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Try and come for my job, but also be forced to treat them! no thanks.

 
It seems risky. I wouldn’t want a doctor I complained about to treat me yikes.

That’s like staying with my bf after I called the cops on him. No thanks. Just bc the cpso tried to mandate it, it doesn’t mean it’s possible or practical.

I’d consider agreeing to your policy if you allow the MOH to give an add on billing code E666 that pays per visit (maybe like $45.00). This may allow docs to handle the complex needs and nuances required to deal with said patients who threaten the treating physicians livelihood. It obviously requires extra time, care, and dedicated time to remove all biases on either side. Wouldn’t you agree cpso?

My human brain won’t allow me to objectively treat someone without bias if they threaten to take away my livelihood. I’m only human. Don’t come for my job but also expect that things can go on as before. There is obviously no malice, but there may be subconscious bias which may impair quality of care for better or for worse. It’s precisely why I don’t complain about restaurant staff service until AFTER I received all the food. I’m not coming to complain to the manager then eat the food there.

Absolutely under no circumstances should I be required to continue providing care for a patient that either threatens me with a CPSO complaint or pursues one. Complaints are the single most stressful and soul destroying thing a physician can go through and no way would I be able to objectively care for a patient afterwards. CPSO is actively against physicians.

Whose idea was it to change the current status? Who does it benefit? It certainly does not benefit physicians who have to deal with negative consequences (emotional, and yes PHYSICAL) when it comes to ongoing care for patients who are unhappy with the care they recieve. Patients are welcome to complain to CPSO (and sometimes those complaints are very valid) but you cant have your cake and eat it too. They must understand that proceeding with a complaint comes with valid consequences -- i.e. ending the relationship. No other profession would encourage their constituents to continue to see such patients/clients. And yet physicians are asked to do so? why? who does it benefit? the patient... surely its detrimental to the patient too

If a patient threatens to file a complaint, that should automatically terminate the physician-patient relationship. That's just common sense.

You are encouraging poor biased patient care with this policy by placing a barrier to a physician from objectively removing themselves from a patients care due to breakdown in trust. Any CPSO report will likely result in loss of trust of at least one side of the complaint regardless of the content or outcome of the complaint. Even without contacting CPSO, patients will use CPSO as a threat to force their physician to comply to their wishes and even that should warrant grounds to dismiss.

If patient complains to college, that means they do not trust their physician. the patient and physician relationship has been broken by the patient once they chose to purse this action. they should not expect to be able to cont the same relationship with their physician that they just complained about as if nothing happened. "Physicians should not automatically end their relationship with a patient in response to the patient’s contact with CPSO" is coercive and abusive to the physician, and this sentence needs to be removed.

This policy will not serve to protect patients. If a patient does not trust a physician enough to bring their complaint to them directly (and instead brings the complaint to their regulatory body), then there is insufficient patient-physician trust. This will ultimately lead to worse patient care and further erosion of family medicine within Ontario if physicians cannot discharge patients that complain to their regulatory body from their practice. This sentence specifically should be removed: "Physicians should not automatically end their relationship with a patient in response to the patient’s contact with CPSO".

If patient is unsafe (violent, threatening, racist/ sexist) towards other patients or community members on clinic grounds (including parking lot), that should be grounds for ending relationship. If patient makes cpso complaint , physician should be able to end relationship on basis of termination of therapeutic relationship, without further discussion with patient. Physicians should be able to decline a patient transfer from someone in the same physician group, even if they are still accepting new patients externally and internally.

I believe a threat to file a complaint is an automatic breakdown in trust which is required for a good physician patient relation. It's very difficult to provide good and objective care to someone who would not trust our medical expertise and threaten a complaint against a physician. It's absurd to continue a physician patient relation when there is no trust.

It might be difficult for a doctor to provide care to a patient who has launched a complaint against the doctor. I think this very step makes it difficult for a physician to be objective in their care; they may feel coerced into making decisions that aren’t necessarily warranted in an effort to not upset the patient further. Also, how is this not an automatic breakdown of trust in the patient-physician relationship? Most doctors are devastated by a complaint even if frivolous and it is a major source of stress for them and takes a toll on their mental health. To then put them through this mental gymnastics is not fair.

Implying that patients can approach the College to discipline their doctor without consequences fosters an abusive dynamic toward physicians. If you trust your doctor, there should be no need to escalate concerns to their governing body in an attempt to modify their behavior. This policy risks empowering inappropriate patient behavior and contributing to a culture of disrespect. Shame on those who proposed this approach. While it is every patient’s right to contact the College, they should not expect to return to a doctor-patient relationship unchanged after taking such action.

Hello,

The following is my feedback about the proposed language for the updated policy about terminating the doctor-patient relationship.

Specifically, the verbiage “Physicians should not automatically end their relationship with a patient in response to the patient’s contact with CPSO”.

In my opinion, this is absurd. There's no way you could maintain your objectivity about a patient who's made a complaint against you, especially if the complaint is seemingly ridiculous.

Absolutely under no circumstances should I be required to continue providing care for a patient that either threatens me with a CPSO complaint or pursues one. Complaints are the single most stressful and soul destroying thing a physician can go through and no way would I be able to objectively care for a patient afterwards.

Completely disagree with: "Physicians should not automatically end their relationship with a patient in response to the patient’s contact with CPSO" This usually constitutes a breakdown of physician-patient relationship and trust, and if a physician is forced to continue the relationship despite that, it’ll be to the detriment of both the physician and the patient.

Physicians should have the right to end a doctor-patient relationship if the patient has filed a complaint against them with the CPSO. The therapeutic relationship relies heavily on mutual trust and respect, and this trust is inevitably compromised when a complaint is lodged. Continuing care in such circumstances risks undermining the quality of care and could harm both parties. Just as patients have the unrestricted ability to file complaints, physicians should retain the ability to assess and maintain the integrity of the therapeutic relationship, ensuring it remains conducive to effective care.

The policy update regarding termination of patients after a complaint is not reasonable. After a complaint by a patient, it would be impossible to maintain a patient physician relationship built on trust. Therefore, it almost certainly should result in the end of the therapeutic relationship.

The notion that a physician should have to retain a patient who was made a complaint to the CPSO (most of which are groundless/vindictive) is really quite absurd as there is no way a physician would be able to maintain objectivity under these circumstances.

The absurdity of this update is beyond me. There is clearly a breakdown in physician patient relationship when the patient chooses to approach CPSO to complain about the physician. This will decrease my willingness to take on new patients and increase my reason to leave Ontario to practice elsewhere.

Please consider simplifying and rewording the document for easier comprehension and integration. This is easily achieved with help from AI large language models and appropriate prompting. I will advocate striking a balance between patient care and physician burnout.

‘Ending a physician-patient relationship is a significant decision that requires careful consideration to ensure patient care continuity and to mitigate physician burnout. The College of Physicians and Surgeons of Ontario (CPSO) provides guidelines to navigate this process effectively. 

Key Considerations: 

1. Assess the Situation: 

- Evaluate the Relationship: Determine if the relationship has deteriorated to a point where effective care is compromised. 

- Patient Welfare:Consider the potential impact on the patient's health and access to care. 

2. Attempt Resolution: 

- Communication: Discuss concerns with the patient to seek a mutual understanding. 

- Support Services:*Utilize mediation or counseling services if appropriate. 

3. Decision to Terminate: 

- Justifiable Reasons: Ensure reasons align with CPSO guidelines, such as persistent non-compliance, abusive behaviour toward the physician or health care team member, or irreparable breakdown of trust. 

- Prohibited Reasons: Do not terminate based on discriminatory factors or patient decisions regarding their care that do not pose a risk to others. 

Steps to End the Relationship: 

1. Provide Notice: 

- Written Notification: Inform the patient in writing, clearly stating the decision and the reasons, if appropriate. 

- Notice Period: Allow sufficient time for the patient to find alternative care, typically at least three months. 

2. Ensure Continuity of Care:

 - Emergency Care: Continue to provide urgent medical services until the patient secures a new healthcare provider. 

- Referrals: Assist the patient in finding another physician or healthcare facility. 

3. Transfer Medical Records:

 - Patient Access: Inform the patient of their right to access their medical records.

- Timely Transfer:*Expedite the transfer of records to the new healthcare provider upon patient consent. Documentation: 

- Record Keeping: Document all communications, reasons for termination, and steps taken to ensure continuity of care in the patient's medical record. 

Preventing Physician Burnout: 

- Set Boundaries: Maintain professional boundaries to prevent overextension. 

- Seek Support: Utilize peer support networks and professional counseling when needed. 

- Workload Management: Delegate tasks appropriately and consider practice adjustments to manage workload. 

- Self-Care: Prioritize personal health and well-being to sustain professional performance. 

By following these guidelines, physicians can ethically and professionally end a physician-patient relationship while safeguarding their well-being and ensuring patients continue to receive necessary care.