information received from the Narcotics Monitoring System (NMS), the CPSO initiated investigations into the opioid prescribing of 84 physicians. To date, 56 investigations have been completed and 28 investigations are still in progress. The College’s goal, whenever appropriate, is to support education and continued prescribing under supervision, where the physician’s capacity for remediation is apparent. The College is aware that while investigations may identify instances of risk of harm to patients when opioid prescribing is continued, there is also a very real risk of harm to patients when opioid prescribing is discontinued. Understanding and questioning prescribing practices is not intended to discourage appropriate opioid prescribing and we are urging physicians to not suddenly cease prescribing to patients currently on opioid therapy.

The CPSO Opioid Position Statement will appear in the next issue of Dialogue. The cover story will be devoted to a status update on the College’s investigations.

Consultations Underway — Have Your Say

Physician Services During Disasters and Public Health Emergencies Policy

Council reviewed a draft policy entitled Physician Services during Disasters and Public Health Emergencies and has approved it for external consultation.

The draft clarifies that:

• physicians must provide services if they are able to do so;
• physician services provided need not be limited to direct care to people in need; and
• the nature of the situation may require physicians to temporarily practise outside one’s scope of practice.

Please provide your feedback by November 14, 2017. More information is available on our website and in the next issue of Dialogue.

Ensuring Competence: Changing Scope of Practice and/or Re-Entering Practice Policy

Council has approved a draft policy for consultation to ensure physician competence when physicians change their scope of practice and/or re-enter practice after an extended absence. The draft is a combination of two current policies – the Changing Scope of Practice and Re-entering Practice policies.

External preliminary consultations on both the policies took place in 2016 and the feedback garnered informs the new draft, Ensuring Competence: Changing Scope of Practice and/or Re-entering Practice. Overall, the general expectations set out in the current policies have been maintained in the draft policy, however, a few substantive and a number of minor amendments are being proposed.

The substantive changes are:

• The reporting requirement has been changed from three to two years, when:
  • Physicians intend to re-enter practice and have not been engaged in practice for a period of two consecutive years or more; and
  • Physicians intend to return to a scope of practice in which they have not practised for two consecutive years or more.
• Physicians in part-time practice (physicians who have practised less than six months in the preceding five-year period) are no longer captured by the policy.

Please provide your feedback by the November 14, 2017 deadline. More information is available on our website and in the next issue of Dialogue.

Two Preliminary Consultations

Two of the College’s most referenced policies – Medical Records and Maintaining Appropriate Boundaries and Preventing Sexual Abuse – are now open for a preliminary consultation in accordance with the College’s policy review cycle. We urge you to provide feedback by the November 14 deadline.

New Governance Model for CNO

At its December 2016 meeting, the College of Nurses of Ontario’s Council approved a vision for governance for 2020. In a presentation to CPSO Council, Anne Coghlan, CEO and Executive Director of the CNO, explains how the proposed reconfigured board will be better able to reflect the public’s needs and interests. Key proposed changes include reducing the size of the board, moving to appointments rather than elections and using a competency based approach. Watch for an article on Ms. Coghlan’s presentation in the next issue of Dialogue.

Facilitating Public Member Presidents

Council reviewed a proposal to facilitate the election of public members to the position of College President.

While existing provisions in College by-laws permit the election of any member of Council as College President and Vice-President, this is not well known and there is a well-established process in place and an assumption that once a physician is elected to the Executive Committee, they will automatically progress to Vice-President and then President.

Council decided that the Executive Committee will continue to be composed of six members, but a new minimum of two public members and a minimum of two physician members will be instituted. This change will need to be reflected in the College by-law. The Past President will continue to serve as a member of the Executive Committee and the current Vice-President will generally progress to be President.

The Vice-President will generally be elected from the other public or physician members of the current Executive Committee or from public or physician members of Council who have served on the Executive Committee during their current term on Council. This will not be written in the College by-laws, but this approach will be clearly communicated to ensure awareness and transparency. These changes are expected to go into effect in 2019.

New Member Orientation

Council has approved a proposal requiring new applicants to engage in education related to professionalism and professional regulation. As a condition of new members being granted their first certificate of practice in Ontario, they will need to become familiar with issues related to boundary violations and sexual abuse prevention. Council also directed staff to develop a plan for the training to be provided to the entire profession.

Many other Canadian regulators – including at least three medical regulatory authorities (Quebec, Alberta and Saskatchewan) – have educational requirements for new applicants and/or current members related to the laws, regulations and policies that govern a regulated health profession.

Four District 10 Physicians Acclaimed to Council

Four Toronto-area physicians were recently acclaimed as members of Council: Dr. Philip Berger; Dr. Haidar Mahmoud, Dr. Peeter Poldre and Dr. Patrick Safieh. Drs. Mahmoud and Poldre are returning to Council. While Drs. Berger and Safieh are new to the Council table, they have been active in College committees. Dr. Safieh is the current co-chair of the Quality Assurance Committee.

The District 5 election will run from Tuesday, September 19th to Tuesday, October 10th and close at 4 pm. Members who practise in District 5 (Simcoe; Muskoka; Durham; Peel and York) or who are retired from medicine and live in District 5 are encouraged to vote, and will receive information about the election and an electronic ballot via email.

Annual Report

We are pleased to present the 2016 Annual Report of the College of Physicians and Surgeons of Ontario. Click on any section of the Infographic and you will be brought to the relevant section of our annual report.