Mandatory and Permissive Reporting Draft Policy

Consultation

The CPSO Mandatory Reporting policy is under review in accordance with our regular policy review process. The policy sets out the circumstances under which physicians are required or permitted to report particular events or clinical conditions to the appropriate government or regulatory agency.

Key Features of the Revised Draft
The mandatory reporting obligations of physicians are defined by statute. The draft policy captures previously pending statutory amendments that are now in force, and provides updated statutory references.
The policy title and preamble have been revised to reflect the overall content of the policy.
Under Permissive Reports, the section formerly titled Incapacity has been replaced with Physician Incapacity and Incompetence to provide a more complete representation of this ethical responsibility.
The structure and content of the policy has been reorganized to increase clarity, flow and readability.

Have Your Say
The College is inviting feedback from the profession, the public and other stakeholders on the revised policy.
To ensure transparency and encourage an open dialogue, feedback received is posted on our website in accordance with the posting guidelines.
All feedback is carefully considered by the College’s Executive Committee and Council before the final version of the policy is determined.
The deadline to provide feedback on the draft is August 3rd, 2012.

Special Instructions

The Council of the CPSO kindly asks that you pay particular attention to the Physician Incapacity and Incompetence section of the draft policy under Permissive Reports. This section outlines the expectation that physicians take appropriate action when they have reasonable grounds to believe another physician or health care professional is incapacitated or incompetent. Council recognizes the importance of ensuring language utilized in this section is sufficiently strong, given the potential risk to patient safety in the event that a report is not made. We would appreciate your thoughts on this section of the policy.
http://policyconsult.cpso.on.ca/

Here's the Draft

Incompetence 52. (1) A

Incompetence

52. (1) A panel shall find a member to be incompetent if the member’s professional care of a patient displayed a lack of knowledge, skill or judgment of a nature or to an extent that demonstrates that the member is unfit to continue to practise or that the member’s practice should be restricted. 1991, c. 18, Sched. 2, s. 52 (1); 2007, c. 10, Sched. M, s. 40 (1).

40 - Section 52(1) of the

40 - Section 52(1) of the HPPC states that a panel shall find a member to be incompetent if the member’s professional care of a patient displayed a lack of knowledge, skill or judgment of a nature or to an extent that demonstrates that the member Is unfit to continue to practice of that the member’s practice should be restricted

41 - Section 1(1) of the HPPC states that “incapacitated” means, in relation to a member, that the member is suffering from a physical or mental condition or disorder that makes it desirable in the interest of the public that the member’s certificate of registration be subject to terms, conditions or limitations or that the member no longer be permitted to practice.

1.(1) “incapacitated” means,

1.(1) “incapacitated” means, in relation to a member, that the member is suffering from a physical or mental condition or disorder that makes it desirable in the interest of the public that the member’s certificate of registration be subject to terms, conditions or limitations, or that the member no longer be permitted to practise; (“frappé d’incapacité”)

Looking at the Draft

Looking at the Draft Policy:

2. Physician Incapacity and Incompetence (Item 485 – 495) states:
The College’s expectations with respect to physician incapacity and incompetence (defined above) are based in professionalism and ethics. They are distinct from the legal obligation contained in the Health Professions Procedural Code, which requires health facility operators to report incapacity and incompetence. The reporting duty for facility operators is discussed in section 5 of this policy.

Physicians are expected to take appropriate action when they have reasonable grounds to believe that another physician or health care professional is incapacitated or incompetent. This includes circumstances where a colleague’s pattern of care, health or behaviour poses a risk to patient safety.

Appropriate action may include contacting the physician’s colleagues or family to discuss the most suitable response. The physician may wish to contact the College’s Physician Advisory Services and the Physician Health Program at the Ontario Medical Association.

Therefore, according to the

Therefore, according to the policy, it might be inappropriate to contact the CPSO or the CMPA?

I don't understand. The CPSO is supposed to protect the pubic, isn't it? Why would they not be interested in hearing other doctors' concerns about a doctor?

And, the CMPA is supposed to be concerned about keeping costs down, right?

Isn't that why they don't like to set precedents; because it could open the CMPA up to a lot more financial harm?

Wouldn't it be good if the CMPA were made aware that a doctor, because of his/her possible incompetence or incapacity, might eventually cost the CMPA a lot of money defending the doctor's care, or lack of care?

"Mandatory reports are

"Mandatory reports are legally required and considered necessary in the public interest" according to the Draft Policy.

To ensure safety, there is

To ensure safety, there is mandatory reporting for pilots or air traffic controllers, people affecting railway safety or maritime safety, and mandatory reporting for occupational health and safety, and correctional facilities.

But there is no mandatory reporting for incompetent or incapacitated doctors.

This policy indicates that it's permissible to contact the College's Physian Advisory Services and the Physican Health Program at the Ontario Medical Association.

Does that ensure safety? Puzzled

Let's hope and pray that it does.

"Therefore, according to the

"Therefore, according to the policy, it might be inappropriate to contact the CPSO or the CMPA?"

"I don't understand. The CPSO is supposed to protect the pubic, isn't it? Why would they not be interested in hearing other doctors' concerns about a doctor? "

I was thinking out loud, which can make me look silly, I guess.

The CPSO does not state that it is inapproprate to contact them if you are a doctor and you feel that another doctor might be incompetent or incapacitated.

In fact, what they are saying, if I am reading right, is doctors have a professional and ethical obligation to contact the Physician's Advisory Service if they believe that another doctor could be incompetent or incapacitated.

But, I could be wrong. I may have misunderstood.

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