Bulletins

October 2003

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.

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Officers and Councillors 2002-2003

President - Dr. Marc Panneton, Campbellton
Vice-President - Dr. Rudolph Stocek, Hartland

Dr. Jean-Marie Auffrey, Shediac
Ms. Barbara Bender, Saint John
Dr. Ludger Blier, Edmundston
Dr. Zeljko Bolesnikov, Fredericton
Dr. Marc Bourcier, Moncton
Dr. Terrance E. Brennan, Fredericton
Dr. Douglas Brien, Saint John
Dr. Mary E. Goodfellow, Saint John


Registrar - Dr. Ed Schollenberg


Dr. Paula M. Keating, Miramichi
Mr. Stanley Knowles, Miramichi
Mr. Eugene LeBlanc, Dalhousie
Dr. John McCrea, Moncton
Dr. Robert E. Rae, Saint John
Dr. Beatriz Sainz, Oromocto
Dr. Malcolm Smith, Tracadie-Sheila
Dr. Claudia Whalen (PhD), Fredericton



At its meeting on 19 September, 2003, Council considered the following matters:

COMPLAINTS

There was a complaint that two physicians had disclosed confidential information regarding another physician to colleagues. In reviewing the matter, the Committee could not determine what sort of information was disclosed, nor any evidence of any adverse effect on the physician in question. The Committee did not feel further action could be taken on the matter.

There was another in a series of complaints regarding physicians failing to heed allergy warnings provided by patients attending an Emergency Department. In this case, the physician simply failed to take note that the patient had reported allergies to certain anti-inflammatory drugs. While similar drugs may still be tolerated, there was no evidence that the physician specifically reviewed this before issuing the prescription. The potential problem was discovered by the pharmacist prior to the patient taking any medication. The physician acknowledged the error.

There was a complaint that a company physician had performed an inappropriate assessment regarding an employee. There was an allegation that the terms used in the assessment were simply borrowed from another report. In reviewing the matter, the Committee noted that the policy in the organization was for specific language to be used so that the reports could be interpreted by "lay" supervisors. The Committee could find no fault with the care provided.

There was a complaint regarding the investigation of a tumour in a young adult. After biopsy, the initial verbal report was inconclusive. Given the circumstances, the situation was of some risk to the patient, but the physician determined to reassess the matter in several months. In the meantime, the written report was received making a stronger recommendation for further investigation. By this time, the patient had felt a loss of confidence in the physician and gone elsewhere where the matter was investigated and diagnosed as carcinoma. The expert opinion provided to the Committee did suggest that a more aggressive approach should be taken under these specific clinical circumstances. Nevertheless, there was certainly a range of opinions on the matter. Thus, while the approach taken could be questioned, it was not clearly deficient.

A patient arrived late for an appointment. It was alleged that the physician was sharply critical of the patient for doing so, advising that he had to leave to attend to another matter. He did proceed with the assessment, but the patient alleged his prior conduct was inappropriate. In response the physician states that he makes every effort to adhere to a strict appointment schedule and expects his patients to do the same. In reviewing the matter, the Committee certainly noted that, in many circumstances, it is the physician who is late for an appointment time. Nevertheless, some physicians do manage to conduct their offices in a manner in which most appointments are kept on time. Under the circumstances, the reaction of the physician could create the impression that the patient was not provided with a proper assessment. The Committee felt it would have been better if alternate arrangements were discussed so that the patient could be seen in a less negative context.

There was a complaint that a physician was improperly prescribing narcotics. This matter was referred to the Review Committee for further study.

REVIEW COMMITTEE
The Review Committee continued an ongoing review regarding the psychiatric health of a physician. The Committee also ordered production of psychiatric reports regarding another physician and, finally, ordered an office assessment on a physician who had been the subject of two complaints suggesting improper care.


CORONER'S INQUEST RECOMMENDATIONS
As members have likely been advised from other sources, the Chief Medical Officer of Health has recommended that physicians be again reminded of their legal obligation to report to public health authorities any patient suspected of having a communicable disease. More specifically, the recommendation focused on the risk of E-coli infection and the fact that physicians should be watchful for such and forward appropriate cultures when suspicious.

NOMINATING COMMITTEE
Council has elected the following to the Executive for 2003-2004:

President: Dr. Rudolph Stocek
Past President: Dr. Marc Panneton
Vice-President: Dr. Douglas Brien
Member at large: Dr. Marc Bourcier
Public member: Mr. Eugene LeBlanc

In addition, Council forwarded a list of potential public members to the Minister of Health from whom four will be appointed.

ACCESS TO PHYSICIANS
The College has received reports that certain physicians are expressly refusing to accept into their practice patients in certain circumstances. This has generally taken the form of refusing to see patients over a certain age. Physicians are reminded that this is contrary to the Code of Ethics, as well as to Human Rights legislation. Such an approach creates the risk of a complaint on either basis.

ANNUAL FEES
Council approved a draft budget for 2004. It was noted that, based on a low complaint and disciplinary record, the College had been accumulating surpluses over the last several years. As a consequence, College reserves appeared higher than necessary. For that reason, Council determined to reduce fees for full licensure on a one-time basis.

As a consequence, the annual fee for 2004 will be reduced by $100 to $ 390 for those paying by pre-authorized payment. The annual fee for those who pay by other means will be $410. These fees will likely return to the previous level in subsequent years.