Knowledge is power

Making the most of your 2019 MD Snapshot-Practice Checkup

It’s that time of year again where all Alberta doctors will receive their 2019 MD Snapshot-Practice Checkup. For some of you, that doesn’t mean very much but for others, this report-along with the MD Snapshot-Prescribing reports-can induce a significant emotional response. For some it’s anger and for others, it’s anxiety. The array of emotional responses is as far ranging as you can imagine. Despite the fact that CPSA’s only intent behind these reports is to provide physicians with information about their practice, I have been told by some of you that these tools are designed to shame physicians into cutting back their prescribing or getting them to retire from practice.

Now, I don’t know about you, but when someone tries to tell me what I really meant by something, I typically get defensive. How do they know what my intent was?

In this case however, I had to take a step back and realize that there was a real and legitimate perception by some Alberta physicians that CPSA was trying to change physician behaviour through shame. Just saying, “Trust me, that’s not our intention” isn’t going to work, and it’s going to take time to understand this better.

Let’s take a look at the MD Snapshot-Prescribing report. To me, this seems like a very reasonable report for physicians to receive. CPSA has all the data available to us to begin with; we have different tools that we’ve used for many years to identify prescribing patterns and when we see abnormal practice behaviours, we look into it.

Why wouldn’t we share this information?

Autonomy of practice should also include autonomy of self-evaluation. CPSA is not in a position to look at every individual practice and provide feedback to every physician in Alberta, and I suspect you wouldn’t want that either. Our focus should be on those few physicians who are struggling, so we can provide support and help them improve their practice.

Our mandate from government is not to discipline doctors-it’s to protect the public. Like the practise of medicine, we don’t want to just treat illness, we want to focus on prevention. I would consider the MD Snapshot reports as just one part of CPSA’s public health approach to regulation. CPSA is the disciplinary body for physicians and with that naturally comes some degree of fear of us, but we really are much more than discipline.

When it comes to the annual Practice Checkup, I know there is nothing you can do about being a 65-year-old male physician practising in a rural community, but isn’t it useful to know that there are certain risk factors associated with physicians who fit this description?

Think of it this way: if you have a 65-year-old male patient who is a smoker and a diabetic, would you not want them to know that they could reduce their risk of having a cardiac event by quitting smoking, controlling their blood sugar, eating healthy and getting regular exercise? Like the 65-year-old male physician, the patient can’t do much about their age and sex, but there are risk factors that can be controlled. Being aware of these risk factors is the first step to protecting yourself from a medical error or a complaint.

I think it’s helpful for physicians to be aware and in control of their own information so they can reflect on it and learn from it. Since CPSA does not have data on the demographics of your practice or the spectrum of illnesses you manage with your patients, we are not the ones to assess your unique risk. What we can do is support you in your own assessment-and Practice Checkup is a tool for that assessment. It’s really not much different from having patients accessing their own medical information.

After all, the data CPSA has about you is your information, just like a patient’s information is theirs.

I hope you take a few moments to look at your report on the Physician Portal and reflect. If you would like more information or want a better understanding of it, please feel free to reach out to our Research and Evaluation Unit. We’d also appreciate any feedback you have about your report-you can submit that here.

If you choose to do something with the information in your 2019 report, that’s great. If you decide not to, that is 100 per cent up to you. I can assure you we are not trying to use “shame and blame” as a tactic to change behaviour.

On a closing note, I hope all of you took a moment at the 11^th hour of the 11^th day of the 11^th month to also reflect on those who sacrificed so much, so that we may have the wonderful life that we’re so fortunate to have.

Your comments are appreciated,

Scott