Home

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 will be aware of these matters.

Officers and Councillors 2021-2022

At its meeting on February 4th, 2022, Council considered the following matters.

A patient presented with abdominal pain.  The initial diagnosis was pancreatitis.  Only a CT scan was done, not an ultrasound.  As a consequence, gallstones were not visualized. The patient alleged that the physician had failed to make a timely diagnosis. The Committee did feel that the patient’s presentation warranted an earlier ultrasound than had been done.  The physician was Cautioned.

A patient presented to the family physician with rectal bleeding.  The family physician did an examination and suggested it was only hemorrhoids.  The bleeding persisted and the physician examined the patient again, finding nothing unusual.  A sigmoidoscopy was done which did not reveal any issue except some difficulty with the passage of the scope.  The patient was referred for a colonoscopy which demonstrated a rectal carcinoma.  The Committee could not be certain that this could have been diagnosed any sooner.

A patient who had three previous miscarriages presented with early pregnancy and some bleeding.  She alleged that the physician did not do an appropriate examination and chastised her for requesting any intervention, as the baby was non-viable in any case.  The Committee did not feel the physician had responded appropriately to a stressful situation and issued a Counsel.

A patient was discharged from a physician’s practice.  His receptionist had overheard her and some of her friends having a discussion about the physician’s lifestyle.  No explanation or warning for the discharge was provided. The physician declined to respond.  In the Committee’s view, the decision to discharge the patient, the failure to follow proper procedure in doing so, and the failure to respond to the College, warranted a Censure.

An elderly patient was discharged from a nursing home, evidently as a result of difficulties being created by the patient’s family.  The attending physician made the arrangements for the patient to be transferred to the hospital.  The family subsequently complained about the physician’s actions.  In the Committee’s view, the physician did not participate in the decision to discharge the patient and, in fact, made every effort to make the process as comfortable as possible. 

A patient had had previous difficulties with improper touching by a physician.  Some years later she was referred by her family physician to a consultant regarding a chronic issue.  She requested the consultant see her with a woman present.  The consultant immediately declined to see the patient at all.  The patient was willing to attend the visit regardless of the circumstances.  In reviewing the matter, the Committee felt that the physician should not have declined to see the patient outright.  There was no reason to do so and the patient had already waited many months for the appointment.

An elderly patient with terminal cancer was admitted to a community hospital for pain relief.  The family alleged that the hospital’s attending physician did not see them for several days, declined to respond to their requests for a meeting, and evidently did not respond to attempts to reach him by the nursing staff.  In response, the physician denied there had been any missed attempts to contact him.  In reviewing the records, it was noted that no such requests by the family, nor attempts to contact the physician, were recorded by the nurses.  It was also noted the physician had been led to believe that a second-year resident was available to deal with any issues that arose.  While it would not have changed the patient’s course or outcome, the Committee did question whether the attention from the physician would have benefitted the family in a difficult situation.

Virtual Care

The onset of the pandemic has obviously increased the use of virtual assessments by physicians.  This will almost certainly persist for the future.  In that context, the Council felt it appropriate to issue some guidance to members around a number of issues.  It is important for physicians to consider whether a virtual visit will be sufficient to deal with a particular situation.  It is also considered important that there be some arrangement possible to have the patient seen in person.  It is not considered appropriate to simply send the patient to an Emergency Department without notice.  Finally, there is an ongoing concern that some physicians are using virtual care visits to excess, sometimes approaching their entire practice activity.  This is not considered ideal.  Nevertheless, considering the current situation, this will not be enforced too strictly, but will be monitored in the future.  The complete guideline is available on the College’s website.

Vaccine Resistance

Physicians continue to be frustrated by the misinformation being propagated regarding the value and the safety of the Covid vaccine.  Enclosed is some information from the Public Health Agency of Canada which may have some value in confronting this issue.  Infection Prevention and Control Measures