IN THIS ISSUE:
Message from the Registrar
Speaking Out as Physicians
It may come as a surprise to some, but as physicians our right to free speech is not absolute.
Being a responsible physician sometimes involves speaking out. We are expected to be thought leaders, and health advocates. We are afforded a powerful platform by virtue of being physicians. When we use that platform, we must ensure our voices bring no disrepute upon the profession.
The limits to the freedom of health-care professionals to publicly voice opinions were recently tested in the courts. In 2015, the Saskatchewan Registered Nurses’ Association initiated a complaint against Carolyn Strom. The case involved a 2015 Facebook post in which she criticized the health care her grandfather received in his final days. Ms. Strom did not identify any staff in her comments but made it clear that she herself was a regulated health professional. Ms. Strom was found to have committed professional misconduct and disciplined for harming the reputation of the nursing staff and undermining the public confidence in the profession.
Ms. Strom turned to the courts. After failing at the Court of Queen’s Bench and supported by her union, she succeeded at the Court of Appeal, which found that her freedom of expression had been unjustifiably infringed.
It is entirely legitimate for a professional regulator to impose requirements relating to civility, respectful communication, confidentiality, advertising and other matters that impact freedom of expression.
The court did however acknowledge the responsibility of the regulator in protecting the reputation of health professionals and ensuring public trust in the profession. “It is entirely legitimate for a professional regulator to impose requirements relating to civility, respectful communication, confidentiality, advertising and other matters that impact freedom of expression. Failing to abide by such rules can be found to constitute professional misconduct.”
The decision calls for medical regulators to balance the rights of the physician with the needs of the public and the profession. The court found that criticism of the health-care system is in the public interest, particularly when it comes from informed, front-line workers. When the College investigates complaints against physicians for public commentary, it must balance the competing interests of the physician’s right to expression, the public interest and the reputation of the profession.
The Importance of Renewing your Corporation Permit with the College
As physicians both your registration with Registry of Joint Stocks and your College permit must be renewed annually. With these in hand, physicians may access the tax advantages inherent in practising within a corporation.
There are significant consequences that go with practising medicine in a corporation without a permit from the College. The Medical Corporations Act establishes that offences under the Act are subject to fines by way of summary conviction.
Physicians are, therefore, encouraged to get advice from a tax professional should you wish not to renew your Corporation permit. The College has no control over how the Canada Revenue Agency (CRA) will treat earnings claimed by your corporation from practice during the time your corporation is without the College permit. This will be a matter between you and the CRA exclusively.
For a physician to practise medicine within a corporation, the Medical Corporations Act sets out two principal requirements:
1. That your corporation is appropriately registered with the provincial Registry of Joint Stocks; and
2. That you hold a Permit to Practise Medicine within a Corporation from our College. In essence, this permit can be considered a corporate medical licence.
COVID-19 Measures for Physicians
This Fall in Nova Scotia we have not experienced the significant number of COVID-19 cases as elsewhere in Canada.
Physicians across the province are playing key leadership roles in safely caring for patients during the pandemic. The College expects that physicians in all practice settings adhere to the direction provided by public health regarding safety protocols and to clinical guidelines developed by health professionals.
We are truly grateful to patients and physicians who continue to take all measures necessary to protect the health of Nova Scotians.
The College Congratulates its President Dr. Martin Gardner on Royal College Award
Dr. Martin Gardner
President, College of Physicians & Surgeons of Nova Scotia
Dr. Martin Gardner is the 2020 recipient of the Mentor of the Year award for Region 5. Dr. Gardner, Director of the Inherited Heart Disease Clinic at QEII Health Sciences Centre in Halifax, is the kind of mentor that former trainees connect with years later.
“He is an expert clinician, extremely able listener, and someone who allows you to help work through your issues and concerns in coming to a conclusion as to what is the next best step,” says Simon Jackson, MD, FRCPC, and fellow cardiologist at Dalhousie University.
“I was only one of many lucky individuals who was mentored by Dr. Gardner from my days as a Cardiology resident onward and I still go to him today whenever I have a difficult case or a difficult decision to make,” says Catherine M. Kells, MD, FRCPC, also a cardiologist at Dalhousie.
I was only one of many lucky individuals who was mentored by Dr. Gardner from my days as a Cardiology resident onward and I still go to him today whenever I have a difficult case or a difficult decision to make,” says Catherine M. Kells, MD, FRCPC, also a cardiologist at Dalhousie.
Dalhousie University professor John Sapp, MD, FRCPC, and president of the Canadian Heart Rhythm Society, remembers the impact Dr. Gardner had on him as a junior faculty member. “He made a point of respecting the expertise of colleagues and helping with patient care either by telephone, by reviewing electrocardiogram traces by fax, or by sharing in the clinical care. He set an example for our entire group, showing us how to be responsive and approachable as consultants.”
“He has been a personal inspiration for me and many others, demonstrating all of the attributes of an ideal academic specialist physician,” said Dr. Sapp.
Dr. Gardner says the most rewarding thing in mentorship “is when somebody understands something that was difficult to understand, and they go on to the next step with some sort of excitement or happiness. The second thing is when somebody comes back to me in an informal way to ask for advice because they trust me.”
Report from Council
The College Council, composed of physicians and public representatives met on December 11th. The Council approved the College’s operating budget for 2021 with no increase in licensing fees for next year.
The Council also began a strategic planning process to inform the College’s strategic plan moving forward.
Clinical Assistant Program
The role for physician expanders is growing. The College licenses clinical assistants and accredits the 14 programs in which these international medical graduates work.
The College surveys, evaluates and accredits all of the Clinical Assistant programs in the province.
The objectives of the accreditation process as:
- To ensure the quality of clinical assistant programs, consistent with the College requirements for such programs;
- To provide a means of objective assessment of clinical assistant programs; and
- To provide guidance to institutions in the development and implementation of clinical assistant programs.
Clinical Assistant Licensure information is available here.
Virtual Care Resources
The way physicians care for patients is changing. The Canadian Patient Safety Institute along with CMA have produced valuable resources to help you and your colleagues improve virtual care appointments.