Practice improvement and professional development

College of Physicians and Surgeons of Alberta CPSA, Latest News Archive, Medical Matters, Messenger 5 Comments

This month, I would like to build on something that our Council President, Dr. Bradley, brought up in last month’s Messenger. As a part of his thoughts on where the College should go in the future, he expressed that the medical community has an opportunity to embrace the evidence that’s available to us to improve how physicians learn and provide patient care. These are very insightful words and something everyone should take seriously as we move into a world of digital health care, where data and knowledge will be readily available.

Soon, we will be able to learn at both the system level and the individual care-provider level. The problem is that saying we can learn from this information and actually taking advantage of it are two different things. It’s time for all care providers, not just physicians, to start thinking about what that’s going to look like.

The Federation of Medical Regulatory Authorities of Canada (FMRAC) has already done a great deal of work in this area. In February of 2016, they formalized a position on Physician Practice Improvement (PPI)—I recommend everyone take a look at this document, because it lays out very nicely what a continuous quality improvement approach would look like in a medical practice. The key is the graphic below, from page two of the document:

Step one (understand your practice) will come from the digital data available within the health care system, but knowing what to do with that knowledge is and will be the challenge.

We at the College recognize that we are not the best people to oversee and implement quality improvement programs in health care, but we do have a legislative mandate to ensure physicians who practice in Alberta are maintaining their competency. We believe the best way to do that is to support the FMRAC PPI format of continuous quality improvement in health care. We’re very fortunate in Alberta to have organizations like Alberta Health Services, the Primary Care Networks, the Strategic Clinical Networks, the Health Quality Council and many others, all providing support in this area, which gives us a greater opportunity for success than in many other health jurisdictions in Canada.

We know the vast majority of doctors in Alberta continuously strive for continuous quality improvement. We also know that as this evolves, most will embrace this new approach to continuing professional development, but there will always be those who aren’t interested and will resist something new and different. I understand that and I appreciate that people will be skeptical about this new approach, but it is important that we start thinking about this now. The CPSA, along with most other Colleges in Canada, see this as a mandatory requirement in the future. As a result, you can expect participation in PPI to become a standard of practice for physicians in Canada in the near future. For Alberta, we will most likely have a standard of practice mandating the requirement to participate in an ongoing quality improvement program by 2022

As always, I welcome your comments and questions.

Scott

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Dr. Abdul S. Tabani

This will be a great initiative and support from the CPSA.

Richard Falkenstein

I also believe that most physicians already spend a lot of time reflecting on their practice, and pursuing avenues they perceive as likely to yield high value in the quest to improve their performance (for the sake of their patients). I think most health care providers (not just physicians) already devote more time to their jobs, and these ancillary activities, than is actually healthy for the provider, and their families. Introducing the necessity to “standardize and document” – especially into an unfamiliar (and unlikely-to-be-individualizable) format, seems to have the potential to reduce the actual “doing” of the activities that really… Read more »

Scott McLeod

Hi Richard. Thank you so very much for writing in. We certainly do appreciate the stressors that exist for physicians practicing in Alberta in 2019. We also recognize that the College has an impact on that stress in many ways. That is why we’re starting this conversation now so that we can have the conversation about how we can do this in the best way. As you point out most care providers are doing this already. In fact I suspect they’re likely doing more than what we will be expecting in the future. They do it because they care greatly… Read more »

Randall Sargent

Thanks for this line of thought at the CPSA, I support the concept and ongoing development but I think we also need to be concerned how physicians have learned in the past and ensure we are initiating the learning process needed throughout the career during the years spent in medical training. Maybe it is also time to have periodic examinations throughout our career.

Scott McLeod

Hello Randall and thank you for providing comments. I appreciate your thoughts and suggestion that we may need to consider periodic examination. In my mind, I think it’s best to leave that area to the Royal College and the College of Family Physician to determine how to best confirm that physicians still have to knowledge and skills to remain certified as a specialist or family physician. Examinations may be the way to do that.