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The College of Physicians and Surgeons of British Columbia regulates the practice of medicine under the authority of provincial law. All physicians who practise medicine in the province must be registrants of the College.
The College’s overriding interest is the protection and safety of patients. The role of the College is to ensure physicians meet expected standards of practice and conduct.
Regulation of the medical profession is based on the foundation that the College must act first and foremost in the interest of the public. The primary function of the College is to ensure that physicians are qualified, competent and fit to practise medicine. The College administers processes for responding to complaints from patients and for taking action if a physician is practising in a manner that is incompetent, unethical or unprofessional. The College also administers a number of quality assurance programs to ensure physicians remain competent throughout their professional lives.
The role of the College and its authority and powers are set out in the Health Professions Act, RSBC 1996, c.183, the Regulations and the Bylaws made under the Act. A board of 10 peer-elected physicians and five members of the public appointed by the Ministry of Health govern the College. Under the legislation, the College has 10 committees made up of board members, medical professionals and public representatives who review issues and provide guidance and direction to the Board and the College staff, ensuring a well-balanced and equitable approach to regulation. The daily operations of the College are administered by the registrar and other medical and professional staff.
In June 2016, the College Board adopted a new professional standard to assist physicians with the challenging task of prescribing opioids, benzodiazepines and other potentially harmful drugs, while still allowing flexibility for physicians to exercise good clinical judgement.
Safe Prescribing of Drugs with Potential for Misuse/Diversion replaced an earlier document which outlined precautions specifically related to prescribing opiates. The publication of the standard was timely as BC and other jurisdictions in Canada were in the midst of dealing with an escalating public health crisis related to prescription drug misuse, and the criminal importation of illicit strong opioids (e.g. fentanyl).
In February 2017, Deputy Registrar Ailve McNestry was on As It Happens speaking about safe prescribing.
At the 2017 Best of Both Worlds Quality Forum in Vancouver, 23 health regulatory colleges became the first in Canada to pledge their commitment to making BC’s health system more culturally safe and effective for First Nations and Aboriginal people. The acknowledgement of racism in health care paved the way for creation of the Declaration of Commitment, which advances cultural humility and cultural safety in health services, and was signed in 2015 by the six provincial health authorities, the BC Ministry of Health and First Nations Health Authority.
The declaration has three main pillars: creating a climate for change; engaging and enabling stakeholders; and implementing and sustaining change. It builds on the already transformative and well-received San’yas Indigenous Cultural Safety training offered by the Provincial Health Services Authority, which all physicians and other health-care providers have been encouraged to take.
In early 2016, to ensure provincial readiness for the implementation of medical assistance in dying (MAiD), the BC Ministry of Health established a partnership of key public service and public sector organizations to form the provincial MAiD Working Group (MWG). The MWG included representation from the Ministry of Health, the Ministry of Justice and Attorney General, health authorities, professional regulatory colleges (physicians and surgeons; registered nurses and nurse practitioners; pharmacists) and the BC Coroners Service.
The MWG developed and implemented provincial regulations and practice standards to ensure medical practitioners, persons assisting in MAiD, patients choosing MAiD, and the public were well protected and informed—particularly in the early absence of federal legislation. The MWG and its subcommittees ensured provincial consistency in the development of standards, guidelines, safeguards, and practices for the patient-centred delivery of MAiD, and the approach to oversight and reporting.
The partnership fostered open dialogue amongst all stakeholders to ensure reasonable patient access while recognizing the conscience rights of individual practitioners and faith-based organizations opposed to MAiD.
The College library is a prime source of clinical information for practising registrants to support their efforts to remain current and competent throughout their careers. Core services include indepth literature searches, delivery of documents, and teaching physicians to locate evidence-based medical information. Specific initiatives in 2016 supporting these core activities included engaging key knowledge leaders, expanding outreach and teaching, and piloting a new section in the library’s newsletter, Cites & Bytes.
In 2016:
The College provides workshops and courses on a variety of topics to assist physicians in their ongoing education, including:
College service representatives answer more than 200 calls a day from physicians and members of the public inquiring about the College’s professional standards and guidelines, registration and complaints processes, physician contact information, and other related topics. The College’s medical staff offers advice to physicians in challenging areas of practice such as ethics and professionalism, and statutory compliance.
The College supports physicians by developing relevant professional standards and guidelines that address key areas of practice, and respond to existing or emerging issues and topics.
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The Board establishes standing committees made up of board members, medical professionals and public representatives who review issues and provide guidance and direction to the Board and College staff, ensuring a balanced and equitable approach to medical regulation.
View a complete list of College committee members in 2016/17 (PDF)
This past year, the Board was focused on the concept and principles of “right-touch regulation,” which describes an approach to regulation that the College and other regulators around the globe are adopting.
Right-touch regulation was introduced as a regulatory approach by the Professional Standards Authority, which oversees the work of nine statutory health regulators in the United Kingdom.
According to the Professional Standards Authority:
Right-touch regulation means understanding the problem before jumping to the solution. It makes sure that the level of regulation is proportionate to the level of risk to the public.
Principles of right-touch regulation
The Board believes that it is the correct and appropriate approach to take, and now uses the right-touch principles to evaluate and assess the College’s regulatory processes and functions.
