POLICY MATTERS
Clarifying the
"Effective
Referral"
Requirement
Taking positive action to ensure patient
is connected satisfies requirement in
two high profile policies
A
s part of its policy
redesign process,
Council has clarified
the language of its
“effective referral” requirement that
is embedded within two high profile
policies.
Both the College’s Professional
Obligations and Human Rights
and the Medical Assistance in Dy-
ing policies have sought to balance
the rights of physicians who choose
to limit the services they provide
for reasons of conscience or religion
with patients’ right to access care. To
achieve this balance, an expectation
was adopted requiring physicians
who have a conscientious objection
to make an “effective referral” to
another non-objecting, available,
and accessible physician, health-care
professional, or agency.
Council, however, has recognized
that the term “effective referral” can
be a source of confusion, as the term
“referral” has a pre-existing clinical
meaning that is different from what
these policies require.
The policies previously defined
an effective referral in relation to
making a ‘referral’. As the effective
referral requirement has always rec-
ognized that sometimes a referral in
the clinical sense will not be neces-
sary to ensure access to care, Council
directed that the language of the
policy be updated to define effective
referral as “taking positive action to
ensure the patient is connected” to a
non-objecting, available, and acces-
sible physician, health-care provider,
or agency. This language was previ-
ously found in the College’s Effective
Referral Fact Sheet, but has now been
incorporated into the policy.
“The change simply incorporates
the definition from the Effective
Referral Fact Sheet directly into the
policy in a manner that preserves the
College’s expectation and retains the
term “effective referral”, which has
become part of the vernacular in this
space, while further minimizing the
potential for confusion,” said Craig
Roxborough, Manager of the Col-
lege's Policy Department.
Key aspects of the
requirement
Effective referrals do not
need to be made directly
to another provider. A
connection can be made
to an agency charged with
facilitating referrals for the
health-care services.
There is no requirement for
effective referrals to be made
in writing; a warm hand-off
to a colleague or contacting
the Ontario Care Coordination
Service for MAID is sufficient.
An effective referral does
not require the physician
to assess the patient for
eligibility or suitability for the
service for which they are
being referred.
MD
ISSUE 3, 2019 DIALOGUE
35