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Physician-Assisted Death

The Supreme Court of Canada in its unanimous decision of last February struck down the ban on physician-assisted death.

The court suspended its declaration for a year in order to allow federal and provincial governments time to draft new legislative provisions. As yet, no such provisions are in place. With the deadline of February 2016 fast approaching, it has now fallen to the regulatory bodies to provide direction to both patients and health care providers.

“The profession and the public both are entitled to clear direction as to how the rights established in the Carter decision can be operationalized,” said Dr. Gus Grant, Registrar and CEO of the College. “Physicians, patients and their families are entitled to the comfort that they are accessing this new right in keeping with legal and regulatory expectations.”

The College is currently collaborating with stakeholders in order to align its regulatory response with the Supreme Court’s decision. A working group, including representatives from the Health Authority, the College, the Health Law Institute, the Medical Examiner’s Office, and Doctors Nova Scotia is developing a Standard of Practice document.

The focus of the group is to loyally operationalize only the rights established in the Supreme Court’s Carter decision, specifically that certain competent suffering patients can obtain assistance in dying from willing physicians. The goal is to neither expand nor restrict the decision. It is anticipated that future court decisions or legislation will likely address those questions not answered by Carter.

Upon completing the draft of the Standard, further stakeholder consultation will take place. The Standard will then be put before the College’s Council for approval. In 2016, the College will hold educational sessions to review the Standard with both patients and physicians.

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Supervision of Defined Licences

A Defined Licence allows certain physicians an opportunity to practise medicine as they work towards meeting the criteria for full licensure. Holders of a Defined Licence are subject to a number of conditions, including supervision. Under the new Medical Act, supervision is required for the duration of the Defined Licence.

The requirement for ongoing supervision reflects a consensus reached by the College, Doctors Nova Scotia and the Canadian Medical Protective Association (CMPA) to uphold Canadian standards for licensure. Efforts to onboard international medical graduates who do not meet the Canadian standard to practice, in underserviced areas, must also aim to ensure care is being delivered in keeping with our standards. Supervision provides for an effective check and balance in the interest of public safety.

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Continuing Professional Development

Nova Scotia joined other provinces such as Manitoba, Ontario and British Columbia in setting out mandatory continuing professional development (CPD) requirements. The Medical Act mandates that all licensed physicians participate in a program of continuing medical education through:

As part of your licence renewal, you are required to provide evidence of your enrollment in either the CFPC’s MAINPRO or the Royal College’s MOC programs. You are also to confirm you have submitted the required number of credits for the current year to either program.

Upon enrolling in MAINPRO or MOC please email the Information and Consent Form to the College at: registration@cpsns.ns.ca .

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Peer Review Update

Under the Medical Act, the College is required to conduct a “practice assessment program.” The purpose of the program is to enhance the competence of individual members and promote quality improvement in the profession as a whole.

Across Canada, provincial regulators are exploring the concept of peer review that is tailored to a physician’s practice scope and circumstances. Here in Nova Scotia, the College’s Council has directed College staff to oversee the development of a new Peer Review program with a quality improvement focus. The new program will replace NSPAR which closed in December of last year.

Although all Nova Scotia physicians will eventually participate in this new program, it will have multiple streams and will direct greater support to those physicians more likely to benefit. All participating physicians will receive direct feedback from a trained peer reviewer.

The College is consulting with local experts and practising physicians to inform the design of the program. The College’s new Peer Review program will be piloted for family medicine specialists later in 2016.

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Council Report

The College’s governing Council composed of physicians and public members met October 16th. Among the agenda items discussed were:

  • Physician-Assisted Death
  • Licensing Fees
  • Supervision

Physician-Assisted Death
An update of the Physician-Assisted Death Working Group, which is tasked with the development of a Standard, was provided to Council. Council members discussed the main elements of the Standard. It was noted the draft document has been circulated to stakeholders for feedback.

Licensing Fees
After an extensive review of the licensing fee schedule, the Council approved an updated schedule reflecting the increase in regulatory and administrative costs for each type of licence granted. The Council approved fee increases for licensing in relation to the regulatory and administrative requirements for each licence rather than a flat global fee increase across the board.

Supervision
Supervision of those holding a Defined Licence in the province is a legislative responsibility. In addition, Council recognized the necessary steps to ensure that physicians who do not meet standards for full licensure are practising safely and competently. Supervision enables the College to meet its responsibility of oversight of these exceptionally licensed physicians.

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A Friendly Reminder to Renew Your Licence

If you are licensed to practise medicine in Nova Scotia, you must renew your medical licence annually. If you are a physician practising medicine under a corporation in which you are listed as a Medical Director, you must also renew your corporation permit each year.

Online licence and corporate permit renewal starts November 2ndand ends November 30th.

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Nova Scotia Prescription Monitoring Program Stakeholder Survey

Please note that the Nova Scotia Prescription Monitoring Program (NSPMP) 2015 Stakeholder Survey is currently available online for prescribers and pharmacists to complete. The survey takes no more than 5-10 minutes, and your responses will help contribute toward the success of the Nova Scotia Prescription Monitoring Program.

The survey closes on October 30th. Should you have any questions or require any assistance completing the survey, please contact the NSPMP at 902-496-7123 or toll-free at 1-877-476-7767.

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Guidelines on Responsibilities when Permanently or Temporarily Closing a Medical Practice

Guidelines on Responsibilities when Permanently or Temporarily Closing a Medical Practice (PDF – 5 pages)

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Permanently or Temporarily Closing Your Practice: A Guide for Physicians

Permanently or Temporarily Closing Your Practice: A Guide for Physicians

A physician must comply with a number of statutory and regulatory requirements when permanently or temporarily closing a practice. Key considerations include:

  • Transfer of and Access to Medical Records
  • Notification to Patients, the College and Others
  • Transfer of Patient Care

This resource includes a compilation of information provided by the College, Doctors Nova Scotia and the Canadian Medical Protective Association (CMPA).

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