REGISTRATION and limitations placed on the physician’ s certificate of registration. There were no differences between ARPs and TRPs on these outcomes. There were also no differences in peer assessment performance for four of the seven pathways and policies included in the evaluation. In three of the pathways and policies, ARPs were more likely than TRPs to receive decisions of reassessment, indicating record keeping or minor care concerns that can be addressed educationally. These pathways included ARPs utilizing AIT, Pathways 3 and 4( American trained who were supervised for one or more years in an Ontario practice setting) and those who obtained eligibility for their CFPC examination by practising in another Canadian jurisdiction( and subsequently became eligible for registration in Ontario).
Multi-Source Feedback The same physicians who were peer assessed also participated in an MSF assessment( 481 ARPs and 1,152 TRPs). Feedback about the physician’ s professionalism, communication skills, and ability to collaborate was solicited from patients, fellow physicians, and other health-care professionals who worked closely with the doctor. Analyses revealed no meaningful differences between ARPs and TRPs on MSF scores. Both groups scored well across all stakeholder groups.
Primary Care Indicators Primary care indicators, derived from OHIP billing and other administrative data, were developed and validated by the Institute for Clinical Evaluative Sciences( ICES). These indicators reflect whether a physician billed for a particular type of care and serve as a proxy of whether the care was provided to patients. The ICES component involved 377 ARPs and 11,127 TRPs. Analyses revealed that ARPs were similar to TRPs on the majority of primary care quality indicators including diabetic care, cancer screenings, mammography rates, and hospital readmission rates. Some differences were found in certain ARP subgroups. Most notably, the billing rates of physicians entering Ontario from another Canadian province( either through AIT or through the exam eligibility route for those with practice experience in another Canadian jurisdiction) were different than TRPs in preventive pediatric care, as measured by billing for well-baby visits, 18-month assessments, and immunizations. For some ARP groups, statistically significant respiratory care differences were evident using OHIP claims for spirometry and on a measure of all-cause emergency department visits of chronic condition patients. Although the above was statistically significant, it is important to note that epidemiological approaches using billing data does not help us to answer why such differences may exist. Differences may be due to factors that could not be included in the analyses.
Looking Forward Potential areas for quality improvement were identified for some ARP subgroups. For instance, the current evaluation findings point to early education needs in medical record keeping, and potentially, preventive pediatric care. Education and quality improvement opportunities could be coordinated by multiple organizations in the system, and may include such things as better understanding how billing practices and primary care expectations differ across the country. MD
The College has made increased access to registration possible through a wide variety of strategies that allow internationallytrained physicians to demonstrate qualifications.
ISSUE 1, 2018 DIALOGUE 31