| Physicians suffer from the same health problems as the general population although incidence rates may vary. The College of Physicians & Surgeons of Alberta (CPSA) is mandated to ensure that physicians are fit to practice and that they do not pose a risk to patients. It can be difficult to determine if a medical condition needs to be brought to the attention of the CPSA. Physicians are encouraged to have regular medical care and discuss the impact on their practice with their physician. They may also want to seek feedback from colleagues who observe them in the workplace. The CPSA wants to ensure public safety but will work with physicians to have them return to work if at all possible. At the time of registration and on a yearly basis physicians must declare whether they have had an illness that could impair their ability to practice. This includes but is not limited to: psychiatric illness, neurological illness, metabolic illness, results of accidents such as head injury and any illness that could impair the physicians’ ability to think clearly or to handle the physical demands of their branch of medicine. The CPSA must then decide what information needs to be gathered, what assurances are needed o determine fitness to practice and what monitoring should take place. 1. Identification of physicians with serious health issues: - self report
- report by a colleague
- report by a treating physician
- identification through a complaint process
2. Gathering information to assess fitness to practice for health reasons. Regardless of the way in which a physician is identified, the process to determine their fitness to practice will be similar and include the following: - Reports of treating physicians and the opinion of these physicians as to the fitness to practice.
- Reports from colleagues of work performance.
- Additional investigations or requirements.
If there is a serious concern about a physician’s fitness to practice, they can be asked to voluntarily withdraw from practice until all information is gathered or they could be suspended until fitness to practice was determined. This is a serious matter but patient safety must come first and the CPSA will need to ensure that there is not a risk to patients from impairment. In both cases, the physician will be reminded to seek legal advice to ensure a fair process. 3. Additional information may include the following: - Cognitive assessment and neuropsychological testing to determine ability to practice.
- Physical assessment tailored to the specific problem: i.e.: orthopedic surgeon, neurologist, sleep disorder specialist, internists
- Psychiatric assessment.
- Multidisciplinary assessment for complex cases or when there is a direct patient concern involved.
Physicians must agree to allow the CPSA access to medical records which confirm their fitness to practice. 4. Potential outcomes: - Unfit to practice with no chance of recovery.
- Unfit to practice at the time of assessment but improvements likely.
- Fit to practice with practice limitations or restrictions.
- Fit to practice with no restrictions.
5. Monitoring: Many of the illnesses that can impair the ability to practice are chronic illnesses and change over time. Ongoing monitoring is required to ensure compliance to recommendations of treating physicians, to reassess for fitness to practice and to ensure compliance with any practice restrictions or limitations. This can include the following: - Reports from treating physicians.
- Reports from colleagues or designated practice monitor.
- Reassessment by a third party.
- Practice visits or audits to review their practice.
- Competency assessment.
- Monitoring of billing or medical records to determine compliance to practice restrictions.
6. Continuing Care Contracts: These contracts are entered into to ensure compliance to the requirements as a condition of continued practice and using an informal process rather than the complaints process to resolve issues related to health. If, at any time, a physician would like to resolve any issues related to their health in a formal way they have the option of using the complaints and discipline process. |