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. Christine Davies, Saint John
Registrar - Dr. Ed Schollenberg
Dr. Marc Panneton, Campbellton
At its meeting on 15 June 2001, Council considered the following matters:
A complication was discovered in the first follow-up visit following a surgical procedure. The patient was a child and the parents complained that the complication should not have occurred. On reviewing the matter, with expert opinion, the Committee felt that the complication was a known one which could occur despite the best of care. Nevertheless, the Committee felt that the situation was aggravated by the response of the physician who himself accepted that he could have spent more time acknowledging the matter and explaining the situation to the family.
The patient had presented to the Emergency Department with an expired Medicare card. She offered to return later, but was encouraged by the staff to remain to be seen. She alleged that the physician spent a great deal of time during her assessment complaining about how he was going to get paid. In his response the physician stated that he had mentioned the matter, but had otherwise performed an adequate assessment of the patient. On reviewing the records, the Committee noted that the assessment performed by the physician was likely minimal. It appeared the physician was distracted by the billing issue. The Committee reiterated that the first priority, in any such situation, is the well being of the patient. It was inappropriate for the physician to be pre-occupied with the other issue. The Committee notes that confirmation of a resident's coverage can be obtained from Medicare.
There was a complaint from a patient that a family physician had failed to provide a report to a lawyer in a timely fashion. On reviewing the matter, the Committee noted that the report which was provided was extremely lengthy and complicated. The Committee felt the physician had put an extraordinary amount of effort into the matter. For this reason, any delay, which was minor, was completely reasonable.
The mother of a child complained that a physician had failed to adequately communicate with her regarding her child's condition. It was acknowledged that there were communication difficulties between the mother and the physician. As a consequence, all communication had gone through the child. When the mother requested further clarification, the physician had responded that he did not have time to provide such. On reviewing the matter, the Committee felt the mother's request was not unreasonable and that the physician had to be as satisfied as possible that the mother understood the result of his assessment and his recommendations regarding treatment.
Two appeals from decisions of Council dismissing a complaint
were considered. In both circumstances, the Committee determined that the original order of Council was appropriate.
The Committee considered two requests for reinstatement of licensure of physicians currently under interim suspension. One case was granted, the second was denied, as the physician had refused appropriate assessment.
For many years, it has been a requirement for licensure that physicians who were not certified in family practice or specialty could only be fully licensed if they have the LMCC and appropriate training in a Canadian or American program. In order to meet its obligations under the Agreement on Internal Trade, and to increase the pool of physicians who may be available for recruitment, Council determined to provide some latitude on the location of such training. Hence, physicians who are currently licensed in another province, and who do have the LMCC, may be eligible for licensure here if they can demonstrate training which is equivalent to a Canadian or American program.
Council gave tentative approval to two changes in licensing fees for 2002.
Effective for 2002, the annual fee for a Professional Corporation license will increase from $50. to $100.
Effective for 2002, the annual fee for Border Area license will increase from $60. to $100.
These changes were felt necessary to adequately reflect the cost of administering these particular licenses.
A decision on the full annual license fee will be made later in the year.
PHYSICIANS AND THE
In response to requests from members for guidance regarding the issue, Council felt it appropriate to approve the recently published guideline from the Canadian Medical Association regarding physicians and the pharmaceutical industry. Council felt such was a reasonable statement of a physician's obligation in this area.
Council gave tentative approval to a joint guideline being developed with the New Brunswick Pharmaceutical Society which will outline the respective obligations of physicians and pharmacists regarding prescribing in the ambulatory setting. This guideline was largely based on work previously done by the respective licensing authorities in Alberta.
Council gave approval to the concerns expressed by the Canadian Medical Association regarding the proposals for access to medical marijuana. The concerns principally revolved around the lack of appropriate guidelines for when such treatment was indicated.
It is noted that, subsequently, further amendments have been proposed. Nevertheless, the Canadian Medical Association has stated that such do not address their basic concerns (see www.cma.ca).
While the new proposal does not require the physician to file an application on the patient's behalf, it will be necessary for a physician to support any such request. In the case of terminal patients, such a request can come from any physician. For patients in a specific category of illnesses, approval must come from a specialist. For all other patients, the approval must be endorsed by two specialists.
It is appreciated that this scheme can create difficulties for physicians. While further information on the process of authorization will be published shortly, the basic questions regarding the appropriate indications, dosage, and monitoring, appear unsettled. Hence, the best physicians can do, should they wish to consider providing this for a patient, is to familiarize themselves as much as possible with the available information on the subject.
This is to advise that the following new members of Council were recently elected:
Dr. Paula Keating, Miramichi
Dr. John McCrea, Moncton
In addition, the following members of Council were reelected:
Dr. Douglas Brien, Saint John
Dr. Marc Panneton, Campbellton
Dr. Rudolph Stocek, Hartland
Council members are elected for a three-year term. An individual may serve a maximum of three consecutive terms.