Primary care physicians are contacting the College with questions regarding their professional obligations to treat patients with workplace injuries.

Amidst contract negotiations, the Workers' Compensation Board of Nova Scotia (WCB) recently withdrew the 11% premium it pays physicians to care for injured workers.

Doctors Nova Scotia (DNS) has issued two communications to physicians in response to the withdrawn premium.

The College met with DNS following its initial communication of July 14 to express our concerns. In response to that meeting, DNS advised there would be further clarification provided to physicians. The July 24 communication regarding the professional duties of physicians does not wholly address the College’s concerns.

The College agrees with DNS that physicians are obligated to accept WCB patients in emergency situations. The College further agrees with DNS that physicians cannot withdraw care to a patient they are already treating for a WCB injury.

DNS provides no direction on whether physicians working in walk-in or episodic care clinics are required to provide care to the patient presenting with a workplace injury. The position of the College is that, if a clinic is open to unattached patients, physicians are obligated to treat all who present.

Physicians should not refuse care to the attached patient who presents with a workplace injury, unless the nature of the injury and the care required is beyond the physician’s expertise. Simply posting a notice in your clinic is insufficient.

The College’s position is that professional duties are anchored in a commitment to patient-centered care. This approach is in alignment with regulatory direction in place across the country. I would draw your attention to the relevant College standards, in place before the withdrawal of the WCB premium:

Professional Standard and Guidelines Regarding Accepting New Patients

Professional Standard and Guidelines for Ending the Physician-Patient Relationship

Withdrawing of Physician Services during Job Actions

This guidance aligns with directions in place in other provinces.

The care of patients should not be compromised by the contract negotiations between WCB and DNS. Further, the burdens on our Emergency Departments should not be increased as a result of these negotiations.

Please feel free to contact me directly if you have any questions.

Yours,

Dr. D.A. (Gus) Grant
Registrar and CEO
College of Physicians and Surgeons of Nova Scotia

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