This Bulletin is forwarded to every medical practitioner in the province. Decisions of the College on matters of standards, amendments to Regulations, guidelines, etc., are published in Bulletins. The College therefore assumes that a practitioner should be aware of these matters.
President - Dr. Marc Panneton, Campbellton
Registrar - Dr. Ed Schollenberg
At its meeting on 6 June, 2003, Council considered the following matters:
There was a complaint that a physician had been improperly co-signing prescriptions in order for the prescriptions to be filled at a pharmacy in another province. After a somewhat lengthy process, the physician agreed to no longer participate in such ventures. As a consequence, the Committee recommended no further action on the matter.
There was a complaint regarding the surgical management of a mass in a young patient. To avoid identification, details cannot be discussed, but the Complaints Committee had a number of concerns regarding the initial and follow-up management. This particularly related to the lack of oncological input once the possibility of malignancy was clear. The Committee did not feel that the specific circumstances of the case warranted further action, but did feel it appropriate to contact the hospital authorities to consider reviewing the physician's practice in this area.
In another complaint, a patient presented with a mass for which the physician felt further investigation was necessary. The physician ordered such on a "semi-urgent" basis with the understanding that this meant the procedure would be done within a few weeks. However, the waiting list proved to be much longer and the patient did not have the procedure for several more months, possibly resulting in a significant progression of the matter. The test would have been available within days if the physician had requested such. On reviewing the matter, the Committee questioned whether the physician had made an appropriate initial assessment of the patient. While the delay in the procedure was not clearly the responsibility of the physician ordering the test, it is noted that a physician requesting an investigation bears some responsibility to attempt to have such done within a time frame appropriate for the circumstances. The Committee also noted that, even if a test has been done, but a report not received, courts have found the ordering physician to bear all, or most, of the responsibility for pursuing follow-up. This has been particularly so when the physician has had no system to track significant investigations that have been ordered.
The Review Committee considered two appeals of Council's decision to take no action on a complaint. The Committee declined the appeals.
The Committee met with several physicians. In one case, the physician had received a number of complaints suggesting behaviour or comments to patients which was allegedly inappropriate. After a lengthy discussion with the Committee, and based on other factors, the Committee did not feel there was sufficient evidence to pursue further action on the matter.
The Committee reviewed the approach of a physician regarding the prescribing of narcotics. The Committee discussed several remedial approaches which the physician could consider.
The Committee also reviewed several ongoing matters which the Committee felt may warrant psychiatric intervention.
- Council reviewed a recent policy allowing pharmacists to renew longstanding prescriptions in very limited circumstances where the physician is unavailable. The physician on whose behalf the renewal was provided will be directly advised by the pharmacy. As well, eventually, any prescriptions so refilled will be labeled to assist any physicians further assessing the patient.
- Council also endorsed initiatives by the Canadian Bar Association New Brunswick Branch to seek amendments to the procedures under the Coroners Act.
- Finally, Council reviewed initial proposals from the Canadian Medical Association for a revision of its Code of Ethics. With some minor changes, Council felt that the new version represented several areas of improvement.
In recent elections, Dr. Robert Rae of Saint John, Dr. Marc Bourcier of Moncton, and Dr. Malcolm Smith of Tracadie-Sheila were re-elected. In addition, Dr. François Guinard is the newly elected member from Edmundston.
FROM THE ARCHIVES
75 years ago
Council reviewed the practice of several physicians along the Maine/New Brunswick border, conducted a survey of members regarding requiring the LMCC of all applicants, repealed the minimum age for entering medical school, which had been sixteen, and determined that two years of pre-medical education would be required for all medical school applicants.
50 years ago
Council declined a request from the General Medical Council of the United Kingdom for reciprocity and decided to increase the restrictions on physicians seeking Enabling Certificates to take the Medical Council of Canada exams.
25 Years ago
Council decided to limit specialty recognition to either the Royal College or Quebec College applicants and determined that there would be no full licensure without the LMCC. There were 782 physicians licensed in New Brunswick.