This Bulletin is forwarded to every medical practitioner in the province. Decisions of the College on matters of standards, amendments to Regulations, By-Laws, guidelines, etc., are published in Bulletins. The College therefore assumes that a practitioner should be aware of these matters.
| President - Dr. D.F. McDade, Fredericton
Vice-President - Dr. G.D. Surette, Moncton
Dr. C.E. Doyle, Riverview
Dr. David Beaudin, Saint John
Dr. Leonard Higgins, Saint John
Dr. Donald Craig, Saint John
Dr. Michael Perley, Woodstock
Dr. Jacques Corbin, Edmundston
| Registrar - Dr. Ed Schollenberg
Registrar Emeritus - Dr. V. McLaughlin
Dr. Matthew Swan, Campbellton
Dr. Donald Carson, Bathurst
Dr. William Martin, Newcastle
Dr. David Olmstead, Fredericton
Mr. Marcel Sormany, Edmundston
Mr. Harold Stafford, Saint John
At the November 20th meeting of Council, the following items were considered:
- Amendments to By-laws and Regulations were approved. One of these provided for a change in the licensing fee for a Locum tenens. Henceforth, licenses will be for a minimum of 3 months, and the fee will be fixed at 25% of the current fee for annual license. Also noted that applicants for a Locum tenens license will also require a registration fee of $100, as applies to all other applicants.
- The Notice of Motion was approved to allow a charge of $25. for a letter of good standing. New Brunswick was the only province where there was no charge for this service.
- Council instructed the By-Laws Committee to review the current licensing categories with a view to simplifying them. This was necessary in the context of changes in training requirements which will take effect in 1993.
- Council appointed a Board of Inquiry to investigate alleged sexual misconduct by a physician.
- Council heard and adopted the recommendations of the Complaints and Registration Committee on the following matters.
- A patient had complained that 2 physicians had refused to refer him to a consultant. The Committee recommended that no fault be found with the care provided and noted that subsequent to the complaint, the patient had seen a specialist. Nevertheless, it was noted that the CMA Code of Ethics requires physicians to refer a case to another when a patient requests. While circumstances must be considered, it should still be noted that this is a basic right that patients have. Council authorized a Board of Inquiry to investigate the practice of the physician alleged to have provided inadequate care to a patient. This may have included inadequate examination and failure to refer to a specialist.
- Council authorized a Board of Inquiry to investigate the conduct of a physician who had allegedly written a prescription without examination, to a known addict, and in an improper manner.
- Council heard the report and adopted the recommendations of the Fitness to Practise Committee:
- Council authorized a Board of Inquiry to investigate the Fitness to Practise of a physician who is allegedly impaired by alcohol and substance abuse. Council approved a recommendation not to take further action against a physician who had allegedly had improper contact with a patient during an examination. As similar complaints had arisen in other provinces, physicians are reminded to note the potential for contact which may be misinterpreted during the course of examination such as those of eyes and ears.
- Council adopted the Committee's recommendation concerning a complaint against a psychiatrist. The matter had been heard on an appeal from a previous recommendation of Council. The issue concerned allegedly improper termination of care. The Committee recommended that no further action be taken, but expressed concerns regarding the particular method of treatment used by the psychiatrist in this case.
- Council heard a report on the Medical Council of Canada. There remained continuing controversy regarding the new clinical examination which was to take place during the second year of postgraduate training.
- Council decided to pursue the question of guidelines in several areas, including physicians' relations with the pharmaceutical industry, payment for uninsured services and the role of third-party physicians.
There will shortly be a vacancy for a non-medical member on the Council. The Medical Act requires that the Council approves a list of names which is forwarded to the Minister of Health. Any physician who would wish to suggest a name may provide it to the College. Under the current act, this person will also be on the Complaints and Registration Committee. As such they should be willing to travel to Saint John for both Committee and Council meetings.
Physicians may recall that last year they were required to complete an annual confirmation to update the information base of the College, the Department of Health and Social Services and the Medical Society. While it was hoped to include the same request with this year's annual invoice, changes to the latter prevented that. Consequently, another mailing will be necessary for early in the new year. In any case, physicians are reminded that it is their professional responsibility to complete this form.
Transfer and release of medical records continues to be the source of inquiries to the College. It seems necessary that a detailed policy be developed to handle this matter. In the meantime, physicians are reminded of their current responsibilities:
- according to the Supreme Court of Canada, it is to share all the information in the records with patients who request it. Patients should be allowed to inspect records or to have copies of them. The only exception would be where it was a physician's opinion that such a release of information would be damaging to the health of the patient. The onus of showing that to be the case remains on the physician;
- the other obligation that physicians have is to freely share information, when requested to do so by a patient, with another physician. This may not necessarily mean forwarding complete copies of records, but at least a report of findings.
Where records must be copied, it is reasonable for the physician to charge to the patient a reasonable sum for this service. However, it must not be of such an amount as to prevent the free-flow of information. It is improper for a physician to profit from the information in his records. One question which remains unanswered is whether a physician can insist on payment before transferring records. It would be improper for a physician to do so if the patient could not afford the amount billed. In other jurisdictions, it is improper for the physician to insist on this in any case. While this has not clearly been made a definite policy here, it may be necessary to do so should this continue to present difficulties for patients.