Dialogue Volume 14 Issue 2 2018 - Page 36

All opioid investigations flagged by NMS information completed T he College has completed all 84 of the investigations it conducted after receiving information from the Narcotic Monitor- ing System (NMS) about potentially inappropriate opioid prescribing. And the outcomes make it apparent that the College’s preferred choice of action, in such instances, is to support education and continued prescribing with supervision. A sizable percentage of those physicians investigated – more than half – were ordered to take mandated remediation. This could include an agreement by the doctor to participate in education and/or practise under clinical supervision and to be reassessed. “These outcomes demonstrate that the College will choose a remedial approach in clinical investigations, whenever possible, to help physicians practise to cur- rent standards,” said Dr. Steven Bodley, College Presi- dent. “Our goal is to keep the physician in practice and to support education and provide guidance, where the physician’s capacity for remediation is apparent,” he said. The outcomes of the completed investigations are included in the table, below. Outcomes of NMS-initiated investigations No. of Cases No action 22 Advice 5 Remedial self-study 2 Mandated remediation 38 Mandated remediation and a caution 8 Prescribing restrictions 2 Prescribing restrictions and a caution 1 No longer in practice 4 Referral to the Discipline Committee* 2 Total 84 * One hearing has concluded with a finding of professional misconduct and the physician agreeing to relinquish his licence; the second hearing is pend- ing as of May 30, 2018. 36 DIALOGUE ISSUE 2, 2018 Definitions – Investigative Outcomes Investigations that arise from receipt of informa- tion from the NMS entail seeking more information from the prescribing physician and others in order to better understand and evaluate 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, Complaints 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 provid- ed 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: