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 29 November, 2002, Council considered the following matters:
A physician who had closed his practice had delayed forwarding copies of a patient's records. In response to the complaint, the records were forwarded. The Committee, therefore, recommended no further action. The Committee did note that, after a physician has closed a practice, patients may take many months to access another physician. When closing a practice, physicians should anticipate ongoing requirements to forward charts for months, or even years. Appropriate mechanisms for doing so should be in place.
In attempting to reassure one patient, a physician made a reference to another patient in the practice. Without mentioning that patient's name, enough information was included to allow identification. The patients later communicated. In response the physician acknowledged that the attempt to be reassuring to one patient may have created a problem. Even innocent comments can identify patients in small communities or groups. Physicians are reminded that even comments that another patient had been seen with a similar problem recently may result in an inadvertent breech of confidentiality.
A physician performed a procedure on a patient. Prior to the procedure, the physician appeared critical of those assisting him. The patient complained that the physician was unnecessarily rude and rough. Physicians are reminded that any negative discussion should never take place in front of patients. Under these circumstances, this can only increase anxiety, discomfort, and the risk of a subsequent complaint.
A patient had previously attended an after-hours clinic for an injection. On the last such visit, the physician advised the patient that this was an inappropriate use of the facility and the patient should attend her family physician. In response to the complaint, the physician asserted that it was appropriate to provide this patient such advice. On reviewing the matter, the Committee agreed that the service would have been best provided by the family physician. Under the circumstances in question, the physician is obligated to provide the appropriate care for the situation, but can also provide advice on the appropriate use of the service in question.
A consultant agreed to see another physician directly. After the assessment, the consultant billed the physician directly for a consultation, as such had been denied by Medicare. The physician/patient alleged this was improper. In response the consultant agreed that the approach he took was in error. In reviewing the matter, the Committee noted that it is technically acceptable for the consultant to agree to see a physician directly as a patient. However, a consultation can only be billed if there is communication directly to a primary physician who has requested the service. Such situations can be avoided if all patients, including physicians, access specialists only after an appropriate referral.
A patient injured her mouth and presented to the Emergency Department. She had two teeth which were displaced, but remained attached. She alleged that the physician failed to properly advise her to consult a dentist immediately. In response the physician stated that he advised the patient to see a dentist within twenty-four hours. In reviewing the matter, the Committee agreed that this appeared to be the best approach. Even if a dentist was easily accessible, immediate treatment following an injury may not be offered.
It was alleged that a physician had closed his practice without providing adequate notice to his patients. In reviewing the matter, the Committee concluded that, while some patients may have been aware that the physician was leaving, most did not have clear notice of when such would exactly take place. Physicians are reminded of their obligation to give patients adequate notice so they can make efforts to seek alternative care. Under most circumstances, family physicians should ensure that all of their patients have been given two or three months notice of their impending departure. In response to this situation, Council passed a motion of criticism to be forwarded to the physician.
In response to a number of complaints, Council referred two physicians to the Review Committee for further assessment.
In addition, Council referred an allegation of sexual abuse to a Board of Inquiry.
By now, members should have received invoices for 2003 annual dues for themselves and professional corporations. For those members who pay by cheque, such must be received in the College office by 1 January, 2003. Suspension of the license of the member, or that of their professional corporation, can occur anytime after that, if payment is not received.