policy matters

We are now consulting on an update to our Ending the Physician-Patient Relationship policy and are interested in hearing what you think about the proposed changes .

This policy clarifies the expectations of physicians when ending the physician-patient relationship , and outlines the actions to be followed in doing so . It covers situations where a physician ends the physician-patient relationship with one or more patients in circumstances other than the physician ’ s retirement , relocation , leave of absence or disciplinary action .

To read the full draft and provide feedback during our consultation , please visit our website at www . cpso . on . ca . We want to know what you think .

1

The “ Scope ” section of the policy has been updated to more clearly articulate how the policy applies to specialist physicians . The policy now states that specialist physicians must end the physician-patient relationship as outlined in the policy whenever choosing to discontinue the care of a patient prior to reaching the normal or expected conclusion of that patient ’ s treatment or assessment .

2

The draft expands on the actions physicians are expected to take prior to ending the physicianpatient relationship . These include , wherever possible : proactively communicating expectations for patient conduct to all patients ; considering whether a particular incident or behaviour is an isolated example , or part of a larger pattern ; and having a discussion with the patient regarding the reasons affecting the physician ’ s ability to continue providing care .

3

Detail has been added to help clarify when it may be appropriate to discontinue care due to a significant breakdown in the physician-patient relationship .

4

While the policy recognizes that physicians are entitled to receive and pursue payment for uninsured services , it now explicitly states that it is not appropriate to end the physician-patient relationship solely because the patient has not paid an outstanding fee .

5

The policy has also been updated to clarify that it is not appropriate to end the physician-patient relationship solely because the patient has sought care outside of a rostered practice 1 .

1

Patient rostering in family practice is a process by which patients register with a family practice , family physician , or team . Rostered practices impose specific commitments on both family physicians and their patients : physicians commit to provide comprehensive and timely care , and patients commit to seek treatment from their enrolling physician or group except in specified circumstances . When patients seek care outside of the practice , except in specific circumstances , the physician may incur a financial penalty .

Issue 4 , 2016 Dialogue 19