Prescribing Practices
Referral Practices
Relationship with
Other Health Care Professions
Working in a
Multicultural Environment
Medical Records
Prescribing
Practices
Excerpted and adapted from CPSO
Appropriate prescribing focuses on the best interests of the patient and is done in
accordance with accepted standards of practice and guidelines. Prescribing practices may
vary from province to province. As an example, the following depicts the prescribing
approach defined by the College of Physicians and Surgeons of Ontario:
It is generally in the patient's best
interests to have one physician prescribe all medications. In most cases, this will be the
patient's primary care provider. It is good practice for physicians to report all
suspected adverse drug reactions, regardless of their severity and whether expected or
not, to Health Canada.
Before instituting drug therapy, physicians must take all reasonable steps to identify
every medication that is being used by the patient, including over-the-counter medications
and those involved in complementary therapies. Patients are responsible for providing
their physicians with the information necessary to conduct proper medication reviews.
Physicians should familiarize themselves with the contraindications, precautions, and
effects of the complete set of medications used by a patient to the fullest extent
possible.
Professional misconduct under the Medicine Act can occur when a physician misuses or
abuses their authority to prescribe medication to patients.
back to top >>
Referral
Practices
Excerpted and adapted from College & Physicians and Surgeons of Alberta: Policies and Guidelines
Consultations are an essential health care resource to physicians and patients. The
consultant, the physician and the patient each have responsibilities to ensure that the
maximum benefit is derived from the consultation.
Practices regarding referral approaches may
vary from province to province. The following is an example of an approach to referrals
depicted by the College of Physicians and Surgeons of Alberta. Physicians typically
request the opinion of an appropriate colleague acceptable to the patient when diagnosis
or treatment is difficult or obscure. The referring physician also typically ensures that
all of the necessary documents are made available to the consultant unless such transfers
are explicitly refused by the patient.
Primary care physicians typically remain in contact with the specialist and patient, as
well as perform a primary role in coordinating the care of the patient.
back to top >>
Relationship with Other
Health Care Professions
Excepted
and adapted from the Statistics
Canada web site.
Health services in Canada are delivered by a wide range of care providers, including
physicians, nurses, physiotherapists, occupational therapists, dentists and many others.
Collectively, health occupations make up a considerable part of the Canadian workforce -
895,000 people at the beginning of 2003.
Half of Canada's 58,000 physicians in 2001 were family doctors. That same year, the number
of registered nurses tending the sick in hospitals or working in less traditional settings
(i.e., correctional facilties, substance abuse treatment centres, nursing homes, etc.)
totaled over 231,000 - close to 750 nurses per 100,000 people.
Although nursing and medicine are the two largest groups of regulated health care
providers, there are many other health care professionals integral to the system:
-
Some professionals such as pharmacists,
chiropractors, dentists, medical radiation technologists and medical laboratory
technologists are regulated under legislation. See "Regulated Health Professions in Canada."
Various other professions are not regulated,
including health care managers, home care support workers, and many practitioners of
complementary and alternative medicine.
-
In most provinces/territories, dentists work
independently of the public health care system, except where in-hospital dental surgery is
required. However, in some provinces/territories, dental services for children are covered by public
health care.
Nurses are generally employed in the
hospital sector. However, they also provide community health care including home care and
public health services.
-
An increasing number of Canadians are
seeking out less traditional practitioners of medicine. In 2000/2001, 8 percent of males aged 12
and over and 14% of women visited an alternative practitioner such as a massage therapist,
acupuncturist or homeopath; 11 percent of Canadians consulted a chiropractor.
The following links lead to information on
regulated health care professions in Canada:
CIHI:
Canada's Health Care Providers >>
For descriptions of various health care professions see:
Health
Personnel Trends in Canada, 1993 to 2002
National
Occupational Classification >>
back to top >>
Working in a Multicultural
Environment
Excerpted and adapted from
Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: A critical
distinction in defining physician training outcomes in multicultural education. Journal of
Health Care for the Poor and Underserved. 1998;9(2); 117-124
Practicing medicine in Canada requires that a
physician be sensitive to a patient's beliefs, values, culture and language. Providing
culturally competent care, in our increasingly diverse society, is essential. For example,
in Ontario there are more than 100 different cultural groups. In order for physicians to
be successful in a multicultural setting there are three important steps that must be
taken:
1. Physicians must familiarize themselves with
core cultural issues and sensitivities.
2. Physicians must learn interviewing approaches and methods that elicit information
about the patient’s social and cultural context.
3. Physicians must ensure that their patients fully understand and can retain the medical
information that is being given to them. This, in some cases, requires physicians to
familiarize themselves with the participation of a medical interpreter in the clinical
process.
General
Links and Information Resources >>
back to top >>
Medical
Records
Excerpted and adapted from CPSNS: A Physician's
Guide to Medical Records
Practices regarding medical records may vary from province to province. The following is
an example of an approach to record keeping depicted by the College of Physicians and
Surgeons of Nova Scotia.
The medical record is a confidential account
of a patient's medical assessment, investigation, and course of treatment. It is a source
of information and one component in quality patient care. The record:
• outlines the reason for the patient's visit to
the doctor
• documents the doctor's findings
• details the recommended treatment
• provides information to referring physicians
or other health care
providers
• is used for medical-legal purposes or to meet
requests by third
parties
• serves as a teaching and research tool
• provides a means for assessing the quality of
care by the
practitioner or other health care
providers
The physical record is the property of the physician. The patient, with some exceptions,
is entitled to access the information.
For further discussion of medical records,
visit Medical Council of Canada - CLEO Objectives.
|
