Medical Advisors discuss myths about the College
Unsure if a new area of practice constitutes a change of scope? Need coaching on fulfilling CPSO’s quality improvement requirements? College Medical Advisors (MAs) are a valuable resource for members of the profession who wish to speak directly to a fellow physician about their regulatory questions or concerns. They are also rich sources of knowledge within CPSO, bringing a physician perspective to a file or the development of a policy. And through the years, as practising physicians, they’ve become aware of different misconceptions about the College. In this issue, several medical advisors take the opportunity to explore some of these myths and describe how it squares with their own experience of working at the College.
Myth: CPSO tracks patient care data on all physicians in Ontario
Dr. Ted Everson, Emergency Medicine Physician, Family Physician
Fact: CPSO does not maintain a database related to individual physician patient care metrics or patient outcomes. Individual practice data from sources, such as Health Quality Ontario and Cancer Care Ontario, do not flow into CPSO databases. But the College’s quality programs do encourage physicians to access and utilize external sources of practice data to support quality improvement within their own practice.
CPSO does retain information submitted by physicians about their practice (location, contact information, certification, medicolegal information) during Annual Renewal. You can review this information through your Member Portal profile.
Myth: CPSO quality requirements for physicians are based on a periodic peer assessment
Dr. Ted Everson, Emergency Medicine Physician, Family Physician
Fact: CPSO has moved away from the peer assessment model to ensure quality for the majority of practising physicians. Instead, we developed a Quality Improvement (QI) Program designed to ensure Ontario’s physicians are engaging in self-reflection, practice improvement and meeting their quality requirements in five-year cycles.
Depending on individual circumstances, physicians may complete their requirements entirely online as an individual, in collaboration with the CPSO and their hospital or as part of a group. By 2025, we are projected to have more than 26,000 physicians complete our QI Program.
On the rare occasion the QI Program is not able to adequately support the physician in their quality improvement activity, a focused Peer and Practice Assessment may be recommended by CPSO’s Quality Assurance Committee.
Myth: CPSO’s Annual Renewal form asks intrusive questions about physicians’ medical histories
Dr. Vivian Sapirman, Psychiatrist
Fact: We only ask one question: “Do you have any medical or other condition identified in the previous year that may compromise your ability to practice medicine?” The help text embedded in the annual renewal provides additional clarity, including that the question relates to conditions for which you are not currently receiving appropriate and effective treatment. Medical regulatory authorities owe a duty to the public to assess physicians’ safety to practise and uphold public trust in the medical profession, but we must balance that duty to protect patients with physicians’ right to privacy.
Myth: “I have lots of CPD credits, so I don’t need to do QI”
Dr. Mary Manno, Family Physician
Fact: Under the College’s governing legislation, CPSO must provide quality oversight to practising physicians. This is separate from the Continuing Professional Development (CPD) required to maintain one’s membership in the College of Family Physicians of Canada (CFPC), Royal College of Physicians and Surgeons of Canada (RCPSC) or Medical Psychotherapy Association of Canada (MDPAC). However, these activities can overlap, avoiding duplication of effort.
When contemplating one’s areas of strength and areas for improvement, a member may identify specific CPD activities that can inform one’s Practice Improvement Plan (PIP). For example, an ER physician may identify the need to improve assessment of patients presenting with abdominal pain. A CPD activity aimed at gaining knowledge/skill in point-of-care ultrasound may be part of the interventions planned to achieve that goal.
Myth: It takes too long for CPSO to process applications for practice certificates
Dr. Benjamin Chen, Internist
Fact: CPSO issues most certificates of registration within 90 days of receipt of an application. This is a lot faster than in years past and is significantly faster than many other jurisdictions. Waiting for credentialing documents from third parties accounts for much of the processing time.
Myth: CPSO is adversarial towards doctors
Dr. Anil Chopra, Emergency Medicine Physician
Fact: CPSO is commonly perceived by physicians to be a scary place, existing only to discipline physicians. In fact, only one percent of College investigations are referred for disciplinary action. Many public complaints are resolved by mutual agreement between the physician and the patient. CPSO can provide support to physicians by providing advice and recommendations for further learning, if required.
Myth: CPSO prohibits the use of post-pandemic virtual care
Dr. Ted Everson, Emergency Medicine Physician, Family Physician
Fact: CPSO recognizes the important role virtual care can play within our health-care system and supporting patient access in certain circumstances.
Physicians are expected to use their professional judgment to determine whether virtual care is appropriate for the nature of the patient encounter and must continue to meet the same standard of care that applies to an in-person visit. A key consideration is to only provide virtual care if it is in the patient’s best interest to do so and have in person care available when appropriate. For more information, please read our Virtual Care policy.
