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Annual General Meeting Presentations September 9, 2006

MINUTES NINETY-NINTH ANNUAL MEETING COLLEGE OF PHYSICIANS AND SURGEONS OF SASKATCHEWAN

The ninety-ninth Annual Meeting of the College of Physicians and Surgeons of Saskatchewan was held in the Sheraton Centre, Sheraton Cavalier Hotel, Saskatoon, Saskatchewan on Saturday, September 9, 2006, commencing at 12:30 p.m.

CALL TO ORDER

The meeting was called to order by Dr. S. Kassett, Vice-President of the College and Chair for the meeting.

ARCHIVES REPORT

The Registrar read the following Archives Report:

"Mr. President, it is with deepest regret that I inform you the following names have been removed from the Register through death in the last twelve months:"

William Alexander Baker
John Bradley
C. John Chacko
Clive Leonard Cunning
Zenovey Orest Alexander Danylchuk
Allan Decter
Cecil Cameron Ewing
Laura Marie Hiscock
Gordon Hughes Hodgson
John Alan Hopkins
William Henry Houston
Michael Anton Jacobi
William Hay Kirkaldy-Willis
San Landa		 Max Joseph Miller
Fuad George Mitri Musleh
Harendra Nath
John Joseph O'Dea
Anthony Robin Price
Hans Jacob Renpenning
Alexander Kerr Roy
Phillip Alexander Sheridan
Gaya Singh
Eric James Stark
George Wilkinson Sykes
Alexander John Wasylenki
Stephen Worobetz
Lionel Duley Young

"Mr. Vice-President, will you call a minute of silence for us to remember these colleagues."

The meeting observed one minute of silence.

PRESIDENTIAL REPORT

Dr. E.Y.K. Tsoi, President of the College, gave a comprehensive report on Council activities over the past year.

Dr. Tsoi took this opportunity to thank the College staff for the effort it has put in for this educational event.

Dr. Tsoi stated that the College's responsibilities lie in the areas of licensure, developing and ensuring standards of practice, and regulation.

Licensing issues considered by Council over the past year focused to a great extent on the international medical graduate, such as:

  1. Methods to ensure the performance and competence of IMGs while they meet the requirements for full licensure.

  2. Methods of assessment for physicians whose training is not currently accepted for licensure, i.e. WAAIP (Western Alliance for Assessment of International Physicians), CAPE (Clinicians Assessment and Professional Enhancement Program).

  3. Policies pertaining to specialists educated in the United Kingdom.

The Western Alliance for Assessment of International Physicians (WAAIP) was a one time project involving licensing authorities in British Columbia, Alberta, Saskatchewan and Manitoba. The Clinicians Assessment and Professional Enhancement Program (CAPE) is conducted by the Faculty of Medicine at the University of Manitoba. This assessment costs $3,500.00, half of which is paid through a Government of Saskatchewan grant and the other half by the candidate.

Some physicians who obtain their medical degree outside of Canada also complete some Canadian training. There are also some physicians who take their undergraduate and postgraduate training outside of Canada. Of the physicians currently registered with the College 46% have Canadian medical degrees, while 54% have medical degrees obtained from elsewhere in the world.

Council has had ongoing discussions about remediation for physicians with identified deficiencies, re-registration of physicians, and revalidation.

Council reviewed and approved a set of questions to be asked of all members at the time of annual re-registration after extensive consultation with the SMA. Physicians renewing their licenses for 2007 will be required to answer to these questions.

Council reviewed and approved CME credits of the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada as meeting acceptable requirements for revalidation. Physicians will be required to enroll in one or the other program, and to meet the requirements of those programs before they can renew their licenses.

Dr. Tsoi reported that over the past year the Council has discussed policies relating to a number of practice standards:

  1. Medical Marijuana -- modified the College's policies to align them with those of Health Canada.

  2. Hepatitis B/C/HIV/AIDS -- adopted a policy designed to mitigate risk of public harm from affected physicians/medical students.

  3. Surgical Volumes and Patient Outcomes -- Met with senior staff from the Health Quality Council to learn more about the HQC's research into linkage between surgical volumes and outcomes.

  4. Prevention Program for Cervical Cancer -- Received and accepted a report from the Deputy Registrar in respect to a recommendation from the Privacy Commissioner on the College's role in ensuring physicians provide appropriate information to patients.

  5. Ethical Obligations to Patients -- Directed the Registrar to draft a policy defining the ethical obligations of surgeons and physicians who are unable to fulfill their commitments to patients on surgical or other procedural wait lists before they leave practice or leave the province.

  6. EMT Protocols -- Approved a number of EMT Protocol Amendments recommended by the SMA's Medical Services Committee.

  7. Audits by the Joint Medical Professional Review Committee (JMPRC) -- Discussed the need for effective and equitable JMPRC audit of all forms of physician compensation from the public treasury.

Council adopted a policy that will provide guidance to physicians regarding their access to patient specific prescribing data in the Pharmacy Information Program (PIP) database. It also adopted a policy to ensure the confidentiality of the information provided by physicians to the College at the time of re-registration.

During the past year the Council adopted a number of new or amended bylaws pertaining to:

  1. The operations of the Triplicate Prescription Program (now called the Prescription Review Program).

  2. A revised Code of Ethics for the members of the College.

  3. A revised version of the bylaw governing the Practice Enhancement Program (PEP).

In the area of "ownership linkage" Council approved integrating the College's annual general meeting with that of the Saskatchewan College of Pharmacists and the Saskatchewan Registered Nurses Association. The purpose of this change is for all three organizations to learn together and to create opportunities for joint board development activities. The preferred date for such a joint conference was identified as September 15, 2007.

During Council's recent meeting with the Minister of Health and staff of his department the Minister expressed support for the College's effort and current standard of IMG assessment. He learned of Council's concern in several areas of service delivery including psychiatric and oncology services in the province. The Minister agreed to look at improving compensation of the public members who sit on Council.

In the area of disciplinary activity:

  1. Council laid a charge of unprofessional conduct against a physician following a complaint with respect to his conduct of a breast examination. The charge was subsequently withdrawn after the physician completed a boundaries education course and gave an undertaking to the College that he will have a chaperone present for all future intimate examinations.

  2. A physician agreed to attend a medical records course, rather than having concerns about his record keeping investigated as a matter of possible unprofessional conduct.

  3. Council suspended a physician who was performing certain procedures in spite of physical limitations. That suspension was lifted when the physician agreed to no longer perform the procedures that were the subject of concern.

  4. Council laid charges of unprofessional conduct against three physicians. The cases involved the prescribing of psychotropic medications, the provision of false information to the College on an application for licensure, and the conduct of inappropriate examination of two women. All three matters are awaiting hearing.

  5. Three Preliminary Inquiry Committees that were appointed have not yet reported to Council.

  6. One physician pleaded to charges of unprofessional conduct for failing to respond to an inquiry from the College and was fined $6,000.00

  7. Council determined that a physician lacked skill and knowledge and directed that physician to undergo a specific remedial education program.

  8. Two competency assessments are currently being conducted, the reports from which are not yet available. A third competency assessment was ordered but not completed because the physician left the country.

  9. One discipline finding is currently the subject of appeal, but no date has been set for the court hearing. In another case the College's decision in finding a physician guilty of unprofessional conduct was overturned by the Court of Queen's Bench. The Court of Appeal concluded the judge of the Court of Queen's Bench erred and therefore restored the College's original decision.

  10. During the past year approximately 14 physicians have been the subject of disciplinary or competency proceedings, which is fewer than 1% of the approximately 1,600 physicians who practice in Saskatchewan.

Dr. Tsoi noted the following emerging issues:

  1. HIPA -- Council would like physicians to be mindful of their obligations under The Health Information Protection Act.

  2. Privacy Tool Kit -- Available on the SMA's website.

  3. Licensure of International Medical Graduates (IMGs) and methods to review their practices before they meet the requirements for full licensure.

  4. Patient Safety/Safety Workshop/Safe Prescribing.

REGISTRAR'S REPORT

Dr. D.A. Kendel, Registrar, reported that because of matter of revalidation will mean a significant change for the medical profession, he will ensure that the membership receives adequate information prior to its implementation. The College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada already have maintenance of competence programs and these are the basis on which the CPSS will introduce revalidation. If someone is a member of either organization they won't be required to do anything extra. Both organizations have said their programs will be available to non-members at a cost of $300.00 to $350.00. Members will have to show evidence of their enrolment in either of these programs by the fall of 2007.

Under the Pharmaceutical Information Program (PIP) physicians can check the entire prescription profile for any patient they are attending. The funding received by PIP from Canada Health Infoway is linked to how physicians use this program; there is still a problem of double-doctoring in this province. Pharmacists are inclined to use this program more than physicians.

The SMA has received money from government to help physicians in setting up electronic records systems.

After four years of negotiations between the College, the SMA, government and the RHAs there is now a set of new Model Practitioner Staff Bylaws, which hopefully will be in place by this fall. The physician leader will now be known as the Senior Medical Officer (SMO) and it is expected there will be one in every Health Region.

QUESTION PERIOD

Dr. D. Dattani had concerns about accessing patient profiles under the new HIPA legislation. Mr. B. Salte, the Associate Registrar, said patient consent will not be required before accessing patient files. However, patients will be allowed to "mask" information so no one can see it, i.e. drug utilization. Dr. Dattani then asked who could access the information. The Associate Registrar said anyone who wishes to log into this information must have a unique identifier. The Registrar stated that only about 115 people have requesting "masking" of their files.

In answer to a question from the floor, the Registrar stated that Maintenance of Competence Programs of the Royal College and CFPC are continually evolving. Medicine is about the last health profession to make this a requirement for their members. The two national Colleges will audit/monitor physicians who are members of their organizations. At the end of the five-year cycle the College must affirm if physicians meet the requirements of either of these two bodies. The Associate Registrar stated that whether a physician is or is not a member of one of these organizations the same requirements will have to be met.

In answer to a question from the floor as to whether revalidation is only for physicians with full licensure, the Registrar stated that some physicians who only do surgical assists "may" qualify for exemption otherwise it is for everyone.

ADJOURNMENT

The meeting adjourned at 1:30 p.m.

Recording Secretary - J. Heinen