MESSAGE FROM THE PRESIDENT
competent , but they would need to practise ethically . For the first hundred years , Council was made up entirely of physicians . However , with changing times came changing expectations . Patients , and the public in general , began to feel that they wanted more input into the oversight of health-care professionals .
With the appointment of the first public members by the government in the 1970s , Council has grown and morphed into its present configuration . It now includes 13-15 public members , six physicians appointed by each of the medical schools ( only three of whom are voting members ) and 16 physicians elected by the profession . It is important to emphasize that physicians are elected to Council by physicians not to be their advocates , but rather to represent the interests of the public on their behalf . This subtle , but critical , fact is confusing for many physicians and poorly perceived and understood by many members of the public . So , despite having a structure that reflects a blended regulatory model , a perception persists that the College remains an organization which looks after physicians ’ interests over those of the public .
Council has already recognized that some changes are overdue and necessary . For example , the participation of Council members ( both physicians and public members ) in the work of statutory committees may create confusion with respect to Council ’ s oversight role .
In early 2017 , Council adopted the position to support statutory change to achieve greater independence of the Discipline Committee so that those sitting on hearing panels were not also members of Council . The approach was adopted to ensure greater independence of the adjudicative function and to strengthen the integrity of College processes . Governance needs to focus not on day to day activities , but on matters such as strategy , engagement and how we ensure that all College decisions are made in the public interest .
There have been clear and consistent calls to modernize the process of medical regulation . There is general agreement that modern governance bodies need to be smaller , more diverse in their representation , and include more public members . It has been suggested that members be added on the basis of competence in order to fulfill their mandate to serve the public interest . Some of these concepts are difficult to balance . How can boards become both smaller and at the same time increase in their diversity ? What competencies are required and who will decide how competency will be measured ? At what point will an increasing number of public appointees lead to the confidence that decisions made reflect the public interest and not the interests of physicians ?
And significantly , how will we incorporate the necessary input to governance of physicians who work in the day to day practice of medicine and who maintain the respect and support of their colleagues across Ontario into the system of medical regulation ?
These are some of the fundamental and challenging questions facing Council as we work to provide input into a more modern form of medical regulation . MD
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DIALOGUE ISSUE 2 , 2018