pervisor and approved by the College. After successful completion of the period of clinical supervision, each physician is reassessed to gauge improvement. In some cases, a physician may also receive a caution from the committee that oversees investigations, regarding specific aspects of his or her practice, or professionalism or conduct. Each physician’ s undertaking will be posted on his / her profile on the public register while the terms of the undertaking remain in effect.
Undertakings Imposing Prescribing Restrictions In a small number of cases, physicians have undertaken to no longer prescribe narcotics and controlled drugs. In some cases, a physician may also receive a caution from the committee that oversees investigations, regarding specific aspects of his or her practice, or professionalism or conduct. This information is on the public register.
Undertakings to No Longer Practise Medicine In a small number of cases, physicians have undertaken to no longer practise medicine in Ontario. This information is on the public register.
Referrals to Discipline Where a physician has been referred to the Discipline Committee, the Notice of Hearing, which sets out the allegation( s), is on the public register. Any practice restrictions, if ordered pending the outcome of the hearing, are on the public register.
SUMMARY The College will continue to work with the Ministry of Health as necessary to identify levels of opioid prescribing and investigate prescribing practices that may be harmful to patients. The College is aware that while investigations may identify instances of risk of harm to patients when opioid prescribing is continued, there is also a very real risk of harm to patients when opioid prescribing is discontinued. Understanding and questioning prescribing practices is not intended to discourage appropriate opioid prescribing and we are urging physicians to not suddenly cease prescribing to patients currently on opioid therapy. Dr. David Rouselle, College President, says that the College made it a point to communicate to physicians who were being investigated – and those concerned about a potential investigation – that they not respond by abandoning their patients who are on opioids.“ Abruptly cutting a patient off from opioids could lead them to using a street supply that’ s contaminated with fentanyl and other dangerous substances,” he said. Opioid-use disorder and chronic pain are health conditions like any other, and treatments should include all the ele ments of good practice: making recommendations based on evidence and treating patients with respect and com passion. For some, this may include several tactics including a slow taper or opioid replacement therapy / referral to a substitute treatment program for methadone or suboxone. Our goal is to support continued prescribing when it is appropriate and informed by both clinical guidelines and Col lege policy. MD
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Elaine McNinch, Managing Editor
Mailing address: College of Physicians and Surgeons of Ontario
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DIALOGUE ISSUE 3, 2017