Dialogue Volume 13 Issue 3 2017 - Page 11

“The outcomes demonstrate that the College will take a remedial approach, whenever appropriate, to help physicians practise to current standards” expected to be completed by end of year. The outcomes of the completed investigations are on the infographic on the facing page. “The outcomes demonstrate that the College will take a remedial approach, whenever appropriate, to help physicians practise to current standards,” said Dr. Rocco Gerace, College Registrar. “Our goal, where possible, is to support education and continued prescribing under supervision, where the physician’s capacity for remedia- tion is apparent,” he said. Investigations that arise from receipt of information from the NMS entail seeking more information from the prescribing physician and others in order to better understand and evaluate the context of the prescribing. These investigations include a review of patient charts and interviews by an external assessor to understand whether the physician is practising to current standards, in the patient’s best interest. After a comprehensive investigation has been completed, the Inquiries, Com- plaints and Reports Committee (ICRC), which oversees and determines the outcome of investigations, decides the outcome from a variety of available options: No Action When the investigation confirms that the care provided by the physician is appropriate, no further action will be taken. Examples of situations in which it is appropriate to take no further action are: • Patients are receiving appropriate care; • D  osages are being tapered, when clinically indicated to the patient’s circumstances. In some cases, physi- cians have changed their own prescribing practices in response to more recent evidence, or they are tapering dosage levels initiated by other physicians. Advice or Remedial Self-Study Where minor issues are identified, advice will be given to the physician to improve future practice or the physi- cian may be required to participate in self-study with follow-up from the College to ensure the identified learning needs have been addressed. If an investigation results in no action, advice, or remedial self-study, these outcomes are not available on the public register. Mandated Remediation The terms of a physician’s mandated remediation are set out in an “undertaking”, which is a binding and enforceable agreement between the College and the physician. In general, undertakings set out an obligation or restriction that a physician is giving to the Col- lege (i.e., an agreement by the doctor to participate in remediation; practise under clinical supervision; cease to practise medicine; or abide by practice restrictions, such as no longer being permitted to prescribe narcotics and controlled drugs).  ndertakings to Complete Individualized U Education; Clinical Supervision; Reassessment The majority of physicians with identified learning needs have undertaken to participate in and suc- cessfully complete an individualized education plan developed by the CPSO to address the identified spe- cific learning needs of each physician. The elements of professional education include completion of the University of Toronto Faculty of Medicine program in Safer Opioid Prescribing; and may include the U of T’s Medical Record-Keeping Course. Additionally, a review of a number of resources (e.g., CPSO Pre- scribing Drugs policy; 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain, etc.) is gener- ally undertaken. Physicians practise under the guid- ance of a clinical supervisor, over a graduated period of time, who oversees completion of the educational plan. The level of supervision is reduced to the next phase only when recommended by the clinical su- ISSUE 3, 2017 DIALOGUE 11