Serving the public through excellence and professionalism in medical practice.
Transparent, objective, impartial, and fair.
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.
New standard directs appropriate prescribing of certain drugs
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.
BC health professions pledge their commitment to First Nations
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.
Ensuring access to medical assistance in dying for BC patients
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.
Up-to-date clinical information
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.
- 1,388 in-depth reference questions were answered
- 54,788 articles were delivered to physicians by staff or downloaded by self-service
- an average of 2,083 articles per monthly issue of Cites & Bytes were delivered or downloaded by self-service
The College provides workshops and courses on a variety of topics to assist physicians in their ongoing education, including:
- boundaries, ethics and professionalism
- prescribing for chronic pain
- methadone prescribing
- medical record keeping
- online research tutorials
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.
Ethics and professionalism
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.
New or updated standards and guidelines in 2016/17
- Laser Safety for Physician Practice
- Medical Assistance in Dying
- Safe Prescribing of Drugs with Potential for Misuse/Diversion
- Sale and Dispensing of Drugs by Physicians
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.
Finding the right touch in regulation
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
- Proportionate—regulators should only intervene when necessary. Remedies should be appropriate to the risk posed, and costs identified and minimized.
- Consistent—rules and standards must be joined up and implemented fairly.
- Targeted—regulation should be focused on the problem, and minimize side effects.
- Transparent—regulators should be open, and keep regulations simple and user friendly.
- Accountable—regulators must be able to justify decisions, and be subject to public scrutiny.
- Agile—regulation must look forward and be able to adapt to anticipate change.
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.