The College’s Regulatory Bylaws establish expectations for physicians and for the College.  They establish practice standards, establish a Code of Ethics  and Code of Conduct, define certain forms of conduct as unprofessional and establish requirements for licensure.

There were six (6) changes to College regulatory bylaws since the last edition of the Newsletter.
 
 

Regulatory bylaw 19.1 – replace the word “addiction” with “opioid use disorder”

The word “addiction” carries a stigma and is not the term used in DSM-5. “Opioid use disorder” is the term most commonly used.

Regulatory bylaw 19.1 – Standard for prescribing of methadone or buprenorphine was amended by substituting the term “opioid use disorder”.
 

Regulatory bylaw 2.6 – removing supervision requirement for physicians who achieve certification

Regulatory bylaw 2.6 is the bylaw which establishes the conditions that apply to physicians who have received a provisional licence. Some physicians have attained certification with the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada but have not yet met the requirements for a regular licence.

The bylaw was amended to remove the requirement that physicians who have attained certification but remain on a provisional licence must practise under supervision.
 

Regulatory bylaws 2.5 and 2.6 – licensure of physicians with SEAP attestation

SEAP attestation is provided by the Royal College of Physicians and Surgeons of Canada to some physicians who have international sub-specialty credentials. Among other criteria, the physician must have practised in Canada and must pass the Royal College examination in the sub-specialty.

Bylaws 2.5 and 2.6 were amended to grant a provisional licence to a physician who has attained the SEAP attestation and who meets the other licensure requirements. The physician will practise under supervision until they complete a summative assessment.  A physician who successfully completes a summative assessment will be granted a regular licence, limiting that physician to practise in the sub-specialty.
 

Regulatory bylaw 18.1 amendment to allow verbal prescriptions for PRP medication

Physicians who provided virtual care during the pandemic sometimes had difficulty meeting the bylaw requirements to prescribe prescription review medications. Canadian legislation was amended to temporarily remove the requirement that controlled medications could only be prescribed by a written prescription.

The bylaw amendment permits physicians to issue verbal prescriptions for prescription review medications if the physician concludes that it isn’t reasonably possible to provide a written prescription or an electronic prescription. The physician must include the same information in a verbal prescription as is required in a written prescription.
 

Regulatory bylaw 3.1 amendment to change the questions asked on licence renewal

Physicians are required to respond to a series of questions when applying for a licence or when renewing a licence. There was inconsistency between what was asked on an initial application and what was asked on renewal.

The amendments change the health-related questions asked on renewal to be consistent with the health-related questions asked on an initial application.  The amendment also limits the question about a physician’s blood borne virus status to only those physicians who perform or may perform exposure-prone procedures.
 

Regulatory bylaw 2.4 – licensure of physicians who achieve Royal College certification through the practice eligible route (PER)

The practice eligible route (PER) of the Royal College of Physicians and Surgeons allows physicians with international specialty certification to apply to challenge the Royal College examinations in their specialty. Physicians who have passed the Royal College examinations and who meet the other requirements for licensure can obtain a provisional licence. Physicians will only receive Royal College certification after passing the Royal College examinations and after the Royal College assesses their practice in Canada and concludes that they have practised appropriately. That assessment will only be done after the physician has been in practice in Canada for at least two years.

The bylaw was amended to allow physicians who have achieved Royal College certification through the PER route and who have met the other requirements for licensure to obtain a regular licence without additional requirements. They will not be required to achieve the LMCC or MCCQE1 plus 5 years of successful practice.

* Bylaw changes come into effect once they are approved by the Government of Saskatchewan and published in the Saskatchewan Gazette.

Council regularly reviews the policies, guidelines and standards which are then made available on the College’s website. 

Since the last edition of DocTalk, Council has adopted one new policy and one new guideline. 

*Click on each title below to view the complete version of the policy, standard or guideline.
 
 

NEW GUIDELINE – End of Life Care

See also the article, End of Life Care, in this edition of DocTalk, which provides additional information about this Guideline.

In general terms, the primary focus of the Guideline is to assist physicians who have to consider whether to refuse to provide or withdraw life-sustaining treatments because the treatments would be futile.

NEW POLICY - Responsibility for a Medical Practice

After two rounds of stakeholder consultation, Council approved a new policy, Responsibility for a Medical Practice .  The policy sets out the underlying obligations that exist for all physicians, regardless of their practice environment (with certain limited exceptions).  Physicians are responsible for their own medical practice including patient care provided, taking reasonable care to ensure billings for insured services are appropriate, and ensuring they are familiar and compliant with applicable laws, bylaws, policies and standards.  The policy identifies a number of other obligations that fall on each physician unless another designated physician in the clinic has accepted responsibility.  Even in that circumstance, physicians remain responsible to ensure steps are taken to address any concerns.

The policy also requires all multi-physician clinics (as defined in the policy) to have a “primary contact” who is available to respond to inquiries from the College.  While that individual does not necessarily need to be in a position to answer all questions posed, they must be able to direct the College to a person who will be able to answer.

See also the article, Council Approves New Policy - Responsibility for a Medical Practice, in this edition of DocTalk, which provides additional information about this Policy.