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Medical Practice

Medical Assistance in Dying

Professional Standard Regarding Medical Assistance in Dying December 14, 2018 [1] Introduction On June 17, 2016 new provisions of the Canadian Criminal Code came into force. These amendments to the Criminal Code followed the Supreme Court of Canada decision in Carter v Canada (Attorney General)[2], which struck down the previous prohibitions against medical assistance in dying. The effect of the Carter decision, combined with the subsequent changes to the Criminal Code is that it is now legal for a physician or nurse practitioner to assist an adult patient to die if specified criteria have been met. The College of Physicians and Surgeons of Nova Scotia ([...]

Duty to Report Health Professionals

Professional Standards and Guidelines Regarding Duty to Report Health Professionals Preamble When a physician has reasonable grounds to believe that another physician is impaired, incompetent or unethical, there is a professional obligation to report this concern to the College.  The obligation arises regardless of whether the physician in question is a patient or a colleague. Similarly, physicians with good reason to believe a regulated health professional (other than a physician)  is impaired, incompetent or unethical, there is a professional obligation to report these concerns to the appropriate regulatory authority. These obligations arise from a responsibility to uphold patient safety and to protect the integrity of the health professions. Physicians should contact the

Disruptive Behaviour by Physicians

Professional Standard Regarding Disruptive Behaviour by Physicians Preamble This professional standard specifies the College's expectations of physician behaviour in a professional environment. Disruptive behaviour is conduct characterized by the use of inappropriate words, actions or inactions by physicians which shows disrespect for others or any interpersonal interaction that interferes with or is likelyl to interfere with quality health care delivery. Good faith advocacy is not considered disruptive behaviour. Physicians may be accused of disruptive behaviour by their colleagues, patients or administration and/or leaders at the institution where they practice. In such instances, physicians should contact the Canadian Medical Protective Association as these matters may come before [...]

Physician Use of Social Media

Professional Standards and Guidelines Regarding Physician Use of Social Media Professional Standards Physicians are responsible to act in a manner that upholds the professional standards and ethics of the medical profession at all times. Expectations of professional and ethical conduct are the same whether physicians are interacting in person or online through social media. When using social media, physicians must: Not communicate with individual patients about anything pertaining to their medical care. Do not doctor on social media; Ensure all communications are professional, ethical and in keeping with the standards of the profession. For example, physicians should refrain from portraying any unprofessional images of themselves [...]

Reducing the Size of a Medical Practice

Professional Standards and Guidelines Regarding Reducing the Size of a Medical Practice Preamble Tension exists between the professional duty not to abandon patients and the physician's freedom to manage the size of their practice. Physicians may not discriminate against patients at any time including when considering discharging them from their practice. As providers of professional services, physicians are bound by the Nova Scotia Human Rights Act, which prohibits discrimination regarding provision of or access to services or facilities on the basis of age, race, colour, religion, creed, sex, sexual orientation, gender identity, gender expression, physical disability or mental disability, an irrational fear [...]

Care of Patients Who Have Received Treatment Outside Canada

Professional Standard Regarding Care of Patients Who Have Received Treatment Outside Canada Preamble Physicians have an obligation to treat patients with whom they have an existing physician-patient relationship. In discussing with a patient their desire to seek treatment outside of Canada, a physician may wish to discuss any potential risks and benefits. Physicians are expected to respectfully communicate with due regard for patients’ concerns. Physicians should respect patients’ autonomy in seeking out-of-country procedures. This may include managing complications arising from treatments received elsewhere. Professional Standard Physicians must deliver the appropriate and professional standard of care to all patients including when treating a patient who has received care outside of Canada. Physicians are not obligated [...]

Transfer of Care

Professional Standards Regarding Transfer of Care Preamble In the complex world of medicine, it is imperative that a single physician be identified at all times as the most responsible physician (MRP) for any patient. All patients at all times have a right to know which physician is most responsible for their care. This document sets out the responsibilities of physicians to ensure that there is at all times a MRP for all patients, who is aware of the responsibilities of being the MRP, and whose identity is known to the patient. In short, there must always be a MRP for any patient. The MRP must, at all times, be aware of his or her status as [...]

Treating Self and Family Members

Professional Standards and Guidelines Regarding Treating Self and Family Members Preamble Whenever a physician treats someone with whom he or she has a personal relationship, there is a risk that the relationship will affect the physician’s ability to provide good-quality, clinically objective care.  Similar issues exist when physicians engage in self-treatment. Providing appropriate medical care within the context of a personal relationship is problematic because of the difficulty in defining and maintaining appropriate boundaries. For the purposes of this document the following definitions apply: “Family member” means a physician’s spouse or partner, parent, child, sibling, grandparent or grandchild; a parent, child, sibling, grandparent or grandchild of the physician’s spouse or partner; [...]

Walk-in Clinics – Standard of Care

Professional Standard on the Standard of Care for Walk-in Clinics Preamble The standard of care for patients by physicians does not vary with the location of clinical care. Patients are entitled to receive care of the same appropriate and professional standard at a walk-in clinic as they would receive elsewhere. Professional Standard At minimum physicians working in walk-in-clinics must: Ensure that a patient file is maintained and that a system for registering and recording patient visits is maintained over time; Ensure that they follow-up on investigations they have ordered, unless other physicians involved in the patient’s care have been informed and have explicitly agreed to assume this responsibility. Any [...]

Cosmetic Procedures in Nova Scotia – Qualifications Required to Perform

Professional Standard on Qualifications Required to Perform Certain Cosmetic Procedures in Nova Scotia Introduction Recent tragic events in Canada and other parts of the world have highlighted the need for high levels of training and experience among physicians who undertake cosmetic procedures. In keeping with its public protection mandate, the College of Physicians and Surgeons of Nova Scotia has surveyed several experts in the field and has produced the following list of cosmetic procedures whose degree of risk warrants that they be performed only by highly trained and experienced specialist physicians working within the scope of practice of their specialty. Qualifications and Procedures Only physicians who are listed on the speciality register [...]