FEATURE
be context dependent and require, in part, that
physicians comply with the specific expecta-
tions set out in the companion policies.
The draft policy advises physicians in their
role as health advocates to use their expertise
and influence to help advance the health and
well-being of their patients, their communities,
and the broader populations they serve.
Ms. Joan Powell, a public Council mem-
ber from Thunder Bay and a member of the
working group, said her group’s exploration
of the issues found that patients also have an
important and growing role to play in facilitat-
ing continuity of care, as actions they take may
contribute to or help prevent breakdowns in
continuity of care.
“Informed and engaged patients who under-
stand their role and responsibilities comple-
ment physicians’ efforts to support continuity
of care.” she said. “We also noted that patient
choices regarding when and how to access care,
their availability to receive test results, and
their compliance with getting tests completed
in a timely manner all impact continuity of
care,” Ms. Powell added.
Physicians are encouraged to help patients
understand their role in their health care, as
well as how their actions or inaction can facili-
tate or disrupt continuity of care. The Col-
lege intends to develop a companion patient
engagement document at a later date that will
aim to assist patients in understanding how
they can facilitate continuity of care. More
specific expectations regarding patient engage-
ment have been articulated, where relevant, in
the companion policies.
But while patient engagement can supple-
ment and support physicians’ efforts to
facilitate continuity of care and is an impor-
tant element of patient-centred care, patient
engagement is not meant t o absolve physicians
of their responsibilities in this regard.
Physicians are also strongly advised in the
umbrella policy to capitalize on advances
in technology that can facilitate continuity
of care. Although continuity of care can be
achieved without relying on technology, tech-
nological solutions exist that can assist with, for
example, test results management, facilitating
access and/or coverage, facilitating informa-
tion exchange between health-care providers,
and improving transitions in care, especially
as it pertains to handovers within health-care
institutions, hospital discharges, and the refer-
ral and consultation process.
Availability and Coverage
This draft policy sets out the
College’s expectations of physi-
cians regarding physician avail-
ability, after-hours coverage,
and coverage during temporary
absences from practice.
The draft notes that “continuity of care does
not require individual physicians to personally
provide on-demand and continuous access to
care. Doing so would negatively impact the
quality of care being provided and compromise
physician health.” Rather, continuity of care,
states the draft, means being available and
responsive to patients and health-care providers
and making plans or coverage arrangements
when physicians are unavailable.
“We are asking physicians, who are provid-
ing care as part of a sustained physician-patient
relationship, to use their professional judgment
in developing a plan that works best for their
own practice in regard to the coordination of
care outside regular operating hours,” said Dr.
Copps. The nature of the plan will depend on
a variety of factors, including the time of day
and type of day (i.e., weekday, weekend, and
holiday), the needs of their patients, as well
as on the health-care provider and/or health-
system resources in the community.
“In this way,” she said, “we can minimize un-
coordinated access to care and the inappropriate
usage of emergency rooms or walk-in clinics.”
The working group sought to “strike a bal-
ance between setting an expectation that would
advance the public interest while at the same
time recognizing that there are limitations to
ISSUE 2, 2018 DIALOGUE
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