February Messenger 2020

Table of contents

Medical Matters

And That’s a Wrap!

A Tool of Self-Reflection

When Your Health is Affecting Your Medical Practice

Are You Up to Standard? The Code of Ethics and One Issue Per Visit

Yenege Tesfa Hitsanat: An Alberta Physician’s Story of Care, Compassion and Humanitarian Work in Ethiopia

Physicians’ Notes: Ensuring Continuity of Care for Patients Taking Antiretroviral Medications

Discipline Reports

And That’s a Wrap!

A close to our 2020 main physician annual renewal

Thank you for completing your 2020 renewal. Yes, we ask for a lot of details, but completing the annual Renewal Information Form (RIF) ensures we have information to support you in practice. It also provides us with your updated contact details so we can share with you the news that impacts your practice and patient care.

The making of the RIF

Before we launch the RIF, CPSA leaders consider feedback from the previous year to make adjustments when possible. They also add needed questions, or make edits to ensure we get the data to run various programs that directly support physicians.

Next, a team from various CPSA departments tests and retest the updated form to make sure it all works as expected.

Finally, we do a soft launch to confirm information is being properly transferred and processed to our secure databases.

A closer look at 2020 renewal feedback

This year, approximately 700 physicians took the time to complete the brief feedback survey at the end of the RIF. Although we can’t address every recommendation, this feedback does help us make continual improvements. Here’s a look at what we heard:

• 94% Strongly Agreedor Agreed  the log in process was easy
• 78% Strongly Agreedor Agreed  the form functioned well
• 67% Strongly Agreedor Agreed  RIF questions were clear
• 65% Strongly Agreedor Agreed  the form was easy to complete
• 53% Strongly Agreedor Agreed  the length was reasonable
• 44% Strongly Agreedor Agreed help was readily available, 50% were neutral

Many physicians also left specific comments expressing frustration about the length of the form, lack of pre-populated data, and clarity or irrelevance of questions. We will look at all comments more closely to see what we can do to improve next year’s form.

Help! I didn’t renew

Take a breath, then go to the portal to complete your RIF and pay any outstanding fees, including the late fee. If you don’t do this before Feb. 17, your permit will be cancelled and you will have to reapply for CPSA registration.

Questions? Email the Director of Registration, Bruce Leisen, at Bruce.Leisen@cpsa.ab.ca.

Your 2019 Practice Checkup Summary

With the upload of CPSA’s latest Practice Checkup to your Physician Portal in November, we wanted to say thank you to everyone who took the time to read their report and fill out the attached survey-380 physicians provided valuable feedback that will be used to improve future iterations of Practice Checkup. CPSA’s Research and Evaluation (REVU) team analyzed all the recommendations, critiques, and commendations and below are a few examples of what you thought:

• You are interested in viewing complaint data displayed proportionately across different variables, such as peer comparator groups, patient volume and geographic location. This could provide a more comprehensive breakdown of complaints, thus increasing opportunity for reflection.
• The outcomes of Canadian licensing exams was suggested as a potential predictor for performance.
• Practice Checkup includes a number of risk factors to performance that we recognize are non-modifiable (such as age and gender). Our hope is to promote self-reflection beyond the factor itself and towards what underlying interactions could be present that affect how you provide care to the community and how your patients receive care. The goal for future iterations is to expand beyond these non-modifiable factors, so we can provide more tangible opportunities for physicians to mitigate risks to their practice.
• You appreciated the inclusion of graphical data, the refined self-reflection questions, general improvements to the report and the ease of claiming CME credits.

We thank you again for sharing your experiences and ideas-we aim for the next Practice Checkup to incorporate the important feedback we received.

Questions about Practice Checkup? Please contact the REVU team at REVU.Inquiries@cpsa.ab.ca.

When Your Health is Affecting Your Medical Practice

CPSA’s Physician Health Monitoring Program can help

Anyone can develop a health condition that impacts their work. What’s important is to get help early. Isn’t that what you would tell those you care about-a family member, a colleague or a friend?

When you find yourself in this situation, please take these steps:

1. Talk to your own healthcare provider for early medical attention.
2. Contact AMA’s Physician and Family Support Program (PFSP) for confidential support.
3. Contact Physician Health Monitoring Program (PHMP). We’ll help put supports in place so you can manage your condition safely and confidentially. If your health condition is reasonably likely to negatively impact patient care, CPSA’s Standards of Practice instruct you to contact us.
4. Consider reaching out to the Canadian Medical Protective Association (CMPA) for advice on your responsibility to report your condition to PHMP.

Need help? Call us today.

Dr. Jeremy Beach Assistant Registrar, PHMP
780-969-4940 | 1-800-561-3899 ext. 4940 (in Canada)
jeremy.beach@cpsa.ab.ca

Leanne Minckler, Physician Health Advisor
780-969-4943 or 1-800-561-3899 ext. 4943 (in Canada)
leanne.minckler@cpsa.ab.ca

Learn more about what to expect when you connect with PHMP.

Did you know?

• >80% of physicians in PHMP continue to practise with minimal impact to their work.
• Last year, 115 physicians entered our program. They join the 145 physicians already involved in PHMP.

Yenege Tesfa Hitsanat: An Alberta Physician’s Story of Care, Compassion and Humanitarian Work in Ethiopia

Dr. Richard Northcott jokes that he has a very big practice. In addition to practising as a hospitalist in Medicine Hat and Fort McMurray, he also travels to Ethiopia three-to-four times per year to provide medical care to children and their families-something he’s done for more than 25 years.

Dr. Northcott estimates he’s travelled to Ethiopia for his humanitarian work around 60 times, mostly with Canadian Humanitarian, a charitable volunteer organization that he helped found. The program takes in impoverished Ethiopian children, puts clothes on their backs and a roof over their heads, and provides them with health, social and educational support, all to help break the cycle of poverty. Dr. Northcott leaves for his next humanitarian trip to Ethiopia on Feb. 14, 2020.

In his own words, Dr. Northcott shares more about the important work he and the Canadian Humanitarian team are doing to improve the lives of those in Ethiopia.

Discipline Reports

Dr. David Odugbemi successfully appeals CPSA hearing decision

Dr. David Odugbemi, a family physician from Edmonton, successfully appealed his previous conviction of unprofessional conduct to a CPSA Council Review Panel and will be allowed to present new evidence to a CPSA Hearing Tribunal.

Background

To address issues arising from several complaints about his medical practice, Dr. Odugbemi entered into a Terms of Resolution Agreement (TORA) with CPSA in 2015. After failing to meet the terms of this agreement and repeatedly demonstrating ungovernable behaviour, Dr. Odugbemi was charged with unprofessional conduct by CPSA’s Complaints Director. He was found guilty in 2018 by a CPSA Hearing Tribunal, who subsequently ordered the cancellation of Dr. Odugbemi’s practice permit.

Dr. Odugbemi appealed both the hearing and sanction decision, on the grounds that deeming him ungovernable and permanently cancelling his permit were unreasonable. He asked to be allowed to bring new evidence forward in his defence.

After reviewing all of the evidence, including a report from a professional assessment Dr. Odugbemi underwent in 2019, the Council Review Panel granted Dr. Odugbemi’s request to introduce new evidence and redirected the matter back to the Hearing Tribunal who rendered the original decision.

Dr. Odugbemi’s practice permit is still active pending a final decision, but he is not currently in practice.

Commentary

In their original decision for this case, the Hearing Tribunal concluded that Dr. Odugbemi’s repeated acts of non-compliance with the agreement he willingly signed harmed the integrity of the medical profession. The public looks to regulators like CPSA to ensure healthcare professionals meet a certain standard of professionalism and when a physician fails to meet that standard, it impacts the trust Albertans place in us. That said, it is important that any physician facing disciplinary action is able to present any relevant evidence in their defence. Cancelling a physician’s permit is a last resort-whenever possible, CPSA wants to work with physicians to improve their practice and ensure they’re providing their patients with high-quality care.

Dr. Akadri Alarape suspended for unprofessional conduct after criminal conviction

After pleading guilty to one criminal charge of sexual assault, Dr. Akadri Alarape, a general practitioner from Edmonton, was found guilty of unprofessional conduct and suspended from practice by a CPSA Hearing Tribunal.

Background

In May 2018, Dr. Alarape plead guilty to one criminal charge of sexual assault against a co-worker and was sentenced to 12 months’ probation and a $100 victim surcharge. As a result of his guilty plea and conviction, Dr. Alarape was then charged with unprofessional conduct by CPSA’s Complaints Director. In 2019, the Hearing Tribunal found Dr. Alarape guilty and imposed a number of sanctions:

1. Alarape’s practice permit is suspended for a period of 15 months, beginning Feb. 13, 2020.
2. Upon reinstatement, Dr. Alarape’s practice permit is subject to the following conditions until otherwise determined by CPSA’s Complaints Director:
   1. Alarape must have a chaperone present for all appointments with female patients.
   2. Alarape must advise all staff members employed at his workplace about the chaperone requirement.
   3. Alarape must post a notice about the chaperone requirement in the clinic waiting area and in each exam room.
   4. Alarape must ensure clinic staff advises female patients of the chaperone requirement, either when the appointment is booked or during registration for walk-in appointments.
   5. Alarape must create and maintain a log to show he is complying with sections a, b and c as detailed above.
   6. The Complaints Director is authorized to conduct unannounced inspections to ensure Dr. Alarape’s compliance with his practice conditions.
3. Alarape must enter into a continuing care agreement with CPSA for a period of five years.
4. Alarape must work in a clinical setting which employs at least one other regulated health professional.
5. Alarape must not work one-on-one with a female staff member, or be alone with a female staff member in an enclosed space. This will remain in effect until otherwise determined by the Complaints Director.
6. Alarape is responsible for paying the complete costs of the CPSA investigation and hearing (totalling $81,113.77).
7. The Hearing Tribunal reserves the right to resolve disputes about the nature of these orders.

Because the assault did not involve a patient and occurred in 2017, prior to the implementation of Bill 21: An Act to Protect Patients, sanctions under that legislation do not apply to this case.

Commentary

Given the serious nature of the criminal charge and as part of our ongoing commitment to protect Albertans, CPSA’s Complaints Director sought the cancellation of Dr. Alarape’s practice permit. To support this sanction recommendation, an independent expert testified at the Hearing Tribunal at the request of the Complaints Director, about society’s changing attitudes towards workplace sexual harassment and the negative impact it has on one’s wellbeing. The Hearing Tribunal made their decision on sanction based on the evidence presented and precedence set by previous similar cases. CPSA respects the tribunal’s independence and responsibility to make these difficult decisions, and will continue to use all of the tools available to us to ensure patient safety.