FOR PHYSICIANS


New standard of practice for Prescribing: Drugs with Potential for Misuse or Diversion



Physician Health Monitoring Program (PHMP)

This program provides support to, and monitoring of, physicians whose ability to practise may be affected by a health issue. The College, together with the Alberta Medical Association’s Physician and Family Support Program (PFSP), help physicians access assessment and treatment programs as needed.

Find out more about PHMP

DID YOU KNOW?

College activities outlined in the Health Professions Act (HPA) are subject to the Ombudsman Act. This allows any person not satisfied with these activities to make a formal complaint to the Alberta Ombudsman.

Physician/Patient Relations

The Canadian Medical Association Code of Ethics (which the CPSA endorses) states physicians cannot discriminate against patients on grounds such as age, gender, medical condition, national or ethnic origin, physical or mental disability.

However, in some circumstances:

  • You may not feel qualified to handle the patient’s treatment
  • The patient has missed several appointments
  • The patient has signed a treatment contract and is not following your treatment plan
  • The patient has been abusive or threatening to you and/or your staff

Note:  Doctors may not refuse to treat/accept a patient in an emergency situation if they have the skills required to do so.

Yes, as long as you believe:

  • the treatment will benefit the patient;
  • the treatment will not harm the patient; and
  • the provider is qualified to provide appropriate treatment.

Adequate notice (preferably in writing) must be given to the patient, with specific reasons for the termination of care. These reasons may include (but are not limited to):

  • future retirement or reduction in practice;
  • concerns about staff and physician safety;
  • abusive behaviour toward staff; and/or
  • non-compliance with doctor’s recommendations or refusal to accept advice.

Considerations:

  • As per the CMA Code of Ethics (#15), doctors must “Respect the right of a competent patient to accept or reject any medical care recommended.”
  • A list of other doctors accepting patients or the name of a referral agency (such as the College) should be offered to the patient.
  • Patients should also be given details regarding care to be given (until a certain date) or arrangements made elsewhere and where to access their medical records.

For more information, refer to the CPSA Physician/Patient Relationships Standard of Practice.

Yes, if the gift is small, and of minimal monetary value. However:

  • Items of value or items of a very personal nature should not be accepted.
  • If you feel uncomfortable accepting a gift of any kind, you should decline the offer.

For more information, refer to:

  • The Messenger (February 2006) – Page 6
  • The Messenger (April 2006) – Page 11
  • Document the details of the incident(s), including the names of any witnesses.
  • Contact the Canadian Medical Protection Agency for advice at 1-800-267-6522

Note:  If you believe the patient poses a serious threat to yourself, family members and/or staff, the matter should be reported to the police.

If attempts to reach a resolution with the patient are unsuccessful, you are entitled to discharge the patient from the practice, provided he/she receives written notification stating the reasons for the termination of care.

When a young (underage) patient requests birth control or a controversial procedure (e.g., breast implants), you should:

  • Determine if the patient is mature enough to understand the consequences of his/her decision. If you believe the patient is mature enough, you must provide him/her with the information they need to make an informed decision.
  • Understand that the decision to go ahead with the care plan and the decision to share this information with others rests with the patient.

Yes. Physicians must be able to manage their patient population as well as ensure their own well-being. They are not expected to take on more patients than they believe they can safely manage.

Note:  In an emergency situation, physicians are required to provide care to the best of their ability.

It depends. You may prioritize the concerns of patients with several complaints to address those that need immediate attention and suggest future appointments to address the others. The patient must be advised that this is the recommended approach or plan.

Yes, if it is done correctly. Meeting with patients before entering into a doctor/patient relationship can be an opportunity to:

  • Share information about the practice and to understand the individual’s medical history
  • Allow the individual to determine if this relationship will meet his/her expectations for managing future health needs.
  • Allow both parties to decide if this relationship is mutually beneficial.

However, you may not use the appointment as a means of screening patients i.e. – choosing only the healthy or less-complex patients.

The CMA Code of Ethics states: “physicians cannot discriminate against patients on such grounds as age, gender, marital status, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, sexual orientation, or socioeconomic status.”

For more information, refer to: The Messenger (May 2005) – Page 6.