All opioid investigations flagged
by NMS information completed
T
he College has completed all 84 of the
investigations it conducted after receiving
information from the Narcotic Monitor-
ing System (NMS) about potentially
inappropriate opioid prescribing. And the outcomes
make it apparent that the College’s preferred choice of
action, in such instances, is to support education and
continued prescribing with supervision.
A sizable percentage of those physicians investigated
– more than half – were ordered to take mandated
remediation. This could include an agreement by the
doctor to participate in education and/or practise
under clinical supervision and to be reassessed.
“These outcomes demonstrate that the College will
choose a remedial approach in clinical investigations,
whenever possible, to help physicians practise to cur-
rent standards,” said Dr. Steven Bodley, College Presi-
dent. “Our goal is to keep the physician in practice
and to support education and provide guidance, where
the physician’s capacity for remediation is apparent,”
he said.
The outcomes of the completed investigations are
included in the table, below.
Outcomes of NMS-initiated investigations
No. of
Cases
No action 22
Advice 5
Remedial self-study 2
Mandated remediation 38
Mandated remediation and a caution 8
Prescribing restrictions 2
Prescribing restrictions and a caution 1
No longer in practice 4
Referral to the Discipline Committee* 2
Total
84
* One hearing has concluded with a finding of professional misconduct and
the physician agreeing to relinquish his licence; the second hearing is pend-
ing as of May 30, 2018.
36
DIALOGUE ISSUE 2, 2018
Definitions – Investigative
Outcomes
Investigations that arise from receipt of informa-
tion from the NMS entail seeking more information
from the prescribing physician and others in order
to better understand and evaluate the prescribing.
These investigations include a review of patient
charts and interviews by an external assessor to
understand whether the physician is practising to
current standards, in the patient’s best interest. After
a comprehensive investigation has been completed,
the Inquiries, Complaints and Reports Committee
(ICRC), which oversees and determines the outcome
of investigations, decides the outcome from a variety
of available options:
No Action
When the investigation confirms that the care provid-
ed by the physician is appropriate, no further action
will be taken.
Examples of situations in which it is appropriate to
take no further action are: