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.

Officers and Councillors 2019-2020

President - Dr. Stéphane Paulin, Oromocto   Registrar - Dr. Ed Schollenberg 
Vice-President - Dr. Julie Whalen, Moncton  

     

Dr. Éric Basque, Pointe-des-Robichaud Dr. Marcel Mallet, Moncton
Dr. Zeljko Bolesnikov, Fredericton Dr. Nicole Matthews, Campbellton
Ms. Diane Brideau-Laughlin, Ammon Ms. Patricia I. O'Dell, Riverview
Dr. Hanif J. Chatur, Grafton Dr. Peter Ross, St. Andrews
Ms. Denise Hollway, Rothesay Dr. Kerry Sheppard, Saint John
Dr. Éric Levasseur, Edmundston Dr. Susan E. Skanes, Dieppe
Dr. James Stephenson, Saint John
   

At its meeting on September 28th, 2019, Council considered the following matters.

Complaints

A Counsel is advice as to how to improve the physician’s conduct or practice.

A Caution is intended to express the dissatisfaction of the Committee and to forewarn the physician that if the conduct recurs, more serious disciplinary action may be considered. 

A Censure is the expression of strong disapproval or harsh criticism. 

complaints regarding children being sent home from the Emergency Department only to return later with a serious condition. In one case, the child developed an unusual bacteremia, and in the other, leukemia.  It was alleged that the initial assessments failed to make a timely diagnosis.  On reviewing the matters, the Committee could find no fault with the care provided by the physicians.  They appropriately dealt with the presenting situation and there was no way to anticipate the eventual diagnoses at that time.

A physician was subject to two unrelated complaints which related to his patients misunderstanding their conditions and mismanagement plans. The Committee could find no fault with the clinical decisions made by the physician, but felt the communication with the patients was lacking.  In one case, it was felt appropriate to Caution him to assure himself that the patient understood the information he was providing. 

There were two unrelated complaints from employers regarding doctors supporting work absences of their employees. In each complaint it was alleged that the physician was improperly providing documentation allowing the individuals to be absent from work.  In reviewing the matters, without providing the information to the employers, the Committee noted that both patients had ongoing mental health issues which could not be disclosed.  The physicians appeared to make appropriate judgements on the ability of the patient to return to work.  The Committee did not feel there was anything to support the allegations made.

There was a complaint from a patient regarding access to a physician’s office. This was not his own physician, but he was asked to contact them regarding making follow-up arrangements arising from care in the hospital.  The individual became quite upset and frustrated with his inability to contact the office and an argument developed with the receptionist and eventually the physician.  While the individual, as a parent, acted inappropriately, the Committee noted that the difficulties did arise from the now widespread practice in many offices of limiting access by telephone.  As a remedy, physicians should avoid unnecessarily limiting the times during which their phones are answered.  Any time staff are available to answer the phone, they should do so.  When it is stated that phones are answered at a particular time, this simply encourages a surge of calls which means very few get through. This only increases anxiety and frustration for patients or parents.  Similarly, there was an allegation that a message was left stating that calls would not be answered as there were no further appointments that day.  The Committee did not feel this was a wise approach as there may be other reasons that the office would be contacted.  The Committee notes that alternative digital access to some offices is being pursued and believes such should help alleviate this unnecessary frustration. 

A child was seen in a walk-in clinic and the physician felt that an x-ray was warranted. He sent the child to the Emergency Department where she had to wait over nine hours to have the x-ray done.  The parents felt that the care should have been expedited by the initial physician.  In response, the physician noted that, at times, he can send a patient to an Emergency Department to be dealt with directly, but other times this is impossible.  The Committee felt that, knowing a significant delay was likely, it would have been better to arrange the x-ray himself and follow up the results as necessary.  The Committee felt there was no reason such was not possible, and a Counsel was issued.

A physician had entered into an exchange of texts messages with a patient he had seen in the Emergency Department. The messages would initially be described as a friendly follow-up, but over time, progressed to a level of inappropriate interaction between a physician and a patient.  This, at one point, included an exchange of pictures.  The content of the texts became known to the Registrar who issued a complaint against the physician.  The latter acknowledged the inappropriateness of the communication and expressed significant regret as to how matters progressed.  At the point they began exchanging texts, it was not difficult to see how the level of discussion had become friendlier or even more intimate than would be appropriate.  In the end, the physician was Cautioned on both aspects.  Members are recommended to avoid allowing patients access to their cell phone numbers if possible. If not, the member should be very cognizant of exchanges becoming improper even if such was not the original intent.

Fees
Council has decided that no change in fees is necessary for 2020. The only exception is an increase in the initial registration fee from $150 to $200, to cover the increased costs for criminal records checks done on all new applicants.

Complaint Response Times
For many years, the College has requested physicians to respond to complaints within thirty days. This deadline has proven too short for a variety of reasons and many extensions have been necessary.  Consequently, to simplify matters, Council has agreed to now allow physicians sixty days to respond to complaints.

Peer Assessment Committee
As noted in the annual report, the Regional Assessment Program is being dissolved at the end of the year. Their function, in New Brunswick, will be taken over by a Committee of the College, which will still operate at arm’s length through an office in Moncton. Individual physicians will not notice any changes in the procedures for arranging and providing an assessment.  As the case with its predecessor, this Committee continues to need assessors to provide this service.  Anyone interested should make themselves known.

 A “Choosing Wisely” guideline on family medicine is enclosed for interest and guidance.

https://choosingwiselycanada.org/family-medicine/

 

General Information

Address all correspondence to

Dr. Ed Schollenberg, Registrar
College of Physicians and Surgeons of New Brunswick
One Hampton Road, Suite 300
Rothesay, NB E2E 5K8 

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