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Medical Matters: A word from CPSA Deputy Registrar Dr. Susan Ulan
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February Messenger 2022, Medical Matters |
Posted February 10, 2022
Read time: 3 minutes
| For the past four and a half years, I have been sharing my thoughts and keeping the profession up to date on important regulatory issues through Medical Matters. Going forward, we thought you might be interested in hearing from some of the other members of CPSA’s leadership team. We hope this will provide a different perspective and allow you to learn more about the important work taking place across the organization. I’ll likely still have a couple articles throughout the year, but the vast majority will be from other CPSA team members. To kick things off, our Deputy Registrar, Dr. Susan Ulan, is going to share a bit of her background and dive deeper into her role at CPSA.
– Dr. Scott McLeod |
My name is Dr. Susan Ulan and I am a family physician. I joined CPSA in 2009 as a Senior Medical Advisor and have held a variety of leadership roles since 2014. I have been the Deputy Registrar since 2020, providing executive support to the Hearings Director’s Office and the Continuing Competence portfolio. You may be wondering what exactly the role of Deputy Registrar entails—I did too! After some time familiarizing myself with my role and learning where I could add value to the organization and our profession, I’m happy to offer a glimpse into my work at CPSA.
At a high level, I support Dr. McLeod in carrying out organization-wide initiatives and liaising with provincial and national stakeholders to advance CPSA’s strategic goals. In 2022, one of my priorities will be leading the transition from CPSA’s new strategic plan to an organizational action plan, developing corporate key performance indicators so we can track our progress along the way.
This may sound dry and administrative to some of you, but I have found it incredibly rewarding to collaborate with our partners and develop initiatives that have a positive influence on our healthcare system. It has been a challenging few years for all of us in health care, but I have been inspired by the resilience and creativity of those who work in our profession to adapt and innovate in the face of difficult circumstances.
As regulators, we’ve also had to adapt and reprioritize throughout the pandemic to meet the needs of our regulated members and Albertans. In addition to our usual work in 2021, Continuing Competence triaged over 1,500 inquiries and concerns from regulated members and the public relating to COVID-19 (up from over 200 in 2020). A small team of people from Continuing Competence responded to these inquiries and worked with our Communications team to prepare key messages and guidance when themes were identified. Most inquiries are resolved with a phone call or written correspondence from CPSA to the physician or Albertan in question.
Occasionally, we received COVID-19-related concerns about physician compliance with public health measures, or misinformation allegations that, if true, would put the public at risk. We examined options in the Health Professions Act (HPA) to substantiate these concerns and looked at alternatives to our formal complaints and discipline process. Under part 3.1 of the HPA, CPSA has conducted nine unannounced inspections of physician practices in the Edmonton, Calgary, Central and South Zones. Inspections primarily involve a review of patient charts and are conducted by two CPSA inspectors: the Infection Prevention & Control Program Manager and a physician.
To date, five physicians have signed voluntary agreements to no longer offer exemptions from COVID-19 vaccination or masking requirements, or to prescribe or recommend off-label use of drugs such as ivermectin to treat or prevent COVID-19. Physicians who do not voluntarily agree to these conditions are referred by the Deputy Registrar (me) to CPSA’s Complaints Director to determine whether there is evidence to support unprofessional conduct.
It’s clear the vast majority of physicians are working very hard under difficult circumstances to provide the best possible care to their patients, while complying with public health restrictions and best practice guidelines—no small task when the COVID-19 landscape is in such flux. I am optimistic that this upcoming year will be a little more settled and we can begin incorporating some of our new approaches to our work as regulators. Thank you all for the incredible work you do on a daily basis and the sacrifices you have made to do what is best for your patients and the healthcare system as a whole. It is truly appreciated.
Thanks for your work Susan. Whilst I had not given it much though before, I have noticed a number of my colleagues in their young 60s retiring, not because of issues with health, in fact most keep up well with work and CPD, but just want to cut back to enjoy family and interests. They do not really want to retire, but find that with reduced work the financial burden of regulation and statutory membership is just not worth it. This is a pity.
It may be an idea for the College to look at how to retain older physicians at a time when communities are struggling to attract and retain physicians. I know my personal cost of regulation compliance, without cpd costs is about $12000 per year adding professional associations, zone fees section fees, College fees, CMPA and CFP, and that is after the CMPA rebate which is itself a bit touch and go since AHS took the reins. Adding cpd can push this intonthe mid 20 thousands before any othe kind of overhead is considered.
My feeling is that steps could be taken to rationalise and minimise all of these fees for physicians over a certain age, perhaps on a sliding scale, to help incentivise ongoing participation without unnecessary burden. Perhaps this could start with College reducing fees by10% per year for each year on ongoing registration after 60 or 62 (arbitrary ages) and perhaps waiving the need to subscribe to the CFP or RC for cpd accounting in the last 5 years of anticipated work, leaving this to honour. I may approach the AMA about this issue too, but a round table amongst the regulatory and membership heirarchy would probably help.
Hi Neil, I appreciate you taking the time to share your feedback and perspective on physician retention as it relates to financial implications. I think you’ve made some very interesting points and will certainly share this feedback with our Leadership team for their consideration. Thank you.
We are going through a period when most of the healthcare workers in the frontline feel the heat and dissonance in practicing of Medicine. Even the most resilient physicians would have confessed (to self at least) about the experience of being burn out. Policies reshaped and then impacted by political, social, ideological and religious reasons have only made the matters worse for the frontline physicians.
I have witnessed colleagues walking away after admitting the failure of the system revolving around the pandemic with a plethora of policies and notifications; and not failure from facing the virus itself. Policy makers and the policy ‘audience’ appeared like left hand not knowing what the right hand does. Of course our generation have no experience of facing a pandemic of this level. The evolving hindsight (since foresight is ignored) teaches a lot more, especially about the simple medical codes of prevention.
Who would you turn to if you feel burned out by dealing with / helping those who seek help for being burned out? When Human Rights are misinterpreted as a sense of entitlement, the situation becomes more complex. Hence identifying these two is the only way to uphold the Health of the Nation at its best.
Hi Madhavan, thank you for taking the time to read The Messenger. We recognize the pandemic has taken a toll on patients and physicians alike. We appreciate the sacrifice, dedication and professionalism healthcare workers have shown over the past two years, especially as they faced an influx of ever-changing information and guidance. CPSA will continue to work with partner organizations and regulated members to provide the best possible guidance in this complex and constantly-changing environment.
If physicians are feeling burnt out, and understandably so, I would suggest reaching out to the AMA’s Physician and Family Support Program or having a conversation with Dr. Beach in our Physician Health Monitoring Program.
Take care.