Thank you for taking the opportunity to provide feedback on our draft Standard of Practice.

Your input will inform the Standard of Practice and ensure that it:
  • reflects current practice issues,
  • embodies the duties of medical professionalism, and
  • is consistent with the College’s mandate to act in the public interest.
Please note: All feedback collected through this survey is anonymous.

The draft Standard of Practice can be found here.

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* 1. Which best describes you? (select all that apply)

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* 2. The updated draft Standard states:

Physicians who are able to accept new patients into their practice must use a First-Come, First-Served approach. Decisions to accept or refuse new patients must be made in good faith.

Where a prospective patient’s medical needs are outside of a physician’s competence, area of practice, or scope of practice (e.g. terms, conditions, or restrictions of licensure), the physician must promptly communicate this information to the patient or the referring healthcare professional to facilitate timely access to care from another suitable provider.

Do you support these statements?

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* 3. The updated draft Standard states:

A physician who restricts or selects patients for their practice for any reason must establish a selection process which is non-discriminatory and clearly articulated to the prospective patient. The selection criteria for accepting patients must be relevant to the physician’s clinical competence and medical practice and to a patient’s healthcare needs. A physician must not refuse to accept a patient on the basis that the medical care required could or will become complex or time consuming unless the care required is outside of the clinical competence of the physician.

Do you support these statements?

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* 4. The updated draft Standard states:

Physicians should not refuse to accept a patient seeking to transfer their care for the sole reason that they are rostered to another physician. There could be many reasons why that relationship is no longer serving the patient’s healthcare needs, and patients in these circumstances should have the ability to transfer to another physician.

Do you support these statements?

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* 5. The updated draft Standard states:

Physicians are permitted to depart from the First-Come, First-Served approach to prioritize access to care for higher need and/or complex patients. Decisions to prioritize a patient’s access to care must be made in good faith.

Physicians must use their professional judgment to determine whether prioritizing or triaging patients based on need is appropriate, considering the patient’s healthcare needs and circumstances (e.g. a patient with urgent healthcare needs which require ongoing management).

The College acknowledges that caring for patients and their immediate family members (e.g. spouse or dependent child) may assist in the provision of quality care. Accordingly, where a family physician’s practice is otherwise closed, physicians are permitted to prioritize the immediate family members of current patients.

Do you support these statements?

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* 6. The updated draft Standard states:

A physician-patient relationship is established when an individual forms a professional relationship with a physician. Indicators of a physician-patient relationship include circumstances where the physician has engaged in one or more of the following activities:
  1. gathered clinical information for the purpose of making an assessment;
  2. provided medical advice, treatment, counselling, or a diagnosis for the individual;
  3. authored a medical record for the individual;
  4. charged or received payment for medical services to the individual;
  5. prescribed a drug to the individual; or
  6. provided other services which are typically associated with a physician-patient relationship.

Do you support these statements?

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* 7. The updated draft Standard states:

Excepting circumstances such as one-time consultative or emergency care, once a relationship is established, physicians are expected to continue to provide services until these services are no longer required or until after the patient has been given reasonable notice that the physician intends to end the relationship. When ending the relationship, physicians are expected to meet the expectations of the College as set out below in this document and in the College’s Standard of Practice on Closing or Taking Leave from a Medical Practice, as applicable.

Do you support these statements?

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* 8. The updated draft Standard states:

The expectations outlined in this Standard of Practice apply only in circumstances where the physician-patient relationship is terminated by the physician as a result of a breakdown in the relationship or for other legitimate reasons.

These expectations do not apply in situations where the physician’s involvement with a patient reaches its natural or expected conclusion, such as consultative care or emergency medicine.

When ending the physician-patient relationship, a physician must:
  1. make reasonable efforts to resolve the issue and only end the relationship if those efforts have been unsuccessful;*
  2. have reasonable grounds to end the relationship;
  3. provide adequate notice to the patient or their representative; and
  4. facilitate continuity of care and the transfer of medical records.
*The College recognizes that there are circumstances where a physician would not be required to attempt to resolve an issue with a patient prior to ending the relationship. In these situations, the physician is under no obligation to engage with the patient directly prior to ending the relationship. An example of such a circumstance includes a patient who is abusive or poses a safety risk to the physician, office staff, or other patients.

Do you support these statements?

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* 9. The updated draft Standard states:

In circumstances where a physician must end their relationship with patients to decrease the size of their practice, the physician must use a method to select which patients to remove which is fair, non-discriminatory, transparent, compassionate, and take into consideration the medical needs of each patient. A patient must not be removed from the practice for the sole reason that their medical care is complex or time-consuming.

Do you support these statements?

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* 10. Are there any gaps in the draft Standard which you think we should address?

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* 11. Please share any comments and/or concerns about the draft Standard.

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* Please feel free to answer the following additional questions regarding your demographics.

Information collected will allow us to ensure we have reached a diverse group of survey respondents and identify any trends. 

Optional Question 1: In which NL Health Services zone or geographic region do you reside?

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* Optional Question 2: How do you identify?

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* Optional Question 3: Which category includes your age?

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