board meeting - college of physicians and surgeons of british

APPROVED

Board Meeting College of Physicians and Surgeons of British Columbia

Members Staff Present: Present: • Dr. L.C. Jewett (President) • Dr. G.A. Vaughan (Treasurer) • Mr. W.M. Creed • Ms. L. Charvat • Dr. A.I. Clarke • Dr. M. Corfield (DM) • Dr. M.A. Docherty • Dr. D.J. Etches • Mr. S.S. Gill • Dr. D.M.S. Hammell • Dr. N.D. James • Ms. V. Jenkinson • Dr. G. Parhar • Dr. P.D. Rowe

• Dr. H.M. Oetter (Registrar) • Dr. W.R. Vroom (Senior Deputy Registrar) • Dr. A.J. Burak (Deputy Registrar) • Dr. A.M. McNestry (Deputy Registrar) • Dr. J.G. Wilson (Deputy Registrar) • Mr. M. Epp (Chief Operating Officer) • Mr. G. Keirstead (Chief Legal Counsel) • Ms. S. Prins (Director of Communications)

Regrets: • Dr. J.R. Stogryn (Vice-President)

Recorder of Minutes: • Ms. J. Bergen, Executive Assistant to the

Registrar

Summary of Resolutions and Actions discussed at meeting of September 19, 2013 Item # Item September 19, 2013 Resolutions Resolution No. 1 Adoption of

the agenda RESOLVED that the agenda for the Board open regular meeting scheduled September 19, 2013, be adopted as circulated.

13-676

2 Adoption of the Minutes

RESOLVED that the minutes of the Board open regular meeting held May 31, 2013 be adopted as amended.

13-677

MINUTES Minutes of the Board of the College of Physicians and Surgeons of British Columbia scheduled September 19, 2013 in the 8th floor Board Room, 669 Howe Street, Vancouver, BC

OPEN

College of Physicians and Surgeons of British Columbia APPROVED Board Regular Open Minutes September 19, 2013 page 2 of 13

ACTION ITEMS

Meeting Convened A quorum being present, Dr. L.C. Jewett, President, called the meeting to order at 9:57 a.m. on September 19, 2013.

1. Adoption of the Agenda The following resolutions were MOVED, SECONDED and CARRIED: RESOLUTION 13-676 RESOLVED that the agenda for the Board open regular meeting scheduled September 19, 2013, be adopted as circulated.

2. Adoption of the Minutes: May 31, 2013 The following resolutions were MOVED, SECONDED and CARRIED: RESOLUTION 13-677 RESOLVED that the minutes of the Board open regular meeting held May 31, 2013 be adopted as amended.

3. Report of the Registrar The registrar reported on the following:

• The BC Registry approved the name Health Profession Regulators of BC Society, the

creation of which the Board endorsed in the closed session. • The funding for the Health Council of Canada has been withdrawn, and the Health

Council will stop operating soon. This Health Council had been tasked with reporting on the health system in Canada.

• In follow up to Dr. Doug Cochrane’s presentation on quality assurance to the Board at its closed session, Dr. Oetter noted the challenge and opportunity facing the Board. The public has an expectation that every physician will be engaged in

RFA # Item # Item Responsible Action / Comments Board O-13-09-19-001

5.1 Website update

HMO MSP be contacted for permission to publish MSP billing numbers on the website


meaningful and accountable quality assurance activities. To do so in a cost effective manner will be a priority activity for the College for the next few years.

The registrar read the following resolutions passed at the closed session of the Board meeting held on September 17 and 18, 2013:

• RESOLVED that the Board support in principle that the BC Health Regulators Organization governance be formalized by way of a constitution and bylaws pursuant to the Society Act.

4. Report of the President The president reported on the following: • As the new president of the Board, Dr. Jewett looks forward to working closely with

Dr. Oetter and the registrar staff. • Mr. Graeme Keirstead has been hired as the College’s Chief Legal Counsel. • The Terms of Reference for the Human Resources Committee have been developed. • Two personal goals as the new president:

o Enhance the working relationship between the health authorities and the College.

o Remind registrants of the privilege and responsibility of self-regulation, all of which will be highlighted in the speech to be given at the Annual General Meeting on September 20, 2013.

5. Unfinished Business 5.1 Website update – demonstration of new website Presentation: S. Prins, 9:30 a.m. Ms. Susan Prins, Director of Communications, provided the Board with a demonstration of the College’s new website launched in August 2013, which includes a new design, simpler navigation and improved functionality. The College currently prints the medical directory of physicians including fax numbers and MSP numbers for billing and referral purposes. The directory is distributed to registrants each year. The same information is available on the website once a registrant has logged in. The public view of the registrant profile does not include MSP numbers or fax numbers. Moving this information to the public side of the web would facilitate referrals, and bypass the need to log in, which can only be done by registrants. Given the expanding range of practitioners who refer patients (nurse practitioners, midwives, podiatrists, etc) making this information public may be the preferred state.


The Board directed that permission be sought from the Medical Services Plan to publish MSP numbers on the College website.

Request for Action: RFA # Board O-13-09-19-001 MSP be contacted for permission to publish MSP billing numbers on the website

5.2 HRO Public Relations Campaign Presentation: S. Prins, 9:45 a.m. Ms. Prins provided the board with a powerpoint presentation on the BC Health Regulatory organizations’ public awareness campaign. The public awareness campaign includes transit shelter ads, articles and ads in community papers, television closed-captioning messages and the launch of a new website at www.bchealthregulators.ca. The campaign is designed to raise people’s awareness about which health professions are regulated, why it is important to check the credentials and ensure that the health professional they choose to see is regulated, and inform them about what can be done if they have concerns about the care they receive. Materials are being developed in English, French, Spanish, Cantonese / Mandarin, Punjabi, Korean, Vietnamese, Tagalog and Farsi. It was noted that the College contributed $10,000 towards the public awareness campaign. The Board was advised that the College makes translators available to complainants, if necessary. This was provided to the Board for their information. 5.3 2013 Education Day and Annual General Meeting

• 2013 Education Day and Annual General Meeting Program Ms. Prins provided the Board with an overview of the 2013 Education Day and Annual General Meeting to be held on Friday, September 20, 2013 at the Vancouver Convention Centre. The Board was advised that there are 320 registered to attend. As in previous years, board members will be assigned a specific table at lunch to encourage dialogue with registrants. The Board was requested to provide feedback on their lunch table discussions to Ms. Prins. The Board was asked to provide suggested topics for the Education Day in 2014.

http://www.bchealthregulators.ca/


5.4 Family Medicine Practice Ready Assessments (PRA)

• Update re selection of applicants Deferred to the November 2013 meeting of the Board.

6. Committee Reports 6.1 Executive Committee: June 28, 2013 and August 23, 2013 meeting minutes

• Executive Committee open minutes of June 28, 2013 • Executive Committee open minutes of August 23, 2013

Board members were provided with the June 28, 2013 and August 23, 2013 open Executive Committee minutes for information. 6.2 Diagnostic Accreditation Program – report of Dr. Vroom Dr. Vroom reported that the Diagnostic Accreditation Program (DAP) conducted the following on-site accreditation surveys from May 15, 2013 to September 9, 2013. It was noted that the DAP does not survey in July and August. Diagnostic imaging • 20 on site accreditation surveys • 97 distance medical assessments Laboratory medicine • six onsite accreditation surveys • two cessation of service Pulmonary function • two on site accreditation surveys 6.3 Non-Hospital Medical and Surgical Facilities Program – report of Dr. Vroom No report.


6.4 Registration Committee – report of Dr. Corfield, Chair Dr. Corfield, Chair of the Registration Committee, provided the Board with a verbal report on the following items: • Updating of the registration department’s systems continues as it prepares to

implement new business processes and IT system that will streamline all its processes and improve the speed and efficiency of its work.

• On the national level, work continues on developing national registration standards for the Provision Class of registration for all provinces and territories. Together with the Medical Council of Canada (MCC), Federation of Medical Regulatory Authorities of Canada (FMRAC) and its member colleges began developing the web-based electronic application for physicians wanting to obtain full or provisional registration in any province of Canada. The MCC has launched a new system and candidate portal on May 23, 2013 at www.physiciansapply.ca. Pilots of the web-based electronic application began in 2013. The College will be coming on board in 2014, once its new database has been developed and fully implemented.

• The Registration Committee recently reviewed the process in place for requiring Certificates of Professional Conduct every six months from approved registrants who are practicing in more than one jurisdiction regularly. Currently, a registrant completes a waiver form and this form is then provided to the Registration Committee for review. Once approved, the registrant signs undertakings that indicate their responsibilities regarding the provision of Certificates of Professional Conduct. The current process is onerous on registrants and staff in terms of follow-up and the compliance level is low (there is a lot of follow-up required to ensure that the certificates of professional conduct are provided as required every six months or upon return to the province of British Columbia).

Additionally, the College can achieve the same goal of being advised of any issues that may be of concern regarding public safety by streamlining and changing the process for registrants and College staff. The final version of the policy governing the new process (which would tie the requirement for the provision of Certificates of Professional Conduct to an annual event as part of the annual license renewal process) and the revised Undertakings will be presented to the Registration Committee at its meeting to be held in October 2013.

• From December 6, 2012 to September 3, 2013, there were 680 new registrants in

the provisional and full classes, 330 general practitioners and 350 specialists. The committee assessed 279 applications from international medical graduates (IMGs) from January 22, 2013 to September 12, 2013.


1. Health Professions Review Board – registration decision • Health Professions Review Board Matters – Report to Board, August

28, 2013 The Board was provided with a report from Ms. S. Hellman, staff lawyer, of appeals to the Health Professions Review Board (HPRB) regarding registration from 2009 to 2013. This was received for information and is appended to the minutes. 6.5 Inquiry Committee – Panels A, B, C, D & E Mr. B. Fishbook, director of complaints, submitted an aggregate report of complaints concluded by Inquiry Committee panels since the May 2013 Board meeting. This was received for information and is appended to the minutes. Dr. L.C. Jewett, Chair of the Inquiry Committee Panel A, advised the Board that the committee met on September 12, 2013. Dr. Jewett highlighted the following: • This was a transition meeting as the committee had two new committee members

and a new deputy registrar assisted. • There were 18 complaints reviewed of which 12 were concluded. • The themes of the complaints ranged from misperceived examinations to dual

relationships with patients and a recently reported sexual relationship with a patient a number of years ago that is acknowledged by the registrant.

Dr. P.D. Rowe, Chair of the Inquiry Committee Panel B, provided the Board with a verbal report of the committee’s meeting on September 16, 2013. The committee reviewed 10 ongoing complaints and 19 new complaints. Of the 19, 13 concluded with criticism of the physician and six were not critical of the physician. The committee reviewed complaints with the following themes: • Consent forms are signed with no clear documentation that a discussion regarding

consent took place in the consultation letter. • Management and follow up of diagnostic test results where tests results are

misplaced, misread or not responded to. Dr. N.D. James, Chair of the Inquiry Committee Panel C, advised the Board that the committee will meet on September 24, 2013.


Dr. Etches, Chair of Inquiry Committee Panel D, provided the Board with a verbal report on the committee’s recent activities. The committee reviews complaints on a monthly basis. This month 75 files were reviewed and the committee agreed with the reviews delegated by the deputy registrar except for one or two. Those dispositions not accepted are referred to another panel for further deliberation. Dr. Vaughan, Chair of Inquiry Committee Panel E, reported that earlier this year the Board agreed with the formation of Panel E of the Inquiry Committee. The intent was the concentration of responsibility for oversight and review of practice investigation reports. The first meeting of the committee is scheduled for November 26, 2013. Dr. Vaughan acknowledged the efforts of senior management in the recruitment of committee members and assessors, organization of support staff and the design of a new assessment template that clearly sets out the issues that gave rise to the practice investigation. An electronic assessment form is also under development. 1. Health Professions Review Board – complaints dispositions

• Health Professions Review Board Matters – Report to Board, August 28, 2013

The Board was provided with a report from Ms. S. Hellman, staff lawyer, on the status of appeals to the Health Professions Review Board (HPRB) regarding complaint dispositions from 2009 to 2013. This was received for information and is appended to the minutes. 6.6 Quality Assurance Committee – report of Dr. Docherty, Chair

• On-table Quality Assurance Committee report to Board, dated September 12, 2013

• On-table Multi-Source Feedback Physician Report – General Practitioner with the following attachments: o Medical colleague Questionnaire o Co-Worker Questionnaire o Patient Questionnaire o Self-Assessment Questionnaire

Dr. Docherty, Chair of the Quality Assurance Committee, provided the Board with a written report of the committee’s meeting on September 12, 2013. This was provided for information. Dr. Docherty’s report highlighted the following: • Statistical data on Physician Performance Enhancement Program and physician

assessments for 2013: o Peer assessments: 530 assigned, 312 completed


o Multi-Source Feedback (MSF): 525 assigned, 243 completed o Summative assessments: 64 assigned, 34 completed

• 161 completed peer practice assessments reviewed by the Medical Practice Assessments Committee (MPAC).

Physician Multi-source Feedback Assessment The multi-source feedback (MSF) tool provides physician information on their performance as rated by peers, patients and non-physician co-workers. Topics covered in the survey include medical competency, communication skills and office management. The purpose of MSF is formative, designed to help physicians identify opportunities for practice improvement. To date, 243 MSF reports have been completed. Dr. Vroom reviewed in detail with the Board a sample MSF physician report, the medical colleague questionnaire, co-worker questionnaire, patient questionnaire, and self-assessment questionnaire . The information collected is compiled into an aggregate, anonymized report and sent to the College. He noted that two medical consultants have been hired to confidentially work with the physicians in interpreting and acting on their reports. This was provided to the Board for their information. 6.7 Library Committee – report of Dr. Rowe, Chair Dr. P.D. Rowe, Chair of the Library Committee, provided the Board with a written report of the committee’s meeting on September 18, 2013. Dr. Rowe highlighted the following: • The committee welcomed new committee members, Drs. Blanka Jurenka and Dr.

Teresa Kope. • With several new members, the committee reviewed the Library’s 2012 statistics

and proposed 2014-2015 budget to familiarize itself with the particulars of the Library’s services and responsibilities. A robust discussion took place about the optimal timing in educating medical students regarding the role of the College Library in supporting their clinical practice needs upon transitioning to full registration of the College, and how to facilitate this form of outreach. Dr. Wilson and Ms. MacDonell will research the topic and report to the committee in November.

• The Committee reviewed the Library’s 2013 Key Performance Indicators (KPIs), which intends to generate relevant performance-oriented data to determine if the Library is affecting clinical practice in a positive way. The College Library study will


focus on Library usage by key knowledge leaders across British Columbia, and the committee reviewed the steps completed thus far and those upcoming.

• The Library Committee’s Terms of Reference have not been reviewed in some time, therefore a new draft was presented. The Committee was asked to review the draft and forward suggestions to the Library Director for discussion at the Committee’s November meeting.

• The Committee reviewed an updated draft of the Library’s Circulation and Collection Use Policy, incorporating the criteria for extension of services to the “Former, resigned” category of College registrants. The committee was asked to review the draft for further discussion at the committee’s November meeting.

7. New Business 7.1 Rohani, Dr. Farrokh – penalty hearing pursuant to section 39(2) ADJOURNED 7.2 Health Services Preferential Access Inquiry Report

• Health Services Preferential Access Inquiry Report • Article “Ban on private imaging scans urged in Alberta”, from Postmedia

News, dated August 30, 2013 • Article “Proposed ban on private MRIs sparks alarm about longer waits” from

Calgary Herald, dated August 30, 2013 The Health Quality Council in Alberta released an Inquiry Report by the Health Services Preferential Access Inquiry. The Alberta government established the inquiry under the Health Quality Council of Alberta Act in February 2012. The Board was advised that there exists a pervasive belief that Canada has a two-tiered health care systems, where advantage is secured, not necessarily through wealth, but through connections or status. Some believe that others get faster access to healthcare for reasons other than medical need. The Board was provided with the Executive Summary of the Inquiry Report. The Board suggested that the issue be a topic for a future Board meeting. 7.3 Inquiry Committee Presentation Dr. Wilson, Deputy Registrar, and Mr. Fishbook, Director of Complaints, provided the Board with an educational session on “Complaints and Practice Investigations”. A copy of their presentation is attached to these minutes. Dr. Wilson and Mr. Fishbook responded to questions from the Board.


This was provided to the Board for their information.

8. Information Items 8.1 Globe and Mail article “Why wait for a health-care crisis to put patients’ safety

first?” • Article “Why wait for a health-care crisis to put patients’ safety first?” from

the Globe and Mail, dated August 8, 2013 This was received for information. 8.2 LifeLabs welcomes naturopathic doctors

• Excerpt from www.lifelabs.com/Lifelabs_BC/News “LifeLabs Welcomes Naturopathic Doctors”

LifeLabs and BC Biomedical announced laboratory collection and testing services to naturopathic doctors in BC. This was provided to the Board for their information. 8.3 College of Family Physicians of Canada – Opioid Addiction Recovery

Community: Doctor Locator Request • Letter to Dr. Jaime Meuser, Associate Executive Director/Director, Continuing

Professional Development, College of Family Physicians of Canada, from Dr. Oetter, dated August 21, 2013

• Memorandum to Dr. Oetter, from Dr. Jamie Meuser, dated August 12, 2013 The College of Family Physicians of Canada (CFPC) is collaborating on the creation of an online interactive digital community to inform and support patients (and their families) with an opioid addiction. As part of the collaboration, CFPC is seeking the cooperation of the College to communicate with physicians who provide methadone maintenance treatment to determine their interest in making their services known to the public. The intent is to create a web-based resource for patients who are seeking a physician who provide opioid addiction care. In a letter to the CFPC dated August 21, 2013, the College confirmed that it will forward CFPC’s inquiry to the relevant physicians in BC and invite them if they wish to be noted in CFPC’s “doctor locator” tool to contact CFPC directly. This was provided to the Board for their information.


8.4 Globe and Mail article “The Canadian medical profession is facing major

upheaval” • Article “The Canadian medical profession is facing major upheaval”, from the

Globe and Mail, dated August 23, 2013 This was received for information. 8.5 Wall Street Journal article “Doctors Face New Scrutiny Over Gifts”

• Article “Doctors Face New Scrutiny Over Gifts”, from The Wall Street Journal, dated August 22, 2013

This was received for information. 8.6 CanMEDS 2015 Consultation

• Letter to Dr. Jason R. Frank, Director, Special Education, Strategy and Standards, Office of Education, Royal College of Physicians and Surgeons of Canada, from Dr. Fleur-Ange Lefebvre of the Federation of Medical Regulatory Authorities of Canada (FMRAC) dated July 8, 2013

The Board was provided with a copy of a letter to the Royal College of Physicians and Surgeons of Canada (RCPSC) from the Federation of Medical Regulatory Authorities of Canada (FMRAC) dated July 8, 2013 supporting the changes to the CanMEDS Competency Framework. This was provided to the Board for their information. 8.7 Canadian Healthcare Network article “I flunked my peer review”

• Article “I flunked my peer review”, from the Canadian Healthcare Network, dated September 4, 2013

This was received for information.

9. Next Meeting The next open regular meeting of the Board of the College of Physicians and Surgeons of British Columbia is scheduled for November 28, 2013.


Conclusion The open regular meeting of the Board of the College of Physicians and Surgeons of British Columbia held September 19, 2013 concluded at 12:40 p.m. on Thursday, September 19, 2013. H.M. Oetter, MD Registrar HMO/jb

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