- New Supervision Program For Defined Licencees
- Medical Aid In Dying: Update
- Scope of Practice
- Opioid Treatment Disorder: Update
- Council Report
- College Staffing Update
New Supervision Program For Defined Licencees
Physicians practising under a Defined Licence in Nova Scotia are now required to have supervision for the duration of that licence.
These requirements, set out in the Medical Act and Medical Practitioners Regulations, will provide both the profession and the public with a greater deal of confidence in the performance of Defined Licencees.
The College’s governing Council has directed staff to develop a program that delivers meaningful supervision to Defined Licensees and fulfills all legislative requirements. The cost of supervision is to be borne by the individual Defined Licence holders.
The College’s new supervision framework has four distinct levels, with progressively increasing intensity of oversight. Defined Licencees will be assigned a preliminary level of supervision and will be adjusted up or down as necessary based on their ongoing supervisory reports.
While we aim to have the program operational within the next 12 months, program development continues on a number of fronts including:
- Reviewing and, where necessary, adapting relevant registration and licensure policies;
- Reconciling the list of Defined Licencees against these policies to ensure that each physician’s licence type is appropriately aligned with their qualifications and circumstances;
- Assigning appropriate levels of supervision;
- Developing supervision tools and reporting frameworks appropriate to the full spectrum of Defined Licence practice in Nova Scotia;
- Building capacity for the recruitment, orientation and support of Defined Licence supervisors;
- Developing a web-based portal that will track supervision activities and reporting, and facilitate the remuneration of supervisors; and
- Communication with prospective and current Defined Licencees.
Medical Aid In Dying: Update
Legislation regarding medical assistance in dying was tabled in the House of Commons on April 14th. Bill C-14 lays out specific criteria for Canadians who wish to end their lives with the help of a medical professional.
In anticipation of this legislation, regulatory Colleges across the country had drafted professional standards, to provide guidance to both the profession and the public on the delivery of this service in their respective jurisdictions.
The College led a working group comprised of stakeholders from government and the health and legal professions. Working over several months this group developed a Draft Standard of Practice: Physician-Assisted Death. The College in collaboration with Doctors Nova Scotia, made available the draft document for broad online consultation. A full report of this consultation along with an executive summary is available.
The College’s working group will reconvene in order to align its professional standard with federal legislation and to provide direction on some matters not addressed in the proposed law.Back to Top
Scope of Practice
The College of Physicians and Surgeons of Ontario (CPSO ) is undertaking a broad physician consultation on scope of practice.
As part of this consultation, CPSO will be reviewing the expectations set out in its Changing Scope of Practice Policy. CPSO will also be looking at the concept of scope of practice more broadly to inform work occurring on this issue at the national level.
CPSO is inviting all stakeholders, including members of the medical profession, the public, health system organizations, and other health professionals to participate in this consultation.
CPSO will post consultation feedback on its website (without posting names of individual participants). Visit the CPSO’s website for further details about the consultation.Back to Top
Opioid Treatment Disorder: Update
Treatment for opioid use disorder may include opioid agonist therapy (also known as opioid substitution/replacement/ maintenance therapy) with methadone or buprenorphine.
- Buprenorphine is subject to the federal Controlled Drugs and Substances Act
- Buprenorphine prescriptions are monitored by the Nova Scotia Prescription Monitoring Program
- Unlike Methadone, a Health Canada exemption is not required to prescribe Buprenorphine in Nova Scotia.
Buprenorphine is commonly combined with naloxone, an opioid antagonist, to reduce the potential for intravenous use or diversion. However, buprenorphine/naloxone has significant potential to cause harm or death if improperly prescribed, used or monitored.
Physicians wishing to prescribe buprenorphine/naloxone for opioid use disorder must be properly informed in its use, including but not limited to its:
- dosing; and
- treatment alternatives.
The Centre for Addiction and Mental Health (CAMH) document Buprenorphine/Naloxone for Opioid Dependence: Clinical Practice Guidelines has been endorsed by the College’s Methadone Maintenance Support Program Committee and is the recommended resource. In addition, formal or informal consultation with a prescriber experienced in the use of buprenorphine/naloxone is strongly recommended.
For those wishing further information or more comprehensive preparation, the College recommends:
- Buprenorphine-Assisted Treatment of Opioid Dependence: An Online Course for Front-Line Clinicians
- Methadone Maintenance Treatment Handbook, Section 3: Options Other than MMT for Opioid Dependence, includes best practices related to Buprenorphine. The second edition of the handbook, due out in May 2016, will include additional information for Buprenorphine prescribers.
The College’s governing Council consisting of practising physicians and public members met April 1st. Among the agenda items discussed were the following:
Continuing Professional Development (CPD):
The Medical Act mandates that all licensed physicians participate in a program of continuing medical education through:
- The College of Family Physicians of Canada (CFPC) MAINPRO Program or
- The Royal College of Physicians and Surgeons of Canada (RSPSC) Maintenance of Competence (MOC) Program
- The Council directed the College to develop compliance guidelines along with a regulatory response to address those physicians not compliant with this mandatory requirement.
Professional Standards & Guidelines approved:
- Professional Standard and Guidelines Regarding Accepting New Patients
- Professional Standard Regarding Medical Records
The 2015 Audited Financial Statements for the Year Ended December 31, 2015 were reviewed and approved by Council. The statements will be made available in the College’s upcoming 2015 Annual Report.Back to Top
College Staffing Update
The College is pleased to announce that Dr. Graham Bullock has been named as the College’s new Deputy Registrar. The College also welcomes Rhonda Kirkwood as the Director of Physician Performance, a position previously held by Dr. Bullock.Back to Top
Safe Opioid Prescribing for Chronic Non-Cancer Pain
May 21st, 2016 in Sydney NS
This one day prescribing course covers opioid prescribing from assessment to tapering.