Dialogue Volume 13 Issue 3 2017 - Page 12

pervisor and approved by the College . After successful completion of the period of clinical supervision , each physician is reassessed to gauge improvement . In some cases , a physician may also receive a caution from the committee that oversees investigations , regarding specific aspects of his or her practice , or professionalism or conduct . Each physician ’ s undertaking will be posted on his / her profile on the public register while the terms of the undertaking remain in effect .
Undertakings Imposing Prescribing Restrictions In a small number of cases , physicians have undertaken to no longer prescribe narcotics and controlled drugs . In some cases , a physician may also receive a caution from the committee that oversees investigations , regarding specific aspects of his or her practice , or professionalism or conduct . This information is on the public register .
Undertakings to No Longer Practise Medicine In a small number of cases , physicians have undertaken to no longer practise medicine in Ontario . This information is on the public register .
Referrals to Discipline Where a physician has been referred to the Discipline Committee , the Notice of Hearing , which sets out the allegation ( s ), is on the public register . Any practice restrictions , if ordered pending the outcome of the hearing , are on the public register .
SUMMARY The College will continue to work with the Ministry of Health as necessary to identify levels of opioid prescribing and investigate prescribing practices that may be harmful to patients . The College is aware that while investigations may identify instances of risk of harm to patients when opioid prescribing is continued , there is also a very real risk of harm to patients when opioid prescribing is discontinued . Understanding and questioning prescribing practices is not intended to discourage appropriate opioid prescribing and we are urging physicians to not suddenly cease prescribing to patients currently on opioid therapy . Dr . David Rouselle , College President , says that the College made it a point to communicate to physicians who were being investigated – and those concerned about a potential investigation – that they not respond by abandoning their patients who are on opioids . “ Abruptly cutting a patient off from opioids could lead them to using a street supply that ’ s contaminated with fentanyl and other dangerous substances ,” he said . Opioid-use disorder and chronic pain are health conditions like any other , and treatments should include all the ele ments of good practice : making recommendations based on evidence and treating patients with respect and com passion . For some , this may include several tactics including a slow taper or opioid replacement therapy / referral to a substitute treatment program for methadone or suboxone . Our goal is to support continued prescribing when it is appropriate and informed by both clinical guidelines and Col lege policy . MD

We welcome your feedback on any issue raised in Dialogue .

We reserve the right to edit letters for length and clarity .
Please send letters to :
Elaine McNinch , Managing Editor
Mailing address : College of Physicians and Surgeons of Ontario
80 College St , Toronto , ON , M5G 2E2 Fax : ( 416 ) 961-8035 Email : editor @ cpso . on . ca
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DIALOGUE ISSUE 3 , 2017