College Of Physicians And Surgeons Of Ontario Research Articles

Reproductive patterns, pregnancy outcomes and parental leave practices of women physicians in Ontario, Canada: the Dr Mom Cohort Study protocol

IntroductionSurveys and qualitative studies suggest that women physicians may delay childbearing, be at increased risk of adverse peripartum complications when they do become pregnant, and face discrimination and lower earnings...

Patients’ complaints involving ophthalmologists in the province of Ontario, Canada: a 5-year review

ObjectiveTo present an overview of complaints against ophthalmologists to the regulatory body in the province of Ontario, Canada, during a 5-year period. DesignRetrospective cross-sectional study. MethodsAll completed complaints to the College of Physicians and Surgeons of Ontario (CPSO) involving ophthalmologists from January 2013 to May 2018 were reviewed. Data regarding the prevalence of complaints, physician characteristics, practice location, reason of complaint, and outcomes as decided by the Inquiries, Complaints and Reports Committee (ICRC) were collected. Identified concerns were classified across 3 domains: clinical care and treatment, professionalism and conduct, and practice management. ResultsThere were 372 complaints involving 211 ophthalmologists out of 448 practicing ophthalmologists in Ontario. A total of 933 issues were raised in the 372 complaints. Complaints related to clinical care and treatment were most common (76.3%), followed by professionalism and conduct (55.4%) and practice management (24.7%). Within these domains, the 5 largest subcategories in order of occurrence were communication, billing practices, consent, procedural mishap, and documentation. Of the 372 investigations, the ICRC took some form of action in 117 cases (31.4%). The most common actionable decisions issued by the ICRC were advice (19.1%), caution (6.2%), and participation in a specified continuing educational or remediation program (3.5%). Four cases (1.1%) were referred to the Discipline Committee. ConclusionsAlmost half of practicing ophthalmologists in Ontario (47%) received at least one formal CPSO complaint within the 5-year study period. Communication was the most common issue raised in complaints.

The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario

The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs) into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO's alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed.

The effect of continuing professional development on public complaints: a case-control study.

This study aimed to investigate the relationship between participation in different types of continuing professional development (CPD), and incidences and types of public complaint against physicians. Cases included physicians against whom complaints were made by members of the public to the medical regulatory body in Ontario, Canada, the College of Physicians and Surgeons of Ontario (CPSO), during 2008 and 2009. The control cohort included physicians against whom no complaints were documented during the same period. We focused on complaints related to physician communication, quality of care and professionalism. The CPD data included all Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC) CPD programme activities reported by the case and control physicians. Multivariate logistic regression models were used to determine if the independent variable, reported participation in CPD, was associated with the dependent variable, the complaints-related status of the physician in the year following reported CPD activities. A total of 2792 physicians were included in the study. There was a significant relationship between participation in CPD, type of CPD and type of complaint received. Analysis indicated that physicians who reported overall participation in CPD activities were significantly less likely (odds ratio 0.604; p = 0.028) to receive quality of care-related complaints than those who did not report participating in CPD. Additionally, participation in group-based CPD was less likely (OR 0.681; p = 0.041) to result in quality of care-related complaints. The findings demonstrate a positive relationship between participation in the national CPD programmes of the CFPC and RCPSC, and lower numbers of public complaints received by the CPSO. As certification bodies and regulators alike are increasingly mandating CPD, they are encouraged to continually evaluate the effectiveness of their programmes to maximise programme impact on physician performance at the population level.

Chiropractic clinic offered referral kickbacks

A chiropractic clinic with locations in Ontario, Nova Scotia and Manitoba offered lucrative kickbacks to physicians for referring clients to its five outlets until the College of Physicians and Surgeons of Ontario (CPSO) apparently stepped in to scuttle the payments as a result of CMAJ inquiries.

Internationally Educated Healthcare Workers: Focus on Physicians in Ontario

The issue of access to licensure for internationally educated health professionals is a critical one, and the impact of inadequate healthcare resources has a profound impact on patients. As the body that licenses doctors in Ontario, issues related to the provincial doctor shortage and problems with access to licensure for international medical graduates (IMGs) have been significant areas of focus for the College of Physicians and Surgeons of Ontario (CPSO). In February 2002, the CPSO Council approved the establishment of the first Physician Resources Task Force. Its mandate was to "find creative ways to meet physician resource needs without compromising registration standards." For the first time, the key stakeholders--regulators, government and educators--were all at the table to try to address the complex issues and processes involved in licensing physicians.

Governments make inroads into medical self-regulation

Ontario is planning to follow Alberta’s lead and give itself the power to appoint a supervisor who could assume the regulatory duties of health profession regulating bodies such as the College of Physicians and Surgeons of Ontario (CPSO). Similar legislation, passed two years ago in Alberta, has

Ethnicity and utilization of family physicians: A case study of Mainland Chinese immigrants in Toronto, Canada

This paper seeks to examine how immigrants in a multicultural society access and utilize culturally- and linguistically-diverse family physicians. It focuses on Mainland Chinese (MLC) immigrants – the most important source of immigrants to Canada since 1996 – in the Toronto Census Metropolitan Area (CMA), Canada. Specifically, the paper aims to explore the choice between Chinese-speaking and non-Chinese-speaking family physicians by MLC immigrants and to determine the underlying reasons for MLC immigrants use of ethnically- and linguistically-matched family physicians. A wide range of data are analyzed including survey and focus group data, physician data from the College of Physicians and Surgeons of Ontario (CPSO) and geo-referenced 2001 Canadian Census data. A mixed-method approach is employed combining quantitative analysis of survey data and Census data, spatial analysis of patient travel behaviour based on the survey and qualitative analysis based on focus groups. The paper reveals an overwhelming preference among MLC survey respondents for Chinese-speaking family physicians regardless of study areas and socioeconomic and demographic status. The focus groups suggest that language, culture and ethnicity are intertwined in a complex way to influence the choice of health care providers and health management strategies in the host society. The paper yields important policy implications for identifying health professional shortage areas for culturally-diverse populations, addressing issues related to foreign-trained physicians and enhancing primary care delivery relevant for immigrant populations.

In Search of a Technical Fee for Endoscopy in Ontario

In Search of a Technical Fee for Endoscopy in Ontario

The case of Dr George Gale v. the College of Physicians and Surgeons of Ontario: a legal analysis.

On March 15, 2002, anaesthetist and pain practitioner, Dr George Gale, had his license to practice medicine in Ontario revoked by a decision of the Discipline Committee of the College of Physicians and Surgeons of Ontario (CPSO) (1,2). To that point, Dr Gale had practiced medicine as an anaesthetist in Ontario without incident. The CPSO Discipline Committee hearing had taken place over 22 days in 2001 and 2002. The focus of the CPSO prosecution against Dr Gale was his pain practice conducted at a well-known pain clinic in Toronto, Ontario. By an Ontario Divisional Court decision dated October 10, 2003, the CPSO Discipline Committee decision was set aside on appeal (3). Most importantly, the Ontario Divisional Court held that the penalty of revocation levied against Dr Gale was unfair and based on several serious errors made by the Discipline Committee. A closer examination of the decisions of both the Discipline Committee and the Ontario Divisional Court will hopefully illustrate both the medical standards of practice issues for pain practitioners, and some of the perils created by the self governing activities of the CPSO. To put the Gale decision in proper context, it will be necessary for us to briefly examine the function of the CPSO and its Discipline Committee.

The Independent Medical Evaluation Relationship

Abstract According to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, an independent medical evaluation (IME) is “an evaluation performed by an independent medical examiner, who evaluates—but does not provide care for—the individual.” In April 2002, the Work Fitness and Disability Evaluation Section of the American College of Occupational and Environmental Medicine (ACOEM) prepared a motion defining the rationale why there is no a priori establishment of a patient–physician relationship during an IME. A figure in the article includes the text of the resolution, which was proposed and debated at the House of Delegates but has not yet been adopted by ACOEM. A table prepared by the College of Physicians and Surgeons of Ontario (CPSO) enumerates differences between the usual doctor–patient relationship and IMEs in terms of duty to provide care, maintaining records, access to records, and fees. CPSO also clarifies that physicians who agree to conduct third-party examinations of individuals whom they are not currently treating have been hired by a third party to perform a particular task, typically to provide an opinion or answer specific questions about the individual. Clear and effective communication with the individual are particularly important because the individual's livelihood or compensation for injury, as well as the person's continuing health, are at stake.

Attempting to Ensure Physician Competence

Ensuring the competence of the 17 000 practicing physicians in the Canadian province of Ontario has occupied more than a decade of activity on the part of the provincial licensing authority, the College of Physicians and Surgeons of Ontario (CPSO). 1 While still in a developmental stage, the provincial peer review system places importance on (and thus provides an opportunity to test models of) physician assessment, learning, and change. The peer review system was initially developed in the mid1970s. At that time, peer review policymakers viewed continuing medical education (CME) activities in a narrow, but appropriately critical, light and rejected compliance with mandatory CME requirements as a measurement of physician competence. This action reflected the belief that most CME programs failed to change physician performance. Studies conducted since that time concluded that formal CME courses do produce knowledge transfer 2-6 ; but without reinforcement, feedback, or other behavior modification techniques, CME

Attempting to ensure physician competence

Ensuring the competence of the 17 000 practicing physicians in the Canadian province of Ontario has occupied more than a decade of activity on the part of the provincial licensing authority, the College of Physicians and Surgeons of Ontario (CPSO).¹While still in a developmental stage, the provincial peer review system places importance on (and thus provides an opportunity to test models of) physician assessment, learning, and change. The peer review system was initially developed in the mid1970s. At that time, peer review policymakers viewed continuing medical education (CME) activities in a narrow, but appropriately critical, light and rejected compliance with mandatory CME requirements as a measurement of physician competence. This action reflected the belief that most CME programs failed to change physician performance. Studies conducted since that time concluded that formal CME courses do produce knowledge transfer^2-6; but without reinforcement, feedback, or other behavior modification techniques, CME