Physicians continue to work collaboratively with health-care professionals to ensure patients are provided with timely, safe, and appropriate care.
Managing Consultation Requests
CPSO has updated the Continuity of Care: Advice to the Profession for the Managing Tests and Transitions in Care policies to highlight for physicians who use e-referral platforms the importance of providing an alternative option for those unable to access the platform.
The advice document also addresses how to appropriately manage follow-up care and testing following a consultation. If, during an assessment, a specialist makes an incidental finding unrelated to the consultation (e.g. abnormal lab or imaging tests), they will need to use their professional judgment to determine what steps are appropriate. For example, if a test result needs to be urgently managed, specialists will need to communicate the results to the patient and take steps to arrange timely follow-up for the patient. If, however, the result is not urgent and not typically within the scope of the specialist to investigate or manage, they will need to inform the patient of the finding and advise them to follow up with their family physician.
Delegation of Controlled Acts to Community Paramedics
CPSO has updated its Advice to the Profession: Delegation of Controlled Acts document to provide guidance to physicians who delegate to community paramedics. Community paramedics can provide a range of non-emergency, preventative, and primary health-care services. Where those services involve controlled acts, they are authorized via delegation by a physician (or another regulated health-care professional authorized to perform the act).
The updated Advice document reminds physicians that they are ultimately responsible for the care being provided on their behalf via delegation. The identity of the delegating physician will therefore need to be clear in all instances. Physicians must also be satisfied that any medical directive being implemented under their authority is appropriate in the circumstances and sufficiently detailed to support the type of care being delivered. When the medical directive is updated, physicians are also responsible for reviewing and signing it.
Working Collaboratively with Dentists
Physicians are sometimes consulted by dentists regarding specific information about a patient’s health condition. The physician would be expected to provide the information required by the dentist to safely plan for dental procedures if the information is accessible and within their scope of practice. This could include, for example, a medication history and shared decision making about altering or discontinuing medications in advance of a dental procedure. Where an assessment is required, the patient may be asked to schedule an appointment with the physician, either virtually or in person, so that the physician can discuss the proposed dental procedure and provide advice as required. However, physicians are not expected to “clear” a patient for anesthesia or fill out specific forms to "clear” a patient for procedures.
