Registrar’s message: lessons learned from a challenging year—working together for positive change

Collectively, we have experienced a once-in-a-century worldwide pandemic; we have confronted the devastating impacts of systemic racism; and we have felt the burden of the ongoing opioid crisis. There is no doubt that this past year has been difficult; yet, it has also been a year of reflection, solidarity, and renewed strength to drive positive, lasting change.

Throughout the pandemic, registrants have been able to adapt their practice by increased use of technology to continue to meet their patients’ needs. This has been no easy feat, and I applaud the hard work and resilience of many registrants who now spend a portion of their clinic day communicating with patients remotely. While virtual care has opened the door to greater access and is clearly here to stay, it will never be a replacement for in-person assessments when and where necessary. Following a comprehensive consultation, revisions to the existing practice standard Telemedicine will need to reflect this new reality.

The College, like other organizations, has taken important steps over the past year to address Indigenous-specific racism. The significance of this work was underscored by the findings from the independent investigation led by Dr. Mary Ellen Turpel-Lafond, which exposed the extent to which Indigenous-specific racism exists in the health-care system. At its annual retreat, the Board spent two days discussing cultural safety and humility and resolved to include it as a core pillar of its 2021–2024 strategic plan. The action items outlined in this core pillar include improving the College’s complaints process to make it more accessible to Indigenous patients, developing a new practice standard, and applying the lens of cultural safety and humility to the College’s operations and governance. 

Though these are all important steps along the path towards truth and reconciliation, the structural reform necessary to protect Indigenous patients will be an ongoing journey requiring continued reflection and action by all. The College has taken a long, introspective look at its policies and processes and expects registrants to do the same. The new Cultural Safety and Humility practice standard is currently being drafted with guidance from our Indigenous community, partners, and registrants, and will likely be published later this year. 

The opioid crisis in BC has been compounded by COVID-19, resulting in a dual public health emergency, which continues to hit our province’s marginalized and vulnerable populations the hardest. In response to the negative impacts the pandemic has had on the opioid crisis, the Ministry of Health, Ministry of Mental Health and Addictions, and BC Centre for Substance Use have initiated numerous rapid changes to the management of opioid use disorder (OUD) and other substance use disorders.

As changes continue to be made based on emerging empirical evidence, the decriminalization of substance use, and increased availability of pharmaceutical alternative prescribing (safe supply), the College anticipates becoming more involved in regulating the management of OUD and will continue to update its Safe Prescribing of Opioids and Sedatives practice standard to best serve BC patients.

I commend all of you who have sacrificed so much this past year to deal with these difficult societal issues. The increasing number of vaccinated British Columbians, commitments made by health-care organizations to ensure culturally safe care, and the changing management of OUD allows us to look forward to a post-pandemic world with renewed but cautious optimism. 

Though much will continue to challenge us over the coming months, the lessons we have learned during the pandemic and the progress we have made by working together to grow and evolve will have enduring impacts.

Heidi M. Oetter, MD
Registrar and CEO

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