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
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Dialogue Issue 2 , 2017