FROM THE REGISTRAR’ S DESK
tion before deciding to write a prescription for opioids for a patient? It is on the table for discussion as we get ready to update our Prescribing Drugs policy. In addition to making NMS data available to Ontario physicians, Health Quality Ontario will soon be providing all physicians in the province with reports that show how their opioid prescribing compares to that of their peers and to best practices. The College will promote their use through policy expectations and potentially integrate the reports into assessment processes. Speaking of assessments, the strategy will also see us continue focused methadone assessments and we will work towards expanding the focus of assessments to opioid prescribing through the Quality Assurance Committee. To ensure that the College is able to consider opioid issues within a quality assurance focus, Council has directed that the role of the Methadone Committee be transitioned to a specialty panel of the Quality Assurance Committee( QAC). This move will maintain the expertise of the Methadone Committee members. Council was clear in its discussions – methadone oversight must remain an important part of the College’ s response to opioid issues. This transition will ensure that the powers of the Regulated Health Professions Act are available when the QAC determines education and remediation for a prescriber are required. We will also continue to identify, investigate and monitor high-risk opioid prescribing. When our investigations identify instances of risk of harm to patients of continued prescribing, we will also be very aware that there exists real risk of harm to patients of discontinuing prescribing. Many patients are on doses of opioids that far exceed the recommended dosages in the recently released national guideline. Patients could suffer harm, even fatal harm, if they were abruptly refused a prescription. In order to balance these risks, the goal of investigations is to support education and continued prescribing where appropriate and ensure that patients are tapered safely. As you can see, multiple strategies are being employed. But it has taken 20 years for this current crisis to develop and there will be no quick fixes or easy answers. It will take time, collaboration with different groups and a steadfast commitment to improved patient safety to in order for us to prevail.
In the meantime, we will continue to regularly communicate with you about our efforts and our expectations. For more information, please visit our strategy infographic on page 22.
*** Bill 87, the Protecting Patients Act, 2017 is now in effect and while we did not get everything we had requested, the government did move forward on a number of the College’ s suggested amendments to strengthen the Bill. Some provisions are in effect on Royal Assent and some will be in effect at a later date( such as those that require regulations to be passed in support of the amendment). Some changes that are in effect include:
• Immediate mandatory suspension powers where the Discipline Committee has found that an act of professional misconduct has been proven that will trigger the mandatory revocation penalty;
• Interim orders to restrict or suspend a doctor’ s practice can be made earlier in the investigative process where the conduct of the doctor exposes or is likely to expose his or her patients to harm or injury;
• Gender-based practice restrictions can no longer be ordered;
• Information added to the public register related to increasing transparency of physician-specific information.
As a result of the College’ s own transparency initiative, we had already identified and implemented virtually all of the public register additions now passed by Bill 87. These changes were implemented by the College from 2012 onward as our by-laws were amended to provide us the authority to post more physician-specific information online. We will continue to provide you with information on Bill 87 as more changes come into effect. Thank you. MD
10
Dialogue Issue 2, 2017