What to Expect During Medical Encounters – Update: Document Approved

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    Stakeholder feedback

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    View the comments posted to our online discussion page

    Our Process

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    The College’s document, What to Expect During Medical Encounters (formerly titled ‘Rights and Responsibilities’), received final approval from the Executive Committee on January 26, 2016 in keeping with Council’s direction, and will be distributed to the public for patients to use as a resource.

    We would like to thank all those who submitted their feedback and contributed to this consultation. While not every comment or suggested edit was incorporated into the final version, all comments were carefully considered.

    Below is a brief summary of the consultation process, including an overview of the feedback received and revisions undertaken:

     

    people

    Who we heard from

    • 138 submissions were received in response to this consultation.
    • Feedback was primarily submitted by physicians, but we also heard from members of the public and a few key organizations such as the Ontario Medical Association, the Ontario Hospital Association, the Information and Privacy Commissioner of Ontario, the Professional Association of Residents of Ontario, and the College of Physicians and Surgeons of Alberta.
    View the feedback: Survey reportWritten Comments

    What we heard

    Other important considerations

    • In general, the feedback was very polarized. Most physician respondents were critical of the draft document as they felt the document placed unreasonable expectations on them, and the document’s tone and contents were offensive because they thought it suggested that physicians are unprofessional and can’t be trusted. On the other hand, most members of the public and organizations were supportive of the draft document.
    • The majority of survey respondents indicated that the draft document is clear, easy to understand, and well organized.
    • Some respondents however, requested clarification, additional detail and/or examples in relation to specific elements of the document. In particular, they thought the general responsibilities outlined in Section 1 were too broad and could be subject to misinterpretation.
    • Respondents were divided about whether the draft document was comprehensive. More specifically, a number of respondents felt a “physician rights” and/or “patient responsibilities” section was missing.
    • Some respondents felt the draft document was unnecessary, and a few respondents requested that the College abandon the document.
    • Of those respondents who provided constructive criticism on the draft document, suggestions included:
        • How to revise the document to improve the overall tone and clarity.
        • To emphasize the importance of effective communication and collaboration between patients and their doctors/other health-care providers.
        • To address the difficulties that physicians may have maintaining professional boundaries, particularly in rural practice settings.
        • To allow physical contact to show compassion or provide comfort to patients.
    • In addition to the feedback, we considered a wide range of other information while developing the final version of the document. This included:
        • The College’s Practice Guide.
        • College policies and guidelines related to sexual abuse and boundaries.
        • The College’s zero tolerance approach to sexual abuse.
        • Documents published for patients by other health regulators and organizations regarding what to expect during medical encounters.

    How we responded to your feedback

    • Key revisions were made to the draft document in response to feedback. The majority aimed to improve the overall clarity of the document and to ensure consistency with the responsibilities set out in the College’s Practice Guide.
    • A few of the more significant revisions are highlighted below, as are two important instances where revisions were not made.
    Decision Rationale
    • The introduction was revised to:
      -acknowledge that the vast majority of doctors do act appropriately;
      -clarify that the responsibilities set out within the document are not new; and
      -move content about patients’ right to contact the College to the introduction.
    • These revisions address concerns regarding the overall tone and clarity of the document.
    • The statement to “limit physical contact” has been deleted.
    • This deletion was made in acknowledgement that there may be some circumstances where physical contact between physicians and patients to show compassion or provide comfort (e.g. hand on shoulder) may be appropriate and would not represent a boundary violation.
    • No revisions were made in response to feedback that the draft document places unreasonable expectations on physicians.
    • The responsibilities set out in this document are not new; they can be found in a number of other College documents including: the Practice Guide, Maintaining Appropriate Boundaries and Preventing Sexual Abuse policy, Boundaries Self-Assessment Tool, and Safe and Effective Office-Based Practices.
    • “Physician rights” and/or “patient responsibilities” were not added to the document.
    • The main objective of the document is to help facilitate access to information on physicians’ responsibilities and patients’ rights.
    • Further, the document is meant to primarily be a resource for patients, and it would not be keeping with the mandate of the College to develop a “physician rights” document.

    The final document

    • The What to Expect During Medical Encounters document received final approval from the Executive Committee on January 26, 2016 in keeping with Council’s direction. The document will be distributed to the public for patients to use as a resource.


    Read the Final Document

    Key messages of the final document:

    • Doctors are expected to fulfill all of the existing responsibilities they have to patients during medical encounters.
    • Effective communication and collaboration between patients and their doctors or other health-care providers is essential.
    • Doctors must always have strictly professional relationships with patients to ensure they maintain their objectivity and provide the best quality health-care possible.
    • Patients can expect that doctors will conduct physician examinations and procedures in an appropriate, respectful and professional manner.
    • The College is responsible for ensuring doctors are caring for their patients in an ethical, professional and safe manner. The College is here for patients if they have any questions or concerns about something their doctor said or did.