POLICY: Physicians at Risk to Patients

 
The CPSS believes, that as members of a regulated profession, every physician has the responsibility to ensure that they and their colleagues provide safe and competent care to their patients.

To meet this responsibility, physicians must recognize in themselves, and in colleagues, indications that their ability to provide safe and competent care to patients may be compromised.

Examples of impairment include, but are not limited to:

• Substance abuse
• Bloodborne pathogens while engaging in high risk medical or surgical procedures
• Compromised clinical judgment
• Behaviour irregularities that may adversely affect patient care or safety
• Psychological illness which may adversely affect patient care or safety
• Failure to recognize the limitations of one’s own competence
• Physical limitations where relevant motor skills are necessary

Remember to “Consider first the wellbeing of the patient; always act to benefit the patient and promote the good of the patient”, from the CMA Code of Ethics and Professionalism. Physicians who have diminished ability to provide safe and competent care have an ethical responsibility to appropriately restrict practice, or withdraw from practice. The College expects physicians to self-report impairment to their regional medical staff or the College. Physicians may self-report to the Physician Health Program of the Saskatchewan Medical Association to obtain confidential assistance to deal with impairment, provided patient safety is not compromised.

If a physician has reason to believe that a colleague has a diminished capacity to provide safe and competent care, the physician must promptly confront the issue. This can be done with the assistance of regional medical staff, the SMA or the College. If the issue is not resolved, the physician has an ethical obligation to inform the College. 

Paragraph 31 of Regulatory Bylaw 7.1 states there is a duty to, “report to the appropriate authority any unprofessional conduct by colleagues or concerns, based upon reasonable grounds, that a colleague is practising medicine at a level below an acceptable medical standard, or that a colleague’s ability to practise medicine competently is affected by a chemical dependency or medical disability.”

The CPSS policy on Sexual Boundaries also outlines a duty to report a boundary breach by another physician. 

OTHER RESOURCES

College of Physicians and Surgeons of Saskatchewan – Regulatory Bylaw 7.1, The Code of Ethics

College of Physician and Surgeons of Saskatchewan – Policy: Sexual Boundaries

College of Physicians and Surgeons of Saskatchewan – Regulatory Bylaw 24.1 – Reporting of Blood-Borne Viruses

College of Physicians and Surgeons of Saskatchewan – Policy: Blood-Borne Viruses: Screening, Reporting and Monitoring of Physicians/Medical Students