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it is not often feasible to tell a patient in person that we are firing them
difficult and often invites confrontation
would say notification should be done by registered letter for sure
why don’t you do what we do and send them a letter that you are moving? if they demand face to face, pretend you are pregnant..again.
“While fees are outstanding, physicians must not withhold any aspect of medical care.”
This does not seem reasonable. I agree with the essence of the paragraph immediately preceeding (that patient relationship not be TERMINATED due to non-payment of monies owing ). Please note that the only charges ever owing on a patient chart are for missed appointments, as I don’t send forms out until payment is received for completion of same. I fill fax prescriptions without cost, and don’t charge for sick notes and minor forms. However, this blanket ‘not withhold any aspect of medical care’ binds me to continue to give appointments and fill scripts for a patient who does not show the courtesy of attending scheduled appointments. It would also bind me to send out lengthy insurance forms without patient’s paying (as the form ‘has to be filled out by the doctor’). Unfortunately, some members of society do not accept responsibility for their debts, and it is unfair that I be obliged to provide ongoing appointments and have no recourse if persons do not attend.
As a specialist with 200-300 patients waiting to be seen for consultation, this policy makes me want to restrict my practice to consultation only, so I do not carry any ‘ongoing’ patients. I have 13+ years of post-secondary education, and as much as I love my practice, I am also running a business; it is not reasonable to say I must continually provide medical care for a patient when they do not have the courtesy to respect one’s time and pay for missed appointments.
Physicians give a lot – there is much work which is done without compensation – but I believe we should have the autonomy to run a business. I would never refuse emergency care to any patient, monies owing or not, and do see patients in ER even if they have no coverage (and have never sent a bill for this). But non-emergent medical care is my business and I would like the prerogative to be able to have some value placed on my time, not to become a door mat of infinite altruism once a patient is under my care.
Please reconsider this overly broad ‘blanket’ statement regarding medical care, and ADHERE to the STATED SUBJECT of the policy, which is ENDING the Physician-Patient relationship. I assert that LINE 135 is outside the purview of this Policy.
Line 135 should be removed. The way it is phrased, it requires a physician to write off the patient’s debt to the doctor, before ending the professional relationship.
Although the physicians should be passionate about the care delivered to their patients, by no means should this undermine the patients’ financial responsibilities and obligations to the MD’s office. The College is in no position to impose such a regulation as to make physicians to ignore the reasonable charges they are allowed to bill. I agree that denying an urgent care to a patient who has an outstanding bill is unethical and unprofessional; but continuing to provide non-urgent care, spending time on the phone to answer questions by staff or MD, or filling up more and more paper works while there is outstanding bills is meaningless and abusive.
I believe to make this policy sustainable, both physicians’ and patients’ right should be balanced.
I strongly request the college provide phrases to protect the physicians right to terminate or limit non-critical services provided under these circumstances.
What this policy fails to note is that the College will dutiful investigate malicious complaints arising patients you terminate, irrespective of whether you do it according to this policy, and they will make the investigation long and painful. Thus any decision to terminate a patient must weigh the possibility of dealing with a college complaint (or a defamatory review on rate MD’s, a lawsuit, or some other vengeful act by the patient) with no longer having to deal with that patient directly as their doctor.
A wise physician once told me ‘it’s much better for a patient to leave you, then for you to leave the patient’.
Unfortunately, by investigating frivolous complaints and making it so easy for patients to complain with no risk of harm to themselves, the College has fostered a ‘customer is always right’ attitude and put pressure on physicians to accede to inappropriate requests. This has no doubt played a factor in the current opioid crisis (not to mention the medical marijuana free-for-all) as well as lost economic productivity from pressure to endorse unwarranted disability claims and so on, all in the name of keeping patients happy and avoiding complaints.
Overall the College has undermined the authority of the profession and it is now backfiring as the profession continues to come under disrepute and is increasingly being treated with disrespect by the government, the media and patients alike.
I agree one hundred percent with the above physician. Most of the doctors I speak with often give the patient what they want so as to avoid a possible complaint. This leads to excessive narcotics, giving into requests for dubious sick notes etc. I also think it is a contributing factor to the “doctor shortage.” In talking to other family doctors the number one thing keeping them from taking on more patients is getting difficult patients. And by difficult I don’t mean time consuming or complex but I mean people who want things that we should not be giving them. People who repeatedly put us in difficult positions of giving in or facing a complaint. The sad thing is that the doctor most likely to be discouraged from taking on new patients by this policy is the kind hearted doctor who has a hard time saying no and dislikes conflict.
Unfortunately, I am unaware of any policy at the College level as what complaints should be reviewed and what supporting documentation a complainant should provide to support an investigation. I am aware of multiple administrative investigation in the hospitals where a patient complaint was files as a doctor refused to prescribe controlled substances to the amount the patient had requested, or when the physician had provided only a small dose for the weekend and asked the patient to consult her MRP. The policy of keeping patients happy at any price, respecting their behaviour at any cost to the public, has caused significant cost to the public funding of health and has undermined the authority of physicians to make a proper professional judgement.
Try to ask a plumber to change the size of a pipe in your home to a smaller or a larger than allowed by regulations and see how far it goes.
I recently discharged a patient from my care,for making unreasonable demands on myself&my staff,for providing care and services at my office,including making specific threats,and also advised him to return to care of the referring physician for further service&followup.Under the specific situation,I thought continuing appropriate&therapeutic professional relationship with this patient is absolutely impossible and counter productive,and may degenerate into demand-threat-blackmail level.
I believe,I conducted myself in the manner of appropriate professional standards,in such situation.As a profession,we have to be vigilant about such prying&predatory people we may run into,inspite of our best intentions of providing professional care&service,to those in need.
There are multiple physicians who Contravene their mandated responsibility as per CPSO guidelines, and whose power-drunk secretaries (who enjoy their gatekeeper status power, and know that the doctor is not going to fire them for being obnoxious with patients) also contravene the guidelines of respect and civility towards patients.
IF a patient voices a concern to the doctor, there have been multiple instances that the doctor often chooses to do NOTHING at all, and IGNORES the patient complaints.
IF then the patient is left with NO viable option but to either (first cc-copy CPSO in sending a written complaint to the doctor), and THEN (as the next escalation step) complain to CPSO,
the physician shows his Nuisance-Value and Vindictive Reprisal by asking the patient to go find another physician.
CPSO does NOT do anything anyway (for such complaints), except get the patient involved in a long bureaucratic “process” of cumbersome paper-work back and forth, with (in our experience, multiple mistakes made by their assigned investigators, who have sent BACK-Dated communication) the NET result that CPSO does NOTHING at all either.
The NET TANGIBLE result is that the patient is left without a physician and there is NO guarantee that the next physician is going to be any better.
Thus, it is a BROKEN system, where the power inequation (and Balance of Power) lies in the hands of the physician and his secretary, who CONTINUE to contravene their mandated license responsibility (knowing fully well that the Vulnerable patient is too scared to do anything, and that CPSO will do NOTHING, especially if the physician is Caucasian-White and the patient is a Visible-Minority). In other words, the NON-EXISTENT Enforceability of doctor Contravention (of Mandated responsibility) is fully well known to the physician (and his staff), who CONTINUE in their tyrannical ways, and DROP the patient (IF the patient dares to complain).
Complaining to CPSO and the PERFUNCTORY HPARB is just a waste of time, since the doctor and CPSO (with more money and deeper pockets) have access to better lawyers and often the assigned investigators have also evidenced PREJUDICED BIAS (at least in my experience in dealing with this “BROKEN SYSTEM”).
your generalizations are too obtuse and you offer no alternative solution.
“rude secretaries” “insensitive doctors”, “useless CPSO” and “perfunctory HPARB” all seem to be colluding in your opinion.
I doubt that you have ever been subject to a CPSO complaint as physician to know how distressful it could to a physician regardless of outcome. In fact, I am convinced you are NOT a physician, contrary to having posted as one, since you seem to have a very grudging patient-sided view of the matter.
I concur. Disgruntled patient, not a Physician.
It occurred to me also that this was posted by a disgruntled patient. I understand that many physicians endure many years of post secondary education and work ridiculously long hours as residents on their way to becoming qualified, but as a consumer of the healthcare system I have also experienced some of the negative aspects expressed by this individual.
If someone is suffering from a condition that is difficult to diagnose and seeks treatment from a physician that gives the impression that he is not listening but the patient follows the direction of that physician and gets no relief, after repeated attempts, and receives no referral to a specialist who might be able to succeed in diagnosing the problem, what recourse does that individual have ?
Leave and find another doctor. Complaining to the college will not make your relationship with your doctor better or your care from that doctor better, if anything it may make it worse or end it. Too often complaints do nothing but drag a patient and doctor through a long beaureaucratic process and build up resentment on both sides.
The patients always have the right to ask for a second opinion. This is widely acceptable at all levels of medical practice.
all physicians should be the same. you should expect the same treatment everywhere in Ontario. if a phys’s personal things are too obnoxious then definatly just go elsewhere. but most pateints go to a doctor in their area not a specific doctor.
Please refrain from racistic steriotyping. I’d expect better from a so-called “Physician (including retired”. Your retoric will likely have a “Trump-effect”.
Clearly, even though you listed yourself as a physician, you are not one and used this forum for a diatribe against doctors. This is not the venue. You have a right to spew your venom- but not here.
We may be physicians and patients, but we are still citizens of Canada and the law of the land should precede any policy the College makes. Unless forced labour and servitude become the law of the land, no physician should be forced to stay in a doctor-patient relationship that may be abusive, threatening or unsafe.
The doctor should continue the care/scripts for a brief amount of time. If the patient does not make an effort to find alternate care, it should be the patient’s responsibility.
Unless in very remote areas, the patient can find temporary alternate healthcare in hospitals, walk-in clinics, etc. until they find a more permanent provider.
In remote areas, it may be harder but a physician cannot and should not be forced to stay in an abusive relationship. Which do you prefer? the doctor to quit from a remote area or have a fair policy?
i recieved a letter from my family doctor in may 2016 . stating that patient doctor relationship has been compromised and that i was to find another doctor. so i went without a doctor for 3 months because he stated in the letter that other doctors that practise in that office ,i was not allowed to see another doctor in that office. and i was not allowed to show anybody the letter he sent me. i live in bc. and now i am having trouble with getting my medications becuse tey say i dont fall under the ” specific” , i have osteo artritis , i have been to a speialist in vancouver twice. i am need of some guidence as to my crisis.
Patients do lie to the College to obtain narcotics and marijuana. If refused, the patient makes a complaint to CPSO. CPSO always believes the patient. A friend of the patient “hears” about the compliant, and threatens another compliant, if the physician does not give the requested narcotic/medication. CPSO is harsher with a second compliant. It is hard and some times even physically dangerous to refuse. I am seriously thinking of having new or seldom seen patient visits monitored. An threat will be answered with call to the police. Sorry state of affairs! Such patients are asked to leave the clinic. If necessary a restraining order will be obtained. This is a legal remedy to prevent the patient from returning to the clinic without having to fire the patient.
Doctors will invariably have difficult patients. I think accepting this and developing skills to deal with it is crucial. This should be introduced early on in training but takes time, experience, and emotional regulation to develop.
In my experience, conflict tends to arise when patient expectations are not being met, be they reasonable or not.
Expectations may be related to controlled substance prescriptions, form completion, demand of healthcare time and resources etc.
The challenge is achieving a balance between compromise, maintaining integrity and avoid trouble from an unhappy patient.
However, if a patient becomes abusive, verbally or otherwise, I think that’s immediate grounds for termination. In my view, a letter suffices, an in-person meeting just invites further conflict and confrontation.
The College can help by recognizing and rapidly dealing with complaints from disgruntled patients. I would also support a move to indemnify doctors who refuse to prescribe drugs of addiction.
Overall, the patient is foremost but a doctor’s right to integrity, security and job satisfaction must also be prioritized..
Hope this helps.
There seems to be a lot of regulations in this draft policy to protect the rights of the physicians, but there is nothing in it to assist a patient who, for instance, has signed up with a new physician who is not providing adequate treatment.
The introduction of Local Health Integrated Networks in Ontario has introduced an additional layer of bureaucracy to an already overburdened healthcare system. The expense of carrying this unnecessary layer comes out of the health care budget, and in the case of a network outside of the major population centers, can have the effect of decreasing the quality of diagnosis and treatment of the taxpayers in that area.
In the past, physicians were motivated to treat whatever conditions affected their patients, to the best of their abilities, and if they could not, as a general practitioner,refer them to a specialist or surgeon. In the present, it would appear that there are financial incentives that encourage physicians to refill prescriptions and have as many patients on their roster as possible. There is no incentive for them to actually see these patients or effectively treat their conditions. As consumers, we are paying for a healthcare system that rewards pill pushers and gatekeepers that obstruct effective diagnoses to prevent disease.
There is no mention in the draft policy of what is the professional conduct of the physician when the patient initiates the disconnect.Yes,patients do hire doctors and as such have the right to terminate their services.This draft needs to include that possibility with specific guidelines for the physician to adhere to.
There is no express policy but behavior expected:
forward medical records to patients new physician/give copy to patient at the suggested OMA Third Party Fee, for which patient is responsible.
I think you absolutely need to address the termination of patients by physicians when a patient has derostered from the practice, to go on health-care connect. Too many patients are not getting on hCC for fear of their doctor not seeing them anymore – but the doctor-patient relationship should not be based on the rostering status. I think you need to be clear that the physician needs to continue to look after the patient fully even after they have derostered themselves. Very important issue in our rural area with patients trying to get on the list for any new doctor!
If a patient de-rosters they are essentially ending their enrollment in that physicians practice. There should be no ongoing responsibility on the physicians part. They could agree to see you on a fee-for-service basis, but no obligation to fill rx’s via fax, discuss results over phone, etc
The colleges current changes strongly favor the patients satisfaction rather than outcome. There has to be a component of this that respects the physicians rights and uses the same priciples, as long as care is provided via an alternate means, to discontinue a poor relationship. The colleges recent changes are creating a vulnerability and a culture of physician bullying by select patients that are dissatisfied with their healthcare.
Outside use: simply reminding a patient that they have a commitment to seek care at the clinic prior to accessing a walk-in clinic is not enough.
A physician is charged the full cost of that visit; repeated outside use can mean that doctor is losing money annually to have the patient. If a patient is repeatedly using a walk-in clinic, the physician should be able to either deroster/end the relationship OR the patient should be responsible for reimbursing the physician for their repeated outside use. Additionally, the family physician should not be responsible for following up any tests that were completed that resulted in negation.
There is too much onus on physician respecting PEM contract and no patient responsibility.
The physician can simply deroster the patient and the access bonus loss stops.
However, the physician may question the patient about doctor-shopping, question the patient’s commitment to his/her practice and suggest that the patient may well be best served by choosing one of the other doctors they have repeatedly consulted.
There are different levels of ongoing Physician patient Relationships.
Obviously the strongest is with a patient’s primary care provider.
The least strong is with a physician working in a “Walk in” Clinic.
In the middle is that between a Specialist and a patient referred for a “Consultation”.
If the Specialist feels that the patient’s condition is outside of his level of expertise, then the Specialist should have the option of sending the patient back to the referring doctor or referring the patient to another Specialist if he knows one.
I have a colleague who wants to terminate the doctor – patient relationship due to a breakdown In trust – strong suspicion that drugs are being diverted, with some evidence from a trusted third party. Even in this situation the physician is being advised to tread very carefully about removing this patient from the list – yet the therapeutic relationship is thoroughly broken!
I do believe in many of the aspects of this policy but do not agree with a few 1) I do not think that rostered patients CANNOT be dismissed for going elsewhere. I believe that this is contract that they have signed to be in the FHO and is affecting my income and income to the FHT. This is not fair. When will the CPSO actually stand up and make pts accountable for their part of the doctor patient relationship? 2) I believe that if someone does not pay for multiple things and is refusing to abide by non ohip standards that this is a reason to end the doctor pt relationship. How can I go on taking care of this pt, without bias, when they are refusing to pay for services rendered that were clearly laid out with the non insured services guide? That is a breech in trust and the doctor pt relationship. This ex would not be a case of people who cannot afford this but rather people who have refused despite being told that there is a charge…..
More and more it seems that the college sees its role as “protecting the public from those horrible money grubbing doctors”. Nowhere is this more clear than in the proposal that should we charge a patient for letters written, forms filled in or even missed appointments, that we have no right to request that they find another doctor in the event that they decide they don’t want to pay us. Can you imagine if the Law Society of Upper Canada told lawyers “yes we know you did a whole case for this person and they have decided not to pay you, but you have to continue to be their lawyer and do any legal work they need” or if the law mandated that electricians or plumbers or mechanics had to continue to do work for a client who refused to pay for work already done. We already have so little autonomy these days, and the college wants to control even more. I totally agree that no physician should be allowed to fire or refuse to take on patients on the basis of their religion, colour, or orientation. I also think I should have the right to tell parents that they need to find a different physician for their child if they refuse to immunize. Their decision indicates that they don’t believe what we are telling them, what science is telling them, so it is clear that it would be a problematic relationship from the beginning. Perhaps the college’s next step would be to mandate that we have to provide a separate evening or weekend to accommodate all the unimmunized people without risking the health of our immunized population? No wonder more and more physicians are finding any interactions with the college to be confrontational. They treat us with disdain and contempt, it feels.
I agree with above comment
College policy has to be reasonable and based on common sense
They are following General medical council in UK and trying to paint doctors as villains in this .
I fail to see why the CPSO maintains that a physician must not end a doctor patient relationship purely for non-payment of uninsured services.
All my colleagues take into consideration the financial situation of their patients and often provide non-insured services free of charge in may cases.
Considering the above, if the physician feels that certain uninsured services require payments, and if a patient repeatedly refuses to pay for the provision of those services, this would mean that that patient has absolutely no regard, respect nor care for the value of the physician’s work.
Personally, I will not have this type of patient in my practice.
The College’s insistence that this is not grounds for dismissal of said type of patient shows that the College itself has no respect for the members who have to pay our dues.
1- Non payment of fees: The College’s annual mandatory fees are $1,595 to be increased to $1,625. Would the college renew my license if I don’t pay?
No, we pay penalty and interest.
But I cannot enforce any billings from patients.
2- No to face to face ending a relationship. I need to make sure that what I am saying to the pt is 100% legal and I want to put it in writing. The pt may have a different version for verbal communication
3- Overall, the college is transferring the patients’ anger from the failure of the politicians to put it on the back of doctors.
On the long term, in spite of the fact that most of us do this profession out of passion, we may just leave the province or the profession. You cannot always be one sided and you have to show some accountability to your members as well.
You asked for our thoughts and here they are in all honesty.
1- It is ok for the CPSO to charge physicians $1600 + per year in fees, if unpaid, high interest and penalty is charged, almost $800.
But not ok for physicians to collect no show fees and other fees from patients?
2- I would want a legal letter delivered formally to a pt if I am firing them, not a face to face bad encounter.
3- Please enough stepping on physicians. some have revolted against the OMA when it went too far, I do not wish to see this happening to the CPSO, but do not push physicians into more hardship.
Information and Privacy Commissioner of OntarioResponse in PDF format.
In case a patient has a specialty physician patient relationship and the patient changes to another physician of the same specialty e.g. after hospitalization,is the previous specialty physician entitled to discontinue the previous specialty physician patient relationship?
Most of your membership are opposed to this policy. You have alienated the second most important stake holders after you patients, your doctors that you are supposed to govern.
There is a sense of alienation and non belonging from Ontario physicians towards the College and this is in no ones best interest.
Physicians feel that self governance is lost already and this sounds like the ministry talking.
Suggestions: surveys, open real consultation, real OMA involvement in consultations.
Do not alienate your physicians and I wish to remind you of the events that occurred since last summer involving the OMA, the physicians may end up taking legal action
against the CPSO.
Please forgive my naivety as I am a new physician in Ontario.
When a patient fires you, do you have a responsibility to find or assist the patient in finding a new specialist?
Does the answer to the above question change in the following circumstances:
1. Acutely unwell patient on admission in a hospital but is competent.
2. Patient attending outpatient clinic?
3. Specialist vs family doctor treating the patient?
If a patient continues to seek care outside the rostered practice, despite reasonable access to the practice, then I think it is more than reasonable to end the physician-patient relationship. In these situations providing comprehensive care is near impossible and the patient is not fulfilling their responsibility in the FHO or FHT. I have too often had patients who go to the nearest Walmart walk in or call the house call doctor because it was more convenient despite having my ability to see same/next day for urgent issues and having access to our FHO’s urgent care which is open M-F 9am-8pm & Sat, Sun & holidays 9am-3pm, only closed Christmas Day.
The term “reasonable” is vague, and open to interpretation by patient, physician and courts. College should avoid leaving such a vague term in such an important policy.
The Plumbing standard – much less important than human safety and relationship – has exact numbers and requires the home owners, and plumbers to follow.
Even in Southern Ontario it is not easy to find a doctor; without a reference for “reasonable time” the Policy will leave physicians liable and unprotected.
I have a female colleague of mine who wishes to terminate the medical relationship with a patient who continues to have inappropriate even sexual comments. “No harm” has been done, at least physically! The College has not supported physicians or office staff who are being verbally harassed. I have a policy in my office stating such a patient will not be seen. I would not tolerate sexual or verbal harassment to myself or my staff.
The college should include this in the policy. Physicians and Staff should have the right to terminate such relationship, even though “No Harm” has been done. I belive it should be explicitly mentioned.
tell him you need to reduce your hours and that you need to find him another family doctor…. a man. don’t try to change people. if its a female, just tell her not to make any sarcastic or sexual comments because it makes ppl uncomfortable in the workplace. and are you doing anything to incite the harassment? maybe the patient is uncomfortable with things he/she has to go through.
I agree with so much of the commentary that points to the College being far too vague, and using legalese “reasonable” that provides no sense of expectation that a doctor patient relationship always be based on mutual respect, and that physicians have the prerogative to make such judgements.
specifically, on a clause I do not notice comment on yet, the very last #9 clause that speaks to “actions to be taken…” the draft policy precludes a physician notifying other relevant care providers if the patient has expressly restricted one from doing so…I can think of all kinds of situations where that would be grossly irresponsible, discourteous to colleagues, etc to not let fellow care providers know of such an important and likely very difficult decision, that may have major implications to those remaining a in care provision role (the judgement of some patients in making that express restriction can well be malicious and/or manipulative in nature, for example)
I have an issue in that both my kids went away to university and when they get sick they see the on campus physician. They aren’t going to travel 3 to 8 hours to come home for a 15 minute doctors appt. They then receive calls at home admonishing them for seeing another physician. I am worried that they will be asked to leave the family physicians roster.
Shouldn’t your policies account for students that study away from home and not punish the family physician monetarily?
1. Can the policy more specifically address the physician’s responsibility in situations where a patient brings concerns forward regarding their care with the intent of resolving them, and the physician perceives there to be a breakdown in trust/therapeutic relationship and wants to fire the patient?
2. Can the discussion with the patient be done by phone rather than in person?
3. On page 3 where there are examples of situations that may lead to breakdown – would this include lack of trust in the recommended treatment plan?
4. Statement 101 is quite vague and the term difficult patient seems inappropriate
5. On page 7 where the policy mentions helping the patient find another provider – what if the patient is resistant and unhelpful with this process?
Having read the draft, I find a significant inconsistency in lines 133-134 vis a vie 86-88 in that:
1. Non payment of an outstanding debt is a justifiable cause of a relationship breakdown.
2. It is unreasonable to remove the “last resort” of dismissal as the means of encouraging debt payment
3. Dismissal for non payment only occurs after every other means is used to remedy payment
4. Debt non payment is rarely and I would say never an isolated issue but only one symptom of a challenged therapeutic relationship
5. Debt payment is a basic right in any service oriented relationship. Taking this away from physicians only belittles their professional integrity.
Please consider modifying lines 133-134 by adding this clause at the end of line 134; “without exhausting all other reasonable solutions”.
If a patient repeatedly seeks care outside of a rostered practice, there is a breakdown in the patient – physician relationship.
It is like having two Captains of a ship navigating at the same time – it can lead to disaster.
I recently had a patient who wished MRIs which were not medically indicated. She then got the walk in clinic doctor to order them. Now, who is responsible for the follow up? (They were normal like I expected). She continued with this doctor until she discovered that he could not order the medication she wished and then expected me to resume her care. It is a matter of trust – I did not feel that I could do so.
Your draft policy needs to be changed to allow physicians to end the physician – patient relationship when the patient has chosen to seek non urgent care elsewhere on an ongoing or regular basis.
There is a small but significant subset of patients who present a real problem.
They present with a history of substance abuse with excessive demands for medications, they frequently have no records and may refuse to have past records forwarded.
They are manipulative and many aggressive and abusive to the staff and the physician.
The “Elephant in the room” is fear of a complaint to the college when demands are not met.This fear can interfere with efforts to resolve problems with out agreeing to demands for opiods.
This over shadows any effort to give the patient a trial at the clinic with out an option to advise him to seek an alternative doctor if a therapeutic alliance is not reached.
If the college were seen to dismiss such complaints at an early stage [with no record retained on the doctor’s profile[, doctors would be more encouraged to take on these difficult cases.
The college should be seen to be fair and supportive of doctors in this situation, and a lack of this is counterproductive.
I would expect that there would be no coercion to roster theses patients and refusal to do so would not result in retribution.
Response received from the ‘Professional Association of Residents of Ontario’ available in PDF format.
Response received from the ‘Ontario Medical Association’ available in PDF format.
Response received from the ‘Ontario Medical Association Section on General and Family Practice’ available in PDF format.