REGISTRATION and limitations placed on the physician ’ s certificate of registration . There were no differences between ARPs and TRPs on these outcomes . There were also no differences in peer assessment performance for four of the seven pathways and policies included in the evaluation . In three of the pathways and policies , ARPs were more likely than TRPs to receive decisions of reassessment , indicating record keeping or minor care concerns that can be addressed educationally . These pathways included ARPs utilizing AIT , Pathways 3 and 4 ( American trained who were supervised for one or more years in an Ontario practice setting ) and those who obtained eligibility for their CFPC examination by practising in another Canadian jurisdiction ( and subsequently became eligible for registration in Ontario ).
Multi-Source Feedback The same physicians who were peer assessed also participated in an MSF assessment ( 481 ARPs and 1,152 TRPs ). Feedback about the physician ’ s professionalism , communication skills , and ability to collaborate was solicited from patients , fellow physicians , and other health-care professionals who worked closely with the doctor . Analyses revealed no meaningful differences between ARPs and TRPs on MSF scores . Both groups scored well across all stakeholder groups .
Primary Care Indicators Primary care indicators , derived from OHIP billing and other administrative data , were developed and validated by the Institute for Clinical Evaluative Sciences ( ICES ). These indicators reflect whether a physician billed for a particular type of care and serve as a proxy of whether the care was provided to patients . The ICES component involved 377 ARPs and 11,127 TRPs . Analyses revealed that ARPs were similar to TRPs on the majority of primary care quality indicators including diabetic care , cancer screenings , mammography rates , and hospital readmission rates . Some differences were found in certain ARP subgroups . Most notably , the billing rates of physicians entering Ontario from another Canadian province ( either through AIT or through the exam eligibility route for those with practice experience in another Canadian jurisdiction ) were different than TRPs in preventive pediatric care , as measured by billing for well-baby visits , 18-month assessments , and immunizations . For some ARP groups , statistically significant respiratory care differences were evident using OHIP claims for spirometry and on a measure of all-cause emergency department visits of chronic condition patients . Although the above was statistically significant , it is important to note that epidemiological approaches using billing data does not help us to answer why such differences may exist . Differences may be due to factors that could not be included in the analyses .
Looking Forward Potential areas for quality improvement were identified for some ARP subgroups . For instance , the current evaluation findings point to early education needs in medical record keeping , and potentially , preventive pediatric care . Education and quality improvement opportunities could be coordinated by multiple organizations in the system , and may include such things as better understanding how billing practices and primary care expectations differ across the country . MD
The College has made increased access to registration possible through a wide variety of strategies that allow internationallytrained physicians to demonstrate qualifications .
ISSUE 1 , 2018 DIALOGUE 31