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Cannabis in medical practice
New guidance to help navigate a hazy world
How should physicians manage growing patient interest in the use of medical cannabis, with very limited data available on its benefits and uses? As advocacy by the new cannabis industry and recruitment efforts by “cannabis clinics” ramp up, there is an urgent need to clarify good medical practice in this environment.
With the assistance of the Physician Prescribing Practices Committee and community physicians, the College has updated its Cannabis for Medical Purposes advice document, first published in 2014.
The CPSA is also reviewing the current Cannabis for Medical Purposes standard of practice and is proposing an amendment in keeping with current practice guidelines to clarify physicians’ responsibilities in a legalized cannabis environment. The draft amendment is expected to be ready for Council’s consideration in fall 2018, followed by consultation with the profession and others. Feedback from physicians will be very important at that time.
In the meantime, highlights from the updated advice document include:
- Use of medical cannabinoids should be limited, in general. This recommendation comes from a February 2018 article in Canadian Family Physician, which adds cannabis may have potential restricted use for a small subset of medical conditions when standard therapies have failed. These include neuropathic pain, pain in palliative and end-of-life conditions, chemotherapy-induced nausea and vomiting and spasticity due to multiple sclerosis or spinal cord injury.
- Cannabis authorization for patients should be considered ONLY within the context of an established physician-patient relationship. The use of medical cannabis is no different than any other therapy considered as part of a patient’s overall care. To act merely as an authorizer in a cannabis clinic is not conducive to shared and informed decision-making and devalues the fiduciary relationship between physician and patient that is the cornerstone of an ethical physician’s practice.
- Physicians who work in cannabis clinics must comply with the standards of practice (Cannabis for Medical Purposes, Direction and Control of a Medical Practice, Advertising, Patient Record Content and Conflict of Interest) and should be aware of their responsibilities before entering into this type of arrangement.
- Under the Episodic Care standard, physicians are obligated to share treatment information with other healthcare providers in the patient’s circle of care—this includes authorization of medical cannabis.
Questions? Email Dr. Monica Wickland-Weller, Senior Medical Advisor in Continuing Competence, at email@example.com.
TPP Alberta gears up to launch new secure prescription form
Program asks physicians to use up old stock first
Under the direction of the Triplicate Prescription Program (TPP) Steering Committee and after wide consultation with prescribers, dispensers and program partners, TPP Alberta has redesigned its secure prescription form.
Enhanced security features, improved legibility and a new check-box section (Indication for therapy) will help optimize patient care, while prescriber registration numbers have replaced the TPP Prescriber ID to support data quality.
The new form is still a three-part prescription, with one copy each for the prescriber, the dispenser and TPP Alberta. Process and conditions also remain unchanged, including the 72-hour validity and rules for fax transmittal (voiding form post-transmission).
The program anticipates the new forms will be ready for circulation in May/June 2018. If you have triplicate forms remaining in your stock, they are still valid. Please use up your existing supply before reordering.
Take a sneak peek at the new form here.
Questions about the new TPP prescription form?
Email Fizza Gilani, Program Manager for Prescribing & Analytics, at firstname.lastname@example.org.
New documents in your Physician Portal
We’ve updated the Physician Portal to make it easier for you to access time-sensitive and confidential documents from the College.
When a new document is added to the portal from Accounting, Accreditation, Continuing Competence, Professional Conduct or Physician Health Monitoring, you will receive an email notification. You can then log in to the Physician Portal and click on “My Documents” to see what’s new.
If you have any questions about this new process, please contact us at email@example.com.
“My bursary gave me more time with my kids.”
Bursaries from the golf tournament can be used to cover a wide range of expenses. From tuition, to travel costs for medical electives, to rent or groceries, these funds help students alleviate the stress of accumulating debt.
Curtis’s bursary also granted him priceless time with his family. “I am a father of four and medical school keeps me very busy. This money will help cover tuition costs next year, which allows me to spend less time working over the summer and more time making memories with my children.”
In 2017, we broke a record and raised over $69,000 for medical student bursaries. Want to help us do it again?
Monday, June 25, 2018
NEW start time! 9 a.m. shotgun start
Red Deer Golf & Country Club
Your registration fee of $275 includes a continental breakfast, a round of golf with a powered cart at the renowned Red Deer Golf & Country Club and a BBQ lunch. You’ll get free use of the driving range and practice facility, a fantastic souvenir and the opportunity to win great prizes!
Can’t make it this year? Consider making a donation to medical student bursaries.
What do your colleagues think about your College?
The latest physician survey results are in and they say we’re doing well, but could be doing better.
Were you one of the 3,000+ members who responded to the College’s physician survey?
Those of you who’ve been registered with the College for a while probably recognized the survey. We conduct it every two years to get member feedback on how we regulate—that includes our organizational goals, standards of practice and communications with you. This year, we incentivized the survey with a draw to win back your 2018 Annual Renewal fee and members responded positively. In fact, we had a record number of responses – over 3,000.
What did those 3,000+ members have to say? A lot, actually, but here are the common themes:
- The majority of respondents believe the College is doing a good job.
- New organizational goals generally scored a little lower than the goals identified in the 2016 survey.
- Several respondents would welcome better customer service from the College, saying they feel an imbalance of power in their interactions with us.
- There was strong support for the College developing a more collaborative, supportive relationship with members.
- Some members feel our expectations are out of touch with the realities faced by front-line physicians, a trend also found in the 2016 survey.
- A number of respondents said a simplified approach to standards of practice consultation would encourage them to participate.
- Overall, social media ranked in the bottom three methods of how recipients prefer to receive information from the College. However, respondents aged under 25 to 35 responded much more favourably to the potential use of social media.
Stay tuned for the action plan in July 2018
We’re going to analyze all the feedback and share it with Council at the May 24 meeting. Once we finalize how we’re going to address your feedback, we’ll share survey details and an action plan with you in Messenger.
Would you like to help advise on the action plan? Contact firstname.lastname@example.org.
Is physician leadership for me?
Be part of a healthcare evolution
Dr. Louis Hugo Francescutti, Vice-President, CPSA Council
For many physicians in Alberta, the simple thought of taking on a leadership role in health care is fraught with uncertainty, self-doubt and concern. For years, it was seen as “going to the dark side” or giving up on the more important clinical work that just needs to be done.
Worse yet, some physicians believe those who take on medical leadership roles just couldn’t cut it in the “real world” of healthcare delivery. Well, it’s time to move past all of that. If our healthcare system is going to improve, physicians must be a part of its evolution. Who else is better situated to lead health care advancements with the quality challenges that are taking place everywhere?
Effective leadership doesn’t happen overnight
The unfortunate reality is that although many physicians have some natural leadership skills, it takes years of learning, mentoring and coaching to become an effective leader. Last month, I had the pleasure of attending the Canadian Conference on Physician Leadership (CCPL) in Vancouver. Here, I was witness to hundreds of physicians learning how to become better leaders and interacting with others who had the same interests. This is one of the longest running leadership conferences in Canada and I would encourage others to attend as well.
One core component of the CCPL is the recognition of those who have attained the credential of being a Canadian Certified Physician Executive (CCPE). To attain this certification, one must commit themselves to taking on more and more leadership responsibility in Canada’s healthcare system. These are not physicians who have gone to the dark side or who gave up on clinical care—these are people who have sacrificed their love of clinical care because they felt there was a need for more physicians in key leadership positions.
Years of hard work recognized
Among those recognized in Vancouver were two of the CPSA’s very own: our Registrar, Dr. Scott McLeod and our Deputy Registrar, Dr. Karen Mazurek, were both awarded their CCPE certificates. I congratulate them both for the many years of hard work and commitment it took to be recognized in this way. It was also nice to see many other Alberta physicians at the conference and I hope even more will become passionately engaged.
Once again, congratulations to Scott and Karen on your dedication to the profession. We are very proud of your significant accomplishments.