December 6-7, 2018

New CPSO President — Dr. Peeter Poldre

At Council’s  December meeting, Dr. Peeter Poldre became President of the College. Dr. Poldre is a Professor Emeritus of Medicine at the University of Toronto’s Faculty of Medicine and for the past 30 years, he has been a consultant-hematologist at Sunnybrook Health Sciences Centre. Over the next several months, Dr. Poldre will be leading the College through the development of our Strategic Plan.

We thank Dr. Steven Bodley for his leadership over the past year. 

New Chief Medical Advisor Announced

Council was introduced to Dr. Sheila Laredo, who is joining the College as Chief Medical Advisor. Dr. Laredo is an MD and specializes in endocrinology and metabolism. She is a health-care leader and is recognized for her research and teaching excellence.

“We are thrilled to have someone of Dr. Laredo’s calibre joining us as our first Chief Medical Advisor,” said Dr. Nancy Whitmore, Registrar and CEO at the CPSO. “Dr. Laredo’s passion and health-care expertise will be invaluable as we continue on our journey to ensure Ontarians have the safest, highest quality health care.”

Dr. Laredo is joining the CPSO from Women’s College Hospital where she has served as the Chief of Staff since 2013.

We have more about Dr. Laredo in the next issue of Dialogue.

Right Touch Regulation

Dr. Nancy Whitmore, College Registrar/CEO, spoke about right touch regulation, an approach that has been adopted by a number of regulatory bodies. The concept is consistent with an improved approach to investigations, which is to triage complaints on the basis of risk of harm to the public and to offer management of lower risk complaints using alternative dispute resolution.  

Originating with the Professional Standards Authority in the United Kingdom, the six principles of right touch regulation are: proportionate, consistent, targeted, transparent, accountable, and agile.

“We need to change our mindset and work to identify the regulatory force needed to achieve a desired effect. Right-touch does not mean light-touch nor does it mean heavy handed. It means achieving the right balance. Too little is ineffective; too much is a waste of effort,” said Dr. Whitmore.

The College is developing several new self-assessment tools that will increase our proactive engagement with physicians at all stages of their careers and help create conditions most favorable to ensuring their success. 

We will discuss right touch regulation in the next issue of Dialogue.

Traditional Land Acknowledgement

Council opened its meeting with a traditional land acknowledgement statement as a demonstration of recognition and respect for indigenous peoples:

We acknowledge the land we are meeting on is the traditional territory of many nations including the Mississaugas of the Credit, the Anishnabeg, the Chippewa, the Haudenosaunaee and the Wendat peoples and is now home to many diverse First Nations, Inuit and Métis peoples.

Later in the meeting, George Couchie, of Redtail Hawk Training and Consulting, led Council in a session about the importance of understanding Indigenous realities and the concept of reconciliation.  

CPSO Governance Review

Council adopted several recommendations to modernize the governance of the College. We will be presenting  the following recommendations to government:

• Composition: a 50/50 public member/physician member board. 
• A smaller board: 12-16 members, to be determined by each regulatory college. 
• Executive Committee: Each College should have flexibility to determine whether an Executive Committee is required (the number of board members is a determining factor).
• Separation between statutory committees and the board (no overlap in membership)
• A competency-based board model, whereby members, together, have desired attributes and competencies.
• Selection process:  Hybrid model (some competency based appointments, some elected positions for professional members).
• Equal reimbursement for public and physician members of the board.

Council also approved by-law amendments to facilitate opening up the College president and vice-president positions to public members of the Council. 

We have more about our recommendations in the next issue of Dialogue.

No Membership Fee Increase for 2019

There will be no fee increase for a certificate of registration for 2019.

The Finance and Audit Committee brought forward a budget containing efficiencies of almost 3% or savings of $1.8M to achieve this result.

Policy Redesign 

We are redesigning College policies to be more clear and concise with a focus on enhancing their use and readability for physicians. The aim is to transition existing policies to the new approach by the end of 2019.

The new approach consists of the following:

• A move to a numbered/bulleted list format instead of the current long-form narrative approach;
• Clear articulation of required expectations and those that are advisable;
• A clear statement of the purpose of the policy and definition of key terms (i.e., ‘must’ and ‘advised’).

Council also voted to rescind two policies, with the rationale that they state expectations already established in law, other College policies, or clinical standards.

The two policies are:

1. Anabolic Steroids, Substances and Methods Prohibited in Sport
2. Fetal Ultrasound for Non-Medical Reasons

We have an article about the new redesign and the rationale for the rescission of the two policies in the next issue of Dialogue.

MAID – New Federal Regulations

In light of federal regulations for MAID monitoring, effective November 1, Council approved updates to the College’s policy   to ensure that physicians’ new reporting obligations are captured. Under the new federal reporting requirements, a report to Health Canada is required when a physician receives a written request for MAID, and that request does not result in a medically assisted death.

Additional policy revisions address areas identified by the Office of the Chief Coroner and Ministry of Health and Long-Term Care as warranting further clarification.

The key changes made to the Medical Assistance in Dying policy include the following:

• Existing content on data collection and reporting has been consolidated in section titled Reporting Obligations that outlines both federal and provincial reporting requirements;
• Added content on the role of post-graduate medical trainees in MAID, and the capacities in which they may be involved;
• Clarification that where a patient has opted for self-administered MAID, where death isprolonged or not achieved, a physician may only administer an IV backup if the patient is capable of providing their express consent immediately before the medication is administered; and
• Clarification that the Process Map contained in the policy is not prescriptive in terms of sequencing. Any departure from the Process Map, however, must comply with the federal legislation.

General By-law Amendments

Council approved the amendments that revise certain General By-law provisions relating to the public register and mandatory reporting. The bylaw addresses duplications and inconsistencies with the new legislative and regulatory provisions passed under Bill 87 earlier this year. The General By-law already provided for most of the new posting and mandatory reporting provisions, but there are some differences in scope and in language.