Advice to the Profession Regarding Virtual Care During the Pandemic
COVID-19 is putting tremendous pressure on our health care system, in particular those working on the frontlines. While the College expects physicians will practice within the scope of their training and expertise and act in the best interest of their patients, it also recognizes these are extraordinary times. The adoption of virtual/telemedicine care will be called for in the days and weeks ahead. A fee for this service is now in place for physicians, for details contact Doctors NS.
The College wants to ensure physicians can deliver patient care in the face of the pandemic. Central to this effort is the importance of limiting viral spread by:
- Reducing all unnecessary patient and physician travel;
- Reducing unnecessary patient visits to health facilities, and;
- Enabling physicians to provide remote patient service within Nova Scotia or from other jurisdictions.
Care for patients with
- Use virtual means to keep contact with patients who have symptoms and who you are monitoring.
- Reassess patients virtually, and if worsening arrange appropriate follow up.
Care for regular patients
by virtual means whenever possible for the following reasons:
- To avoid unnecessary trips to the office.
- To manage patients with chronic disease.
- To manage other acute illness that may not require a physical exam.
For further guidance please review Professional Standards Regarding the Provision of Telemedicine Services.
The College recognizes the growing role of telemedicine or virtual medicine in our pandemic response. As such, the College wishes physicians to be aware of the following:
- For physicians licensed in Nova Scotia, there is no requirement for College approval for this field of practice.
- Any physician licensed in Canada may deliver telemedicine services in Nova Scotia, unless specifically restricted from doing so by their licensing body;
- The regulation of the medical services you provide into Nova Scotia rests with your licensing college.
- All physicians delivering telemedicine services in Nova Scotia should refer to the College’s Professional Standards for the Provision of Telemedicine Services.
These are extraordinary times, giving rise to many questions from physicians about their ongoing responsibilities. We wish to acknowledge the tremendous efforts of physicians around the province.
encourage physicians to review CMPA’S
COVID-19 guidance which provides a succinct outline of the CMPA’s
expectations of physicians, including:
the challenging conditions of a pandemic/catastrophic event, physicians will be
expected to continue to act professionally on behalf of their patients.”
The College understands that physicians know to exercise sound professional judgement when caring for their patients in the midst of this pandemic. As such, the College expects reasonable measures to be undertaken to minimize risk and maximize your ability to help patients. These measures might include altering your schedule regarding patient encounters, increasing your use of phone or virtual consultations, and limiting physical examinations only to the most necessary.
considering the closure of practice must adhere to the College Standards on Temporarily
or Permanently Closing a Medical Practice and Reducing
the Size of a Medical Practice.
The College wishes to thank all physicians who are called upon during this pandemic. We ask that you use your professional judgement to stay well while caring for your patients.
The College is following public health recommendations and as such our office location is closed. All essential services are being provided remotely by College staff. Essential services include: licensing physicians, addressing complaints, and responding to imminent patient safety concerns. We are monitoring phone messages and email inquiries. We appreciate your patience in responding to your inquiry. For updated information from the College follow us on Twitter or check the College’s news section.
province, doctors are providing excellent care and meaningful leadership during
these challenging and extraordinary times.
The Chief Medical Officer, Dr. Strang, is overseeing our public health response. He has asked the College to directly communicate to physicians on an important matter.
In support of our Chief Medical Officer, and pursuant to the advice of our experts in Infectious Diseases, please be advised that, effective immediately:
Only physicians recognized as specialists in Infectious
Disease may prescribe or initiate treatment with lopinavir/ritonavir (Kaletra), and/or hydroxychloroquine.
Patients already taking these medications may be maintained on their regime by
their regularly prescribing physician
This restriction supplements the approach adopted by the College of Pharmacists, which has instructed its pharmacists not to dispense these medications.
We all need to work together. Each of us has a role to play in keeping Nova Scotians safe. Thank you to the tremendous work of physicians working on the front lines to do just that.
(The following was published in the Chronicle Herald March 14, 2020)
These are nervous times. As we await the first case of COVID-19 in our province, fear and confusion could easily overwhelm us. There are, however, important reminders and reassurances to offset our anxiety.
Unlike many other countries affected by this pandemic, Canada has a robust public health system. In Nova Scotia, we have the necessary expertise and infrastructure to respond well to this challenge.
It is now time to rely on expertise. We must summon the discipline to resist the inexpert advice that is abundantly available through any number of unreliable information sources. Those of us who are not experts must be careful to avoid offering opinions. If our province’s response to the inevitable arrival of COVID-19 is going to be effective, it is incumbent on all to follow the advice of our public health experts. They are providing the leadership; it is our responsibility to follow.
First and foremost, we must embrace the common-sense recommendations from the experts. Wash your hands, well and often. Resist or limit touching your face with your hands. Disinfect surfaces. Observe social distancing. Avoid large, close gatherings. If you can, work from home. If you are sick, do not go into work. If returning from travel, observe the self-isolation recommendations. These measures might seem small and inconsequential in the face of a pandemic. The experts tell us otherwise.
Patients are encouraged to pursue advice from 811. This service provides important triage, directing patients to the appropriate next step. By bypassing 811 and pursuing direct care or in-person advice, patients put the community at risk, the health professionals themselves at risk, and threaten to overwhelm the system. Bypassing the simple step of calling 811 might heighten the problem and weaken the collective response.
Patients should not worry about their medications. The College of Pharmacists and the province will have contingency plans in place, allowing for access to prescription medications in the event that some pharmacies need to close.
Although there is appropriate concern that a rapid outbreak may overwhelm our health-care physical and human resources, physician mobility will not be an issue in our country’s response to the pandemic. The College has activated its business continuity plan to ensure the licensing of physicians will continue to be carried out in a thorough and timely manner.
With respect to emergency medical licensing, the provincial colleges have reached a consensus. Nova Scotian physicians seeking to help in pandemic response in other provinces may do so without hassle. Similarly, physicians from other provinces wishing to support our local response can be licensed on an emergent basis immediately. Physicians recently retired in Nova Scotia wishing to participate in the pandemic response should contact the College to determine if their licences can be reinstated for this purpose. Physicians travelling to respond to the pandemic elsewhere in the country should be aware that their liability coverage will remain in place.
The College is aware that the Medical Council of Canada, the Royal College of Physicians and Surgeons of Canada, and the College of Family Physicians of Canada all are contemplating making changes to their examination schedules. The licensure of physicians in training and provisionally licensed physicians will not be affected by any examination changes. They will be maintained in provisional licensure.
The situation is fluid. Both physicians and patients are well advised to stay current with the latest developments of the pandemic through public health at: https://novascotia.ca/coronavirus/.
The Nova Scotia Health Authority is maintaining active updates at: www.nshealth.ca/news. It is also providing information regarding COVID-19 assessment centres at: www.nshealth.ca/coronavirus.
Nova Scotians are good at preparing for storms. We heed the weather warnings. We batten down the hatches. We stay safe. We do the right things. I am confident we can apply this approach to COVID-19.
Dr. Gus Grant is registrar & CEO of the College of Physicians and Surgeons of Nova Scotia.
The College has been advised that the Medical Council of Canada, Royal College of Physicians & Surgeons of Canada, and the College of Family Physicians of Canada have postponed their examinations due to the COVID-19 pandemic.
If you are registered for one of these examinations, be assured that this will not negatively affect your medical licensure.
If you are provisionally licensed at present, your provisional licensure will be extended.
If you are the end of training, and contemplating independent practice, you will be considered eligible for provisional licensure.
If you have any questions please contact the College’s Registration Department at: email@example.com.
The College of Physicians and Surgeons of Nova Scotia is seeking an individual to serve as a public representative on the governing Council. The College regulates the practice of medicine in Nova Scotia and serves the public interest. The candidate cannot be a physician (either at present or formerly).
The successful candidate will be asked to represent the public perspective regarding the regulation of the medical profession. This includes speaking to the power imbalances between physicians and their patients or members of the public.
In assessing public representatives, the Nominating Committee will
consider a broad range of characteristics including the following:
- Knowledge of position, familiarity with the College of Physicians and Surgeons of Nova Scotia
- Reason for application
- Understanding of “public interest” and role of the position
- Ability to devote the time required to the position
- Experience with community volunteer activities
Read the role description and requirements for council members.
If interested, please forward a cover letter and resume no later than Friday, March 6, 2020 to:
c/o Carolyn MacDonald, Manager, Registrar’s Office
College of Physicians & Surgeons of Nova Scotia
Suite 400 – 175 Western Parkway
Bedford, NS B4B 0V1
The following directions
have been issued by the Hearing Panel subsequent to the hearing of a motion brought by the
College on February 14, 2020. The motion was
brought to address various concerns, including the upholding of the publication
ban respecting the identities of the complainants. The full reasons for
these directions will be set out in a decision to be rendered by the Hearing
Panel at a later date.
The Hearing Panel
directs as follows:
1. In accordance with a publication ban granted on October 24, 2019, the
names and all information that may identify the complainants in this matter are
banned from any form of publication or disclosure;
2. The media are permitted to attend the hearing scheduled to commence on
February 24 at 0930 at the offices of the College. In addition,
individuals such as family members who are identified by legal counsel for
Dr. Moodley or the complainants as their support for the hearing, are
permitted to attend the hearing.
3. Individuals apart from those identified above are not permitted to attend the hearing but will have full access to any decisions of the Hearing Panel, subject to the publication ban.
4. For those permitted to attend the hearing, the following will apply:
a. Subject to the publication ban, the media may take video footage or
photographs on the College’s premises before evidence is called. No video
images or photography may be taken while evidence is being presented.
recording by the media is permitted for note-taking purposes, but not for
c. In order to uphold the publication ban, no live transmission of the evidence is permitted, through live tweeting, blogging or any other simultaneous source of reporting. Media are otherwise permitted to report information about the hearing, but only after the parties have had an opportunity to consider whether any evidence presented may be subject to the publication ban. During the mid-morning and mid-afternoon breaks, and prior to the lunch break and end of the day, the Hearing Panel will canvass the parties to determine if there is evidence that may be subject to the publication ban and will provide direction to the media in this regard prior to the media reporting on the preceding evidence.
5. Those attending the hearing will be required to sign in and acknowledge
agreement with these directions.
6. Inquiries about the hearing should be directed to:
Pattie LaCroix, Director, Communications & Policy
College of Physicians and Surgeons of Nova Scotia
Suite 400-175 Western Parkway, Bedford, NS B4B 0V1
The College will bring a motion to be heard by the Hearing Panel on Friday, February 14, at 2 pm at the offices of the College (400 – 175 Western Parkway, Bedford) to seek a partial exclusion order in accordance with clause 109(2)(a) of the Medical Practitioners’ Regulations. The relevant portions of the regulations read as follows:
Attendance at hearing and publication bans
109 (1) Except as provided in subsections (2) or (3), a
hearing is open to the public.
(2) At the request of a party, a
hearing committee may order that the public, in whole or in part, be excluded
from a hearing or any part of it if a hearing committee is satisfied that any
of the following apply:
medical, financial or other matters that may be disclosed at the hearing are of
such a nature that avoiding public disclosure of those matters in the interest
of the public or any person affected outweighs adhering to the principle that
hearings should be open to the public;
safety of any person may be jeopardized by permitting public attendance.
(3) A hearing committee may make
an order that the public be excluded from a part of a hearing that deals with a
request for an order to exclude the public in whole or in part under subsection