POLICY MATTERS
Providing Physician Services During Job Actions continued from page 20
7. What does the College consider to be medical care
that is ‘urgent’ or otherwise ‘necessary’ to prevent
harm, suffering and/or deterioration?
What is ‘urgent’ or ‘necessary’ medical care would
depend on the specific circumstances of each case, as
stated in the previous response.
The policy specifies that what constitutes urgent and/or
necessary medical care to prevent harm, suffering and/
or deterioration is a matter to be determined by a physician’s clinical judgment, and will be informed by the
existing health status and specific needs of individuals,
and physicians’ individual and collective ethical responsibilities to provide care.
For example, patients and/or the public would likely be
unable to access ‘necessary’ medical care if every single
physician in a rural community or every single physician in a specialty (e.g., all anesthesiologists) stopped
treating patients for a significant amount of time.
8. Is the College’s definition of ‘necessary’ medical
care the same as ‘medically necessary’ services that
are insured?
No. In the context of the policy, the College considers
‘necessary’ medical care to be care that is required to
prevent harm, suffering and/or deterioration. The type
of care that is considered necessary is a matter to be determined by a physician’s clinical judgment, as stated in
the response above. The medical care physicians deem
‘necessary’ may very well be insured services; however, it
does not mean that ALL insured services are ‘necessary’
for the purposes of the policy.
9. What will happen if a complaint is made about a
physician who withdraws his/her services during a
job action?
As with any complaint received by the College, it will
be investigated. A panel consisting of physicians and
members of the public will consider the circumstances
24
DIALOGUE • Issue 1, 2014
of the case and determine whether the physician’s conduct or the care provided was appropriate.
The College will consider any concerns regarding the
provision of services, or lack thereof, during job actions
in accordance with our duty to serve and protect the
public interest.
10. Does this policy apply to physicians who reduce
their office hours and/or on-call availability because
they are overburdened and/or overwhelmed?
It depends. Physicians may consider reducing their
work hours if they feel overburdened and/or overwhelmed, for their own personal health and/or to
maintain quality of patient care. The Practice Guide recognizes that physicians often face competing demands,
which can give rise to stress, fatigue, exhaustion and
frustration. This can have a negative impact on both the
physician personally and the care the physician is able
to provide. In these circumstances, physicians may want
to consider seeking support and/or assistance from the
OMA’s Physician Health Program.
If the concerns cannot be resolved and physicians make
the decision to reduce their work hours “in order to
protest or to raise awareness about concerns they have,
with the ultimate goal of resolving those concerns,” it
would likely be considered a ‘job action’, as defined
in this policy. This policy does apply to the organized
withdrawal of services for reasons related to practice
environments (e.g., concerns about work environments and/or conditions such as on-call schedules),
and physicians would be expected to comply with the
expectations set out in this policy if H