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Review of Monitored Drug History Before Prescribing

Professional Standards Regarding Review of Monitored Drug History Before Prescribing Preamble The College of Physicians and Surgeons of Nova Scotia (CPSNS) supports and encourages the use of the Nova Scotia Prescription Monitoring Program (NSPMP). Through the NSPMP eAccess web application, prescribers and pharmacists can quickly access the most recent 18 months of prescribing history. The College encourages physicians to always review the drug profile of all patients when prescribing controlled substances. Professional Standards When caring for patients in episodic, urgent or emergent care settings, physicians or delegates, where the delegate is a regulated health professional within the patient’s circle of care, must review the patient’s drug profile as maintained by the [...]

Medical Marijuana – Authorization

Professional Standards Regarding the Authorization of Marijuana for Medical Purposes Preamble The College considers the authorization of marijuana for medical purposes to be comparable to prescribing medication. Authorizing a patient's use of marijuana for medical purposes is a clinical decision. The College recommends that any such decision be informed by sound clinical evidence. Physicians who authorize the use of medical marijuana by their patients are encouraged to stay abreast of guidance from the College of Physicians and Surgeons of Nova Scotia, as well as organizations such as the Canadian Medical Protective Association, as medico‐legal and professional concerns apply. Professional Standards The College considers the authorization of marijuana for medical purposes to be a [...]

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 [...]

Prescribing ‘Take Home’ Naloxone – Exemption to the Requirement for Direct Patient Contact

Professional Standards Regarding the Exemption to the Requirement for Direct Patient Contact When Prescribing 'Take Home' Naloxone Preamble Rates of death and injury related to overdose from prescription and illicit opioids have reached unprecedented levels in Canada. Prompt administration of the opioid receptor antagonist Naloxone can be lifesaving. Some, but not all forms of Naloxone, are now available without a prescription. Programs designed to enhance community and institutional access to Naloxone have already proven effective in saving lives with relatively little risk. However, physicians participating in such programs may be placed in conflict with the College’s standard requiring direct patient contact when prescribing. The College wishes [...]

Sexual Misconduct in the Physician-Patient Relationship

Professional Standards and Guidelines Regarding Sexual Misconduct in the Physician-Patient Relationship Preamble Exploitation of a patient is professional misconduct. Sexualized behaviour with a patient is exploitation. Sexualized behaviour with a former patient may be exploitation. This standard reflects ethical responsibilities of physicians set out in the Canadian Medical Association’s Code of Ethics. In particular, the following sections of the Code are reflected: Consider first the well-being of the patient. Practice the profession of medicine in a manner that treats patients with dignity and as a person worthy of respect. Do not exploit patients for [...]

Infection Prevention and Control in the Physician’s Office

Professional Standards Regarding Infection Prevention and Control in the Physician's Office Preamble Ensuring safe and effective infection prevention and control measures is an important component of medical practice. Prevention and control measures mitigate the risks associated with infection transmission for employees and the public. The same standard of care for infection prevention and control is required in a clinical office setting as in a hospital facility. Professional Standards Physicians must maintain safe and effective infection control practices in their workplaces. In order to protect the health and safety of patients, employees and visitors in their offices, physicians must ensure that written policies and procedures are in place for the prevention and control of infectious [...]

Patient Consent to Treatment

Professional Standard and Guidelines Regarding Informed Patient Consent to Treatment Professional Standard Fundamental requirements for valid consent include: It must be voluntary; It must be given by a patient who has capacity; It must be specific as to the treatment; and It must be informed. Physicians must ensure that consent is obtained from patients before performing an examination or treatment, except where specifically permitted by law.1 The College recognizes that further aspects of consent are dynamic and subject to change. It is the responsibility of physicians to keep current with the state of the law on consent. [...]

Third-Party Examinations and Reports

Professional Standards and Guidelines Regarding Third-Party Examinations and Reports Preamble This standard applies to all physicians who prepare third-party reports, or who conduct medical examinations for a third-party report.  The standards and guidelines as set out in this document do not limit a physician’s mandatory reporting obligations. For the purposes of this document, the following definitions apply: “Third-party report” refers to medical information or a professional opinion, unrelated to the provision of health care, provided by a treating physician or independent medical examiner for the purposes of an external process such as applications for insurance benefits or legal proceedings. “Treating physician” is [...]

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; [...]