2013/14 WHITE REPORTDOCTORS OF BC WHITE REPORT. 2013/14. 5. Moved/Seconded Resolution AGM13/06/01-03...

Report of the CEO

BCMA Annual Business Session and General Assembly Draft Minutes

Annual Reports of the Council on Health Promotion

Annual Reports of Doctors of BC Committees and Councils

Annual Reports of Sections and Societies

Annual Reports of Affiliated Organizations

2013/14 WHITE REPORT

doctors of bc white report 2013/142

REPORT OF THE CEOAllan P. Seckel, QC ............................................................. 4

BCMA ANNUAL BUSINESS SESSION & GENERAL ASSEMBLY DRAFT MINUTES..................................................................................................... 5

1. ANNUAL REPORTS OF THE COUNCIL ON HEALTH PROMOTIONCOUNCIL ON HEALTH PROMOTIONLloyd Oppel, MD ................................................................ 13

ALLIED HEALTH PRACTICES COMMITTEELloyd Oppel, MD ................................................................. 13

ATHLETICS AND RECREATION COMMITTEERon Wilson, MD .................................................................. 14

EMERGENCY MEDICAL SERVICES COMMITTEERoy Purssell, MD ................................................................ 14

ENVIRONMENTAL HEALTH COMMITTEEBill Mackie, MD .................................................................... 15

GERIATRICS AND PALLIATIVE CARE COMMITTEERomayne Gallagher, MD................................................. 16

NUTRITION COMMITTEEKathleen Cadenhead, MD .............................................. 16

2. ANNUAL REPORTS OF DOCTORS OF BC COMMITTEES AND COUNCILS ALLOCATION SUPPORT COMMITTEEDavid Brabyn, MB, ChB .................................................. 18

ALTERNATIVE PAYMENTS COMMITTEEJohn Mawson, MD ............................................................. 18

ALTERNATIVE PAYMENT PHYSICIANS ISSUES COMMITTEERoderick Tukker, MD ........................................................ 18

ARCHIVES AND MUSEUM COMMITTEEB. Tamboline, MD ............................................................... 19

AUDIT AND FINANCE COMMITTEE Mark Corbett, MD .............................................................. 19

AUDIT AND INSPECTION COMMITTEEWendy Amirault, MD ..................................................... 20

BC MEDICAL JOURNALDavid R. Richardson, MD ............................................. 20

COLLABORATIVE UTILIZATION AND SYSTEMS IMPROVEMENT COMMITTEEChristopher Sherlock, MD ............................................. 21

CONSTITUTION AND BYLAWS COMMITTEEGordon Mackie, MD .......................................................... 21

CONTINUING PROFESSIONAL DEVELOPMENT NUCLEUS COMMITTEE Ian Schokking, MD ........................................................... 22

COUNCIL ON HEALTH ECONOMICS AND POLICYDonald Milliken, MD ......................................................... 23

COUNCIL ON PUBLIC AFFAIRS AND COMMUNICATIONSBarry Turchen, MD ........................................................... 24

DOCTORS OF BC–WORKSAFEBC LIAISON COMMITTEEJohn Sehmer, MD ............................................................. 25

DOCTORS OF BC–WORKSAFEBC PROJECTS AND INNOVATION COMMITTEEThomas Goetz, MD .......................................................... 25

GENERAL PRACTICE SERVICES COMMITTEEShelley Ross, MD .............................................................. 26

GUIDELINES AND PROTOCOLS ADVISORY COMMITTEEBakul Dalal, MD ................................................................. 27

INSURANCE COMMITTEEMichael A. McCann, MD ................................................. 28

JOINT BENEFITS COMMITTEEMichael A. McCann, MD .................................................. 31

JOINT STANDING COMMITTEE ON RURAL ISSUES Granger Avery, MBBS ..................................................... 32

LAB REFORM COMMITTEEChris Bellamy, MD ........................................................... 34

MEDICAL-LEGAL LIAISON COMMITTEEJack Webster, QC ............................................................. 35

MSC SEARCH AND EVALUATION COMMITTEEMarshall Dahl, MD ............................................................. 35

MEDICAL SERVICES COMMISSION OF BRITISH COLUMBIABrian Gregory, MD .......................................................... 36

NEGOTIATIONS COORDINATING GROUPDavid Attwell, MD ............................................................ 37

NEGOTIATIONS FORUMDouglas W.R. McTaggart, MD ..................................... 37

PATTERNS OF PRACTICE COMMITTEEKeith J. White, MD ........................................................... 38

PHYSICIAN HEALTH PROGRAM STEERING COMMITTEES.H. Lu, MD ......................................................................... 39

TABLE OF CONTENTS

doctors of bc white report 2013/14 3

PHYSICIAN INFORMATION TECHNOLOGY OFFICE STEERING COMMITTEEBruce Hobson, MD .......................................................... 40

PROVINCIAL SURGICAL ADVISORY COUNCILMichael Stanger, MD ........................................................ 41

REFERENCE COMMITTEEChair, Reference Committee ...................................... 42

RURAL ISSUES COMMITTEEAlan Ruddiman, MD ....................................................... 42

SHARED CARE COMMITTEEGordon Hoag, MD ........................................................... 43

SPECIALIST SERVICES COMMITTEESean Virani, MD ................................................................ 44

STATUTORY NEGOTIATING COMMITTEEDavid Attwell, MD ........................................................... 45

TARIFF COMMITTEEBrian Winsby, MD ............................................................ 45

WORKING COMMITTEE TO REVIEW OUTPATIENT DIAGNOSTIC REQUISITION FORMS (REQUISITION COMMITTEE) Catherine Clelland, MD ................................................. 46

WORKSAFEBC FEE-FOR-SERVICE AND SALARY NEGOTIATING COMMITTEE Robert Cheyne, MD..................................................... 47

WORKSAFEBC NEGOTIATIONS COORDINATING GROUPRobert Cheyne, MD ......................................................... 47

3. ANNUAL REPORTS OF SECTIONS AND SOCIETIESSECTION OF CLINICAL FACULTYDerryck H. Smith, MD ................................................... 48

SECTION OF COMMUNITY AND RURAL INTERNAL MEDICINEJennifer Grace, MD ........................................................ 49

SECTION OF DERMATOLOGYEvert Tuyp, MD ...................................................................49

SECTION OF EMERGENCY MEDICINEDavid Haughton, MD ..................................................... 50

SECTION OF ENDOCRINOLOGY AND METABOLISM SOCIETY OF ENDOCRINOLOGY AND METABOLISM OF BCMarshall Dahl, MD ............................................................. 52

SECTION OF GENERAL SURGERYAhmer Karimuddin, MD ................................................. 52

SECTION OF HOSPITALIST MEDICINEMichael Paletta, MD ......................................................... 53

SECTION OF INFECTIOUS DISEASES BRITISH COLUMBIA INFECTIOUS DISEASES SOCIETYDwight A.N. Ferris, MD .................................................. 53

SECTION OF OPHTHALMOLOGY BRITISH COLUMBIA SOCIETY OF EYE PHYSICIANS AND SURGEONSE. Cornock, MD ................................................................. 54

SECTION OF ORTHOPAEDICS BC ORTHOPAEDIC ASSOCIATIONMichael Moran, MD .......................................................... 55

SECTION OF PALLIATIVE MEDICINEW. Yeomans, MD .............................................................. 56

SECTION OF PEDIATRICS BC PEDIATRIC SOCIETYAven Poytner, MD ............................................................. 57

SECTION OF PSYCHIATRY BC PSYCHIATRIC ASSOCIATIONC. Gorman, MD .................................................................. 58

SECTION OF RADIOLOGY BC RADIOLOGICAL SOCIETYR. Peter Tonseth, MD ..................................................... 59

SECTION OF RHEUMATOLOGY BC SOCIETY OF RHEUMATOLOGISTSJason Kur, MD ................................................................... 59

SOCIETY OF GENERAL PRACTITIONERS OF BRITISH COLUMBIAL. Welsh, MD ...................................................................... 60

SOCIETY OF SPECIALIST PHYSICIANS AND SURGEONS OF BRITISH COLUMBIAAndrew Attwell, MD ......................................................... 61

4. ANNUAL REPORTS OF AFFILIATED ORGANIZATIONSBC HEALTH QUALITY NETWORKLyne Filiatrault, MD ......................................................... 63

CMA COUNCIL ON HEALTH POLICY AND ECONOMICSTrina Larsen Soles, MD ................................................. 63

MD UNDERGRADUATE ADMISSIONS POLICY ADVISORY COMMITTEEMary Johnston, MD ........................................................ 64

PROFESSIONAL ASSOCIATION OF RESIDENTS OF BRITISH COLUMBIAArun Jagdeo, MD ............................................................ 64


REPORT OF THE CEO

communities. Mr Paul Straszak (chief negotiator) and Dr Sam Bugis (executive director of Physician and External Affairs) have been involved in more dialogues than ever before with sections concerning negotiations, quality improvement, and other important topics. Doctors of BC has also adopted a more open process for appointments to committees, and the renewed President’s Tour has continued into its second year. These examples are only the beginning with much more to come, such as our new website, scheduled to be launched in 2014.

Another area of key focus involves supporting doctors with issues that affect health care in their facilities and communities. Divisions of Family Practice continue to do their excellent work and have taken on a new challenge this year. A GP for Me is bringing doctors together at the local level to help deal with physician shortages. We have made inroads and will continue to focus on better engagement between specialist doctors and health authorities.

Doctors of BC also continues to create good policy, such as the medical professionalism paper, Working Together: Exploring Professional Relationships, that was released in mid-2013. Through these efforts, we are able to continue to advocate our policies to decision-makers through-out the system.

As you now know, we have adopted a new name to better reflect our members and community. Doctors of BC speaks directly to you and the work you do. When patients think of “the doctor,” they think of you, and you should all be proud of your achievements in becoming better doctors and providing the care that makes your patients better. Doctors of BC is here to help ensure the system runs smoothly and to help you grow as a professional.

I look forward to working together in the coming year.

—Allan P. Seckel, QC

Allan P. Seckel, QC

Making a Meaningful Difference

In the coming year, you’ll be hearing the sentiment better together a lot, because we believe that we can best make a meaningful difference when we work together in partnerships: partnerships with patients; partnerships with government, health authorities, and facilities; and, critically, partner-ships with each other as colleagues. Our organization has been moving in this direction for a few years now—we’re just bringing it into sharper focus, thanks in part to our work on a new 3-year strategic plan.

A solid strategic plan is important, and in my second full year as CEO, I spent much of my time working alongside Board members to make clear our goals and to map out a path to successfully achieve them. At our core, we are here to advocate and provide support so that members like you can provide the highest quality care for your patients, and our plan focuses on two pathways to get us there. First, we will continue to provide the services you have come to expect, and second, we will expand in the areas of engagement and advocacy. By supporting highly engaged doctors, we will help you to become a profession of greater influence.

This year we have already seen a number of members making a meaningful difference in their


Moved/Seconded Resolution AGM13/06/01-03That Drs Derryck Smith, Alan Ruddiman, and Marshall Dahl are members of the Resolutions Committee. CARRIED

4. APPROVAL OF THE AGENDADr Avery drew members’ attention to the agenda and inquired if there were any additions or dele-tions. There being none:Moved/Seconded Resolution AGM13/06/01-04That the agenda is adopted as circulated. CARRIED

5. APPROVAL OF THE 2012 AGM MINUTESDr Avery drew members’ attention to the minutes published in the Annual Reports and inquired if there were any questions. Dr O’Brien-Bell asked if there was an update regarding the motion adopted at the 2012 meeting on noise pollution. Dr Bill Mackie reviewed the work of the Council on Health Promotion Environmental Committee on this topic. A proposal will go forward from the BCMA Caucus to the CMA General Council, recommending that Canada follow the example set by Europe to do noise mapping. There being no further questions, a motion to approve the minutes was introduced:Moved/Seconded Resolution AGM13/06/01-05 That the minutes of the 2012 Annual General Meeting are approved as circulated. CARRIED

6. PRESIDENT’S REPORTDr Ross thanked the members of the profession for providing her with the opportunity to serve as their president. She noted that her year has been filled with pleasure while being a productive and valuable year. Her key goal was to lead a united profession that could speak with one loud voice to have the power to effect change. She has traveled thousands of kilometres throughout the province, speaking with members of the profession on issues that concern them. She advised that there is still work to be done, and the Association will ensure that there is more outreach to the profession and will continue to chip away at

BCMA ANNUAL BUSINESS SESSION & GENERAL ASSEMBLY DRAFT MINUTES—Pan Pacific Hotel, June 1, 2013

BUSINESS SESSION CALL TO ORDERMr Seckel, chief executive officer, called the meeting to order at 9:50 a.m. and welcomed members to the Business Session of the 2013 Annual General Meeting. He invited members to stand and observe a moment of silence in remembrance of colleagues who passed away dur-ing the last year. Mr Seckel then introduced those seated at the head table: Dr Shelley Ross, presi-dent, Dr Nasir Jetha, past president, Dr William Cunningham, president-elect, Dr Charles Webb, chair, General Assembly. He expressed regrets on behalf of the honorary secretary treasurer, Dr Jim Busser, who could not be here today.

1. ELECTION OF CHAIRMr Seckel advised that he had a nomination for chair of the Business Session, Dr Granger Avery. He inquired if there were any additional nominations and there being none:Moved/Seconded Resolution AGM13/06/01-01That Dr Granger Avery is acclaimed as chair of the 2013 BCMA Annual Business Session. CARRIED

2. MEETING STANDING RULESDr Avery drew members’ attention to the meeting standing rules on the reverse side of the agenda, noting that they were the same as used at last year’s meeting. He inquired if there were any questions and, there being none, a motion to adopt the rules was introduced:Moved/Seconded Resolution AGM13/06/01-02That the meeting standing rules are adopted as circulated.

CARRIED

3. ELECTION OF RESOLUTIONS COMMITTEEDr Avery reviewed the role and function of the Resolutions Committee to assist members in prep-aration of any motions they wish to have brought forward. He called for nominations, and Dr John Turner nominated Drs Derryck Smith, Alan Ruddiman, and Marshall Dahl. There being no additional nominations:


provincial health officer to develop and distribute the policy, and the BCMA had no role in the matter. A motion to adopt the president’s report was introduced:Moved/Seconded Resolution AGM13/06/01-06That the report of the president is accepted.

CARRIED

7. CONSIDERATION OF THE REPORT OF THE STATUTORY NEGOTIATING COMMITTEE

Dr David Attwell drew members’ attention to the written report that appears at page 30 of the 2012/13 White Report. He noted that there were significant changes in both the committee and the BCMA Negotiations Department at the conclusion of the 2012 Physician Master Agreement (PMA) negotiations. Dr Brad Fritz stepped down as chair of the committee, and Mr Geoff Holter, chief negotiator, retired. He advised that the newly retained chief negotiator, Mr Paul Straszak, has worked tirelessly to bring himself up to speed to undertake the 2014 PMA reopener. Dr Attwell then reviewed the process of gathering proposals from the membership, the review at the Negotiations Coordinating Group, the development of a plan at the Negotiations Forum, and the review of proposals by the Executive Negotiations Oversight Committee, and finally by the Board of Directors. In conclusion, Dr Attwell noted that as the Liberal government has been re-elected, the time frames established in the PMA for the negotiations process will be adhered to. Dr Attwell invited questions, and there being none:Moved/Seconded Resolution AGM2013/06/01-07That the report of the Statutory Negotiating Committee is adopted.

CARRIED

8. CHIEF EXECUTIVE OFFICER’S REPORTMr Seckel drew members’ attention to his written report at page 4 of the 2012/13 White Report. He noted that the focus this year has been on the mission of the BCMA to improve the satisfaction of the physicians of British Columbia. He advised that the Association is developing a strategic plan to assist physicians in communities and in facilities.

BCMA ANNUAL BUSINESS SESSION & GENERAL ASSEMBLY DRAFT MINUTES

those issues that cause disunity. She noted that physicians throughout the province are work-ing too many hours without infrastructure and support, and the role of the BCMA is to support physicians as they go about taking care of their patients. The BCMA will continue to listen to the stories of physicians and will act upon them in working with all stakeholders to build mutually positive relationships to improve doctor shortages and limited resources. The BCMA will continue to focus on development of a positive relationship between the government and the BCMA by developing collaborative programs in communities throughout the province.

Dr Ross noted that she met with the Minister of Health, Dr MacDiarmid, and with the opposition critic, Mike Farnsworth. Dr Ross also met with media throughout the province, making it clear that patients benefit through the collaborative programs that provide the highest standard of care. Dr Ross also spoke of her outreach to other stakeholders in the province, including attending an anti-bullying conference, working with the Office of the Superintendent of Motor Vehicles and ICBC on road safety issues, and attending events held by the UBC Medical Undergraduate Students and the Professional Association of Residents of BC.

The chair inquired if there were any questions for Dr Ross. Dr Zafar Essak, referring to the decision rendered in the Wang litigation, inquired what procedural steps are being taken to amend the operations of the Board. It was noted that the issues that gave rise to the litigation occurred several years ago, and the Board continues to evolve in a constructive manner. Mr Seckel noted that there is a great deal of openness with respect to the Board business, and he highlighted the work of the Governance and Nominating Committee in posting on the members’ website an open call for positions. Another member inquired why the BCMA did not take a public stand on the issue of health authorities’ management of the influenza policy. Dr Ross noted that it was the responsibility of the


Moved/Seconded Resolution AGM2013/06/01-09That the report of the chair of the Board of Directors is adopted.

CARRIED

10. CONSIDERATION OF THE REPORT OF THE AUDIT AND FINANCE COMMITTEE

Dr Mark Corbett, chair of the committee, drew members’ attention to the written report of the committee at page 11 of the 2012/13 White Report, and to the financial statements commencing at page 24 of the Annual Report.

10.1 PRESENTATION OF THE FINANCIAL STATEMENT

Dr Corbett advised that the BCMA has adopted the new Canadian accounting standards for not-for-profit organizations, and members will note differences in the appearance of the statements. He reviewed the statements and invited questions. There being none, the following motion was introduced:Moved/Seconded Resolution AGM2013/06/01-10That the audited financial statements of 2012 are accepted.

CARRIED

10.2 APPOINTMENT OF THE AUDITORDr Corbett advised the membership that the Audit and Finance Committee is satisfied with the work of our current auditors and is pleased to recommend the same firm be retained for the upcoming year. There were no questions and the following motion was introduced:Moved/Seconded Resolution AGM2013/06/01-11That the firm KPMG LLP is appointed as auditors for the BCMA for the 2013 fiscal year.

CARRIED

10.3 MEMBERSHIP DUES 2014 RECOMMENDATION

Dr Corbett reviewed the history of member dues at the BCMA over the last decade and noted that again this year the Audit and Finance Committee is recommending that there be no dues increase. Dr Cathy Clelland suggested that a permissive motion be introduced to provide flexibility to

Mr Seckel reviewed the work of senior manage-ment and spoke of the excellent teamwork of this group of individuals. Mr Seckel also gave a special acknowledgment of the work of Dr Dan MacCarthy, former executive director of Professional Relations, Practice Support and Quality, now a consultant to the BCMA, and highlighted the growth of the General Practice Services Committee and the collaborative initiatives guided by this committee under Dr MacCarthy’s leadership. The assembly rose in a standing ovation.

In response to questions from Dr Zafar Essak, Mr Seckel clarified issues relating to his registration as a lobbyist for the BCMA in October of 2011, and the circumstances of the termination of his employment by the Government of BC. There being no further questions:Moved/Seconded Resolution AGM2013/06/01-08That the report of the chief executive officer is adopted.

CARRIED

9. CONSIDERATION OF THE REPORT OF THE CHAIR OF THE BOARD OF DIRECTORS

Dr Avery advised that Dr Williams was not able to be in attendance today and drew members’ attention to her written report on page 6 of the 2012/13 White Report. Dr Avery inquired if there were any questions. Dr John O’Brien-Bell inquired whether the BCMA had information on the costs to physicians as a result of amendments to the Limitations Act now requiring physicians to keep patient records for 16 years. Mr Seckel noted that the BCMA has not done an analysis, as it is difficult to generalize those costs, particularly considering the impact of moving to an electronic record.In response to a question relating to communications from the Board relating to referenda, Dr Ross noted that the last two referenda relating to proposed bylaw amendments contained balanced statements of both the pros and cons and also provided links to communications and websites of allied organizations and/or members. The following motion was introduced:


confirmed that he is not in a conflict of interest and would not receive any economic benefit should the motion be adopted.

Members speaking against the proposal noted that Dr Wang has initiated an appeal, and the matter remains before the courts. It was also noted that an offer of settlement was made to Dr Wang prior to the trial, and that offer was declined. The question was called:Moved/Seconded Resolution AGM2013/06/01-13That the BCMA designate sufficient funds, possibly in the order of $1M to $4M, for the specific purpose of settling the legal matter between Dr Caroline Wang and the BCMA. DEFEATED

17.2 NEW BUSINESS—COLLECTION OF SOCIETY DUES BY BCMA

Dr David Brabyn suggested that the collection of dues on behalf of the Society of General Practitioners and the Society of Specialist Physi-cians and Surgeons become a mandatory provision when members pay their BCMA annual dues. A motion to this effect was introduced:Moved/Seconded Resolution AGM2013/06/01-14That the BCMA include membership dues for the Society of General Practitioners of BC and the Society of Specialist Physicians and Surgeons of BC as a mandatory part of the BCMA annual dues. TABLED

During discussion of this proposal, some members inquired whether the BCMA, as a voluntary society, has the legal authority to enforce collection of dues on behalf of the societies. Dr Evert Tuyp, a dermatologist, noted that his section has withdrawn from the Society of Specialist Physicians and would not be in favor of the proposal. Dr Avery noted that there are some complicated aspects that require further investigation and advised the assembly that resolutions from this assembly are advisory to the BCMA Board of Directors. Dr Dahl suggested that, as the issue is complex and requires further work, the matter be tabled and introduced the following motion:


increase the dues up to 1%, as there are several issues that could impact the budget for 2014. She noted that the BCMA will be negotiating the PMA reopener, that there are some changes coming forward from the Canada Revenue Agency, and the honoraria rates are under review. All of these matters could impact the BCMA budget. Dr Corbett noted that the Audit and Finance Committee is developing a more accurate model for budget planning, but did take these and other issues into consideration prior to making its recommendation that the dues remain fixed at the current rate.

Dr Erik Paterson noted that in some other jurisdictions, such as Ontario, payment of CMA dues is optional, while the BCMA has conjoint membership with the CMA and that the annual $450 CMA dues do not represent value to members when the only tangible benefit is to have access to MD Management products and services. Dr Turchen suggested that the CMA dues represent an effective use of money not only on concrete economic benefits, but also on representational benefits. Several other members also spoke of the value of maintaining conjoint membership with the CMA. The recommendation of the Audit and Finance Committee was introduced:Moved/Seconded Resolution AGM2013/06/01-12That there be no BCMA membership dues increase for 2014.

CARRIED

17.1 NEW BUSINESS—SETTLEMENT OF LITIGATION

Dr Essak introduced a motion that the BCMA designate funds for the purpose of settling litigation between Dr Wang and the BCMA. Speaking to the motion, Dr Essak, noting that the Association had a surplus during the last fiscal year, suggested that some of that surplus could be used to resolve the litigation by offering a payment to Dr Wang. He stated that the legal system is a blunt object that does not provide a process to do “the right thing” in light of the finding. In response to a question, Dr Essak


distributed. Following the count:Moved/Seconded Resolution AGM2013/06/01-18That Ms Michelle Chiu, Drs Mark Corbett, and Michael Curry are the three members-at-large of the Audit and Finance Committee.

CARRIED

Dr Saunders, on behalf of the assembly, thanked all of the candidates for being present to speak today, and Dr Avery called for a motion to destroy the ballots:Moved/Seconded Resolution AGM2013/06/01-19That the ballots for the election of the members-at-large of the Audit and Finance Committee be destroyed.

CARRIED

12. INTRODUCTION OF NEWLY ELECTED OFFICERS

Dr Avery introduced the newly elected officers who will take office this evening: Dr Lloyd Op-pel, honorary secretary treasurer, Dr Trina Larsen Soles, chair, General Assembly, Dr William Cavers, president-elect, Dr Shelley Ross, immediate past president, and Dr William Cunningham, president.

18.1 RECESS FOR LUNCHDr Avery called for a motion to recess the meeting to 1:30 p.m.Moved/Seconded Resolution AGM2013/06/01-20That the meeting is recessed until 1:30 p.m.

CARRIED

18.2 RECONVENEDr Avery called the meeting to order at 1:50 p.m. and advised that he has a motion to take from the table the motion relating to the collection of mandatory dues for the societies.

17.2 NEW BUSINESS—COLLECTION OF SOCIETY DUES BY THE BCMA CONTINUED

Dr Avery introduced a motion to take from the table the motion from the morning relating to the collection by the BCMA of dues for the SSPS and the SGP. He noted that the subsequent motion on the topic of dues had been referred to the Board of Directors and suggested that it may be

Moved/Seconded Resolution AGM2013/06/01-15That the motion relating to the mandatory collection by the BCMA of dues for the Society of General Practitioners and the Society of Specialist Physicians is tabled.

CARRIED

17.3 NEW BUSINESS—DUES FOR THE SGP AND THE SSPS TO BE INCLUDED IN THE BASE BCMA DUES

Dr Jean Noel Mahy suggested that members pay enough in dues and introduced a motion that the dues for each of the societies be included in the base of the BCMA dues.Moved/Seconded Resolution AGM2013/06/01-16That the SSPS and the SGP membership dues be included in the base BCMA membership dues.

REFERRED TO BCMA BOARD OF DIRECTORS

Dr David Geen suggested that this motion be referred to the BCMA Board of Directors.Moved/Seconded Resolution AGM2013/06/01-17That the motion calling for the inclusion of the SSPS and SGP membership dues in the base BCMA membership dues is referred to the BCMA Board of Directors.

CARRIED

11. CONSIDERATION OF THE REPORT OF THE GOVERNANCE AND NOMINATING COMMITTEE

The chair invited Dr Robin Saunders, chair of the Governance and Nominating Committee, to speak.

11.1 ELECTION OF MEMBERS-AT-LARGE OF THE AUDIT AND FINANCE COMMITTEE

Dr Saunders advised that the Governance and Nominating Committee is presenting five candidates for the three positions of members-at-large of the Audit and Finance Committee. He reviewed the process for issuing the call for expressions of interest and the manner in which the committee reviews the candidates. Dr Avery inquired if there were any nominations from the floor, and there were none. Dr Saunders then invited each of the five candidates to speak to their nomination, after which ballots were


persons have served in excess of 6 years on any given committee and has encouraged each committee to do succession planning.

Dr Saunders also drew members’ attention to the redesigned BCMA website, pointing out that the name of each committee, together with its mandate, is listed. The BCMA website also advises the membership of any vacant positions. The work plan for the upcoming year includes reviewing the mandate of the G & N Committee with respect to governance issues.

In response to a question regarding the inclusion of students and residents on committees, it was noted that the Council on Health Economics and Policy has one of each, and the Rural Issues Committee includes a resident member. Also, students and residents are encouraged to attend the meetings of the Council on Health Promotion and its subcommittees. Dr David Attwell suggested that it is important to continue to engage those members who have corporate memory, and Dr Saunders assured the assembly that this is kept in mind as part of the consideration of succession planning. A motion to accept the report was introduced: Moved/Seconded Resolution AGM2013/06/01-24That the report of the Governance and Nominating Committee is accepted.

CARRIED

13. CONSIDERATION OF THE REPORT OF THE TARIFF COMMITTEE

Dr Brian Winsby, chair, drew members’ attention to the report at page 30 of the 2012/13 White Report and invited questions. There being none, the following motion was introduced:Moved/Seconded Resolution AGM2013/06/01-25That the report of the Tariff Committee is accepted.

CARRIED


appropriate to refer the first motion also, but in order to give it consideration, the motion has to be raised from the table.Moved/Seconded Resolution AGM2013/06/01-21That the motion relating to the mandatory collection by the BCMA of dues for the Society of General Practitioners and the Society of Specialist Physicians is taken from the table.

CARRIED

The motion is now again before the assembly:Moved/Seconded Resolution AGM2013/06/01-22That the BCMA include membership dues for the Society of General Practitioners of BC and the Society of Specialist Physicians and Surgeons of BC as a mandatory part of BCMA dues. REFERRED TO BOARD OF DIRECTORS

A motion to refer the motion to the Board of Directors was introduced:Moved/Seconded Resolution AGM2013/06/01-23That the motion requesting that the BCMA include membership dues for the Society of General Practitioners of BC and the Society of Specialist Physicians and Surgeons of BC as a mandatory part of BCMA dues is referred to the Board of Directors.

CARRIED

11. CONSIDERATION OF THE REPORT OF THE GOVERNANCE AND NOMINATING COMMITTEE CONTINUED

Dr Saunders came to the podium and gave a presentation on the work of this committee dur-ing the last year. He noted that during the course of the year the committee has received expres-sions of interest from 350 individuals interested in serving on BCMA committees. He advised that the majority of BCMA committees have been reviewed for relevance and to determine that the mandates comply with the “key result areas” established in the strategic plan. He advised that a few committees have been sunsetted and, where the terms of reference permitted, some have been amalgamated. He advised that the G & N Committee has reviewed the membership of BCMA committees to ascertain how many


infrequently. It was suggested that this item of business could be referred to the BCMA Board with a request that it be reviewed at the Tariff Committee and the motion came forward:Moved/Seconded Resolution AGM2013/06/01-28That the BCMA examine the increasing practice of the legal profession and ICBC limiting medicolegal fees to those listed in the BCMA Guide to Fees. REFERRED TO BCMA BOARD

Moved/Seconded Resolution AGM2013/06/01-29That the motion relating to medicolegal fees is referred to the BCMA Board of Directors with a request for review by the BCMA Tariff Committee.

CARRIED

17.5 NEW BUSINESS—BCMA MD-MLA PROGRAMDr Barry Turchen, chair of the Council on Public Affairs and Communications, spoke of the revitalization of the MD-MLA program and drew members’ attention to a package of materials available for those who were seeking an opportunity to be involved.

17.6 NEW BUSINESS—END-OF-LIFE ISSUESDr Derryck Smith asked if the BCMA delegates to the CMA General Council will have a position relating to end-of-life issues. He noted that there has been a decision rendered in a BC case and there is a case before the courts in Quebec relating to physician-assisted suicide/death. Dr Robin Saunders, chair of the CMA Committee on Ethics, advised that the CMA reviewed its current policy, and there is no current policy on this particular issue. He advised that there is also a case before the courts in Ontario. The CMA Board will make a decision as to when to move the debate forward; however, at the present time, it does not appear that this will be undertaken this year. It may be done after the courts have issued decisions. Dr David Attwell, chair of the BCMA Council on Health Economics and Policy, advised that CHEP has reviewed its policy paper on end of life. That paper deals with all stages of life and death, and CHEP did not see any need to revise the paper at this stage.

15. CONSIDERATION OF THE REPORT OF THE SOCIETY OF SPECIALIST PHYSICIANS AND SURGEONS OF BC

Dr Andrew Attwell, president of the SSPS, drew members’ attention to the written report that appears at page 45 of the 2012/2013 White Report and inquired if there were any questions. There being none, the following motion was introduced:Moved/Seconded Resolution AGM2013/06/01-26That the report of the Society of Specialist Physicians and Surgeons of BC is accepted.

CARRIED

16. CONSIDERATION OF THE REPORT OF THE SOCIETY OF GENERAL PRACTITIONERS

Dr Tracy Monk, president of the SGP, drew members’ attention to her written report that appears at page 44 of the 2012/2013 White Report. Dr Monk thanked members for the privilege of serving on the BCMA Board of Directors and noted that the SGP looks forward to working with the BCMA on the resolutions adopted at this meeting relating to dues collection and the important work undertaken by the societies. She spoke of her appreciation of the increased collaboration between the societies. There were no questions of Dr Monk, and the following motion was introduced:Moved/Seconded Resolution AGM2013/06/01-27That the report of the Society of General Practitioners of BC is accepted.

CARRIED

17.4 NEW BUSINESS—MEDICOLEGAL FEESDr John O’Brien-Bell introduced a motion calling on the BCMA to examine the practice of the legal profession and of ICBC to limit medicolegal fees to those listed in the BCMA Guide to Fees. Dr Erik Paterson noted that the preamble states that the fees are “recommended” but that physicians are free to choose what fees they wish to charge. Several members who do this work frequently advised that they establish an hourly fee for work in this area and that members of the legal profession are amenable to this procedure. It was suggested that there may be a lack of understanding on the part of physicians who do this work only


5. NEW BUSINESSDr Webb inquired if there was any new business. A member rose to propose a motion to “delink” the BCMA dues from the CMA dues. As there was no seconder, the motion fell away.

6. ADJOURNMENTThere being no further business, the General Assembly was adjourned at 2:35 p.m.


19. ADJOURNMENTThere being no further business, Dr Avery thanked members for their attendance, for their attention, and for the vigorous debate. The meeting was adjourned at 2:30 p.m.

GENERAL ASSEMBLYDr Charles Webb, chair of the General Assembly, called the meeting to order at 2:31 p.m. Dr Webb thanked the members for their attendance and advised that the purpose of the General Assembly is to review the reports of the BCMA committees, councils, sections, and affiliated organizations.

1. REPORTS OF THE COUNCIL ON HEALTH PROMOTION

Dr Webb drew members’ attention to the reports of the Council on Health Promotion and the subcommittees that appear on pages 6 through 9 of the 2012/2013 White Report. He thanked the volunteer members who serve on these committees and inquired if there were any questions arising. There were no questions.

2. REPORTS OF BCMA COMMITTEES AND COUNCILS

Dr Webb drew members’ attention to the reports of the BCMA committees and councils at pages 10 through 32 of the 2012/2013 White Report and invited questions. No questions came forward.

3. REPORTS OF THE SECTIONS AND SOCIETIESDr Webb drew members’ attention to the reports of the sections and societies at pages 33 through 45 of the 2012/2013 White Report and invited questions. No questions came forward.

4. REPORTS OF AFFILIATED ORGANIZATIONSDr Webb drew members’ attention to the reports of the affiliated organizations at pages 46 through 48 of the 2012/2013 White Report and inquired if there were any questions. No questions came forward.

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ANNUAL REPORTS OF THE COUNCIL ON HEALTH PROMOTION

COUNCIL ON HEALTH PROMOTIONDRS L. OPPEL, CHAIR; K. CADENHEAD, NUTRITION; R. GALLAGHER, GERIATRICS AND PALLIATIVE CARE; W. MACKIE, ENVIRONMENTAL HEALTH; R. PURSSELL, EMERGENCY MEDICAL SERVICES; R. WILSON, ATHLETICS AND RECREATION; E. YOUNG, OFFICE OF THE PROVINCIAL HEALTH OFFICER. MEMBERS: DRS W. ARRUDA, S. LU, D.F. SMITH, C. WILLIAMS; MR R. MASON.

The Council on Health Promotion (COHP) has a mandate to be an effective advocate on societal and policy issues affecting public health and the quality of health care in BC. COHP also engages in community health initiatives and illness prevention.

Over the last year, COHP has been working on a policy paper exploring issues of mental health in transition-age youth (15 to 24 years old). This period of transition, as youth mature into adulthood, is critical in terms of mental health development. The paper will provide an opportunity for physicians to help raise awareness about positive mental health and discuss the role physicians can play, alongside other health professionals, in assisting youth during this important life stage.

To gain insight into the experiences of other organizations in promoting mental health awareness to youth in BC, a forum was held with more than 40 key stakeholders. In addition, COHP sought input from youth by meeting with the youth in residence from the FORCE Society for Kids’ Mental Health.

Having received Board approval, the paper resulting from this forum will be released in fall 2014, along with a new web page, to be hosted on the Doctors of BC website, containing mental health tools and resources for youth, families, and physicians. The communications strategy to promote this paper includes news releases, the use of social media, and youth-oriented posters for doctors’ offices. This paper will help profile the work being done by the Child and Youth Mental Health and Substance Use Collaborative, a joint initiative of the Shared Care Committee, the

Interior Health Authority, and the Ministry for Children and Family Development.

COHP also oversees six subcommittees that provide expertise on a number of targeted areas. This year COHP brought forward several resolutions on behalf of the subcommittees; these were approved by the Board of Directors. The resolutions dealt with improving food literacy education, supporting community-based programs offering naloxone, and addressing drug-impaired driving in BC. COHP also promotes Walk with your Doc and encourages physicians to discuss the importance of physical activity with their patients.

Over the next year, subject to approval of the Board of Directors, COHP plans to develop a policy project focused on the health promotion of informal caregivers.

—Lloyd Oppel, MDChair

ALLIED HEALTH PRACTICES COMMITTEE DRS L. OPPEL, CHAIR; L. BURKHOLDER, I. CONNELL, R. PRESHAW, M. SUTTER, G. TEVAARWERK, M. SUTTER, H.C. WONG. CORRESPONDING MEMBER: DR K. EMMOTT. STAFF: MS L. GRIME, MS K. SAUNDERS, MS H. THI, MS D. VICCARS.

Under the guidance and approval of the Council on Health Promotion (COHP), the Allied Health Practices Committee reviews developments and trends in the public’s use of alternative medical therapies and the ways in which the professional activities of allied health practition-ers interact with those of the medical profession. In addition, the committee advocates for the use of evidence-based medicine and promotes health and wellness and disease prevention.

The committee continues to contribute to the work of the COHP and the Council on Health Economics and Policy (CHEP) in formulating the Doctors of BC and national policies on complementary and alternative medicine and on scope of practice issues. In particular, the committee worked with the CMA Committee of



Ethics on a project outlining ethical issues and professional and scientific standards expected of the medical community when interacting with the world of alternative medicine.

Scope of practice issues continue to present opportunities for comment and recommendations from the medical profession. In this regard, the committee remains active in identifying concerns relating to patient-centred quality care, cost- effectiveness, conflict of interest, and unequal access to health care resources depending on ability to pay.

This year the committee published an article in the BC Medical Journal on the origins of the myth that only 10% of modern medicine is evidence- based.

As always, media inquiries around the issue of scientific standards, scope of practice, and alternative medicine present frequent opportunities for the committee to provide comment and promote good health based on valid research.

—Lloyd Oppel, MDChair

ATHLETICS AND RECREATION COMMITTEEDRS R. WILSON, CHAIR; M. CROSSMAN, A. DAWSON, W. MACKIE, J. MASON, K.P. SOLMUNDSON, J.E. TAUNTON; MS A. CRYSTAL (SPORTS MEDICINE COUNCIL OF BC). STAFF: MS M. ADAIR, MS L. GRIME, MS K. SAUNDERS, MS S. SHORE, MR J. SUYTE , MS H. THI, MS E. TIMMERMAN, MS D. VICCARS.

The major focus of the Athletics and Recreation Committee continues to be concern over the physical activity levels of British Columbians. As more data become available, it is evident that we are falling short of the physical activity guidelines set by Health Canada. This year marks the fifth anniversary of Walk with your Doc (WWYD), and events will be held across BC 3–11 May. Each year, more physicians are participating in this program, with Divisions of Family Practice across the province hosting events in their communities.

This year, as a lead-up to the WWYD event, the committee is introducing Prescription for Health, a handout for patients who are not meeting the guidelines of 150 minutes of activity per week. On the reverse of the prescription is an invitation to the local event, which has received good media attention this year.

Last fall the committee launched Be Active Every Day, an initiative to help kids become more active and make healthier choices. In partnership with their local elementary schools, doctors across BC coordinated a month-long challenge to kids: be active for 60 minutes every day in October. Students also learned about the 5-2-1-0 healthy living concept: eating 5 fruits and vegetables, limiting screen time to 2 hours, being physically active for 1 hour, and drinking 0 sugar-sweetened beverages daily. More than 4000 students from 34 schools across the province participated in Be Active Every Day.

Doctors can and do play a role in promoting the importance of physical activity with their patients. This year the committee hopes to engage more members participating in the WWYD and Be Active Every Day events.

—Ron Wilson, MDChair

EMERGENCY MEDICAL SERVICES COMMITTEEDRS R. PURSSELL, CHAIR; J. BRUBACHER, G. DODD, D.F. SMITH, K. WANGER, K. WHITE; MR A. LAMB, JUSTICE INSTITUTE OF BC; MR S. MACLEOD, OFFICE OF THE SUPERINTENDENT OF MOTOR VEHICLES. STAFF: MS M. ADAIR, MS L. GRIME, MS K. SAUNDERS, MS S. SHORE, MS H. THI, MS D. VICCARS.

The Emergency Medical Services (EMS) Committee’s terms of reference encompass pre-hospital and emergency care, road safety, disaster planning, and trauma care. In the past year, the committee met three times and was very active.


SECTION 1

Medical disaster planning is an important focus of the committee. The following motion, proposed by the committee, was approved at the August 2013 General Council meeting of the Canadian Medical Association: • The Canadian Medical Association calls for

biennial testing of disaster management planning in hospitals.To address community health programs that

work with vulnerable populations, the following motions were brought forward by the committee and approved by the Doctors of BC Board of Directors: • Doctors of BC supports community-based

programs that offer naloxone and other opioid overdose prevention services.

• Doctors of BC also encourages education of health workers and opioid users about the use of naloxone in preventing overdose fatalities. Road safety continues to be a key focus of the committee. In 2013 the committee proposed the following

motions, which were approved by the Board: • Doctors of BC encourages the governments of

British Columbia and Canada to work with stakeholders to improve legislation and policies to address the problem of drug-impaired driving.

• Doctors of BC encourages the governments of British Columbia and Canada to promote and provide funding for the development of improved screening tools to detect drug- impaired drivers.The EMS Committee has long advocated for the

creation of a BC road safety research and evaluation centre. In October 2013 a letter was sent by Doctors of BC and the Justice Institute of BC to the Honourable Suzanne Anton, Minister of Justice and Attorney General, advocating for the creation of this centre. Committee members also played a significant role in developing the document BC Road Safety 2015 and Beyond. Last fall, in an article published in the October issue of the BC Medical Journal, the committee also explored issues concerning senior drivers.

—Roy Purssell, MDChair

ENVIRONMENTAL HEALTH COMMITTEE DRS B. MACKIE, CHAIR; E. BASTIAN, R. COPES, B. DALAL, MR G. EVANS, DRS S. GERMAIN, B. HORNE, MS P. KEEN, DR W.G. MEEKISON, MR R. MORASIEWICZ, DRS J. TOMBLIN, C. VAN NETTEN, E. YOUNG, DEPUTY PROVINCIAL HEALTH OFFICER. STUDENT MEMBERS: M. BENUSIC, O. MACKIE. STAFF: MS M. ADAIR, MS L. GRIME, MS K. SAUNDERS, MS S. SHORE, MS H. THI, MS D. VICCARS.

The Environmental Health Committee this year focused on the increase of antimicrobial resistance and its spread through the environment. Each year there seems to be new bacteria-resistant “superbugs.” Research shows that feeding antibiotics to animals destined for the slaughter-house provides a breeding ground for resistant organisms. Bacteria in the animals’ intestinal tracts are transmitted to workers in the abattoirs and into manure ponds and farmyards that overflow into ditches, streams, rivers, and oceans. This affects the environment and can spread superbugs that cause serious infections that will be impossible to treat. The committee has been advocating for a ban on the use of antibiotics as growth promoters in food animals and will continue these efforts in the coming years. The medical profession requires antibiotics that are effective against infection.

Last year Doctors of BC members asked the committee to look into noise pollution. Dr Hugh Davies, an expert in this field, was invited to speak to the committee. He explained that, although many loud noises can be annoying, much of the noise that bothers us is not damaging. Other loud noises trigger our adrenergic responses and can have adverse health effects. These types of noises can be mapped, as has been done in Europe, and limits can be introduced. The committee successfully prompted the Canadian Medical Association (CMA) to accept this as a motion at General Council last year.

The committee had regular discussions about the physical, mental, and social costs to residents in industrial areas where energy development is taking place. The committee also discussed


fracking and its safeguards and shared its concerns with health promotion experts at the Ministry of Health. A column on fracking, written for the BC Medical Journal by student member Michael Benusic, was published in the June 2013 issue and cited in the Vancouver Sun by health editor Pamela Fayerman.

Other industrial projects that may affect health and the environment captured the committee’s attention. These include the Ajax mine proposal and coal transfer project at the Fraser Surrey Docks. In response to the health concerns emerging from these project proposals, the committee sent a letter to the Honourable Mary Polak, Minister of Environment, offering assistance in assessing the health impact of proposed environmental projects.

The committee also received presentations on nature deprivation syndrome, and we look forward to discussing this issue at future meetings.

Lastly, the committee is proposing four resolutions to be presented at the CMA General Council this August. These resolutions relate to antibiotics in food animals, protection of arable land, environmental health impact assessments, and secondary environmental effects of genetically modified organisms.

—Bill Mackie, MDChair

GERIATRICS AND PALLIATIVE CARE COMMITTEEDRS R. GALLAGHER, CHAIR; M. CHUNG, D. MCGREGOR, S. MINHAS, C. SHOONER, J. SLATER. STUDENT MEMBER: MS T. BHATE. STAFF: MS L. GRIME, MS K. SAUNDERS, MS H. THI, MS D. VICCARS.

This year the Geriatrics and Palliative Care Committee has been active in advocating for and contributing to the better care of seniors and those with serious illness. The committee developed a motion passed by both Doctors of BC and the Canadian Medical Association (CMA), supporting the integration of palliative care into chronic disease management. This motion helped

to inform the CMA’s current policy on end-of-life care in Canada. The committee will submit several motions to this year’s CMA General Council, aimed at improving care for seniors and patients at the end of life.

Dementia is a major concern for British Columbians. In a 2004 Council on Health Promotion policy paper, Building Bridges: A Call for a Coordinated Dementia Strategy in British Columbia, dementia was referred to as the “sleeping giant” that our health care system has not been prepared for. Over the past year, the committee has focused its columns in the BC Medical Journal around care for the elderly and dementia.

This year the committee will review the recommendations from the 2004 policy paper and provide an update of the current landscape of dementia care in BC.

—Romayne Gallagher, MDChair

NUTRITION COMMITTEEDR K. CADENHEAD, CHAIR; MS J. DOUGLAS, NUTRITIONIST, VCH; DR M HINCHCLIFFE, MS. B. LESLIE, HEALTHLINKBC; DRS P. MARTIQUET, M. SWEENY, MS M. YANDEL, PUBLIC HEALTH NUTRITION, MINISTRY OF HEALTH; MS H. YEUNG, NUTRITIONIST. STAFF: MS L. GRIME, MS K. SAUNDERS, MS H. THI, MS D. VICCARS.

The Nutrition Committee’s objective is to raise awareness of local and national nutrition problems and advocate for disease prevention and improved nutrition and health for the population of BC. In addition, the committee strives to develop expertise within the medical profession and ensure physician leadership in healthy eating and nutritional health by providing evidence-based information and liaising with the Ministry of Health and various community groups.

It is essential that physicians maintain a leader-ship role and speak out on issues regarding nutrition. The committee had numerous opportunities for media coverage over the past year with multiple demands for medical opinions regarding diets. In particular, the committee’s



article on gluten in the April 2013 issue of the BC Medical Journal was referenced by Maclean’s magazine last fall. Other articles the committee has developed over the past year have focused on nutrition counseling and healthy eating concepts such as the healthy eating plate, small plate movement, and the 5-2-1-0 healthy living strategy.

The committee was represented in meetings with the Ministry of Health, Child Health BC, and the Dietitians of Canada regarding such areas of interest as national sodium reduction strategic planning, hypertension population initiatives, trans fat reduction, energy drinks, childhood obesity, eating disorders, and natural health food product regulatory issues. Over the past year, the committee has supported mandatory menu labeling in restaurants.

Contributing to the dialogue on education change in BC and with an aim to better prepare our youth for a healthy future, the committee put forward a resolution encouraging the Ministry of Education to implement mandatory food literacy education for all BC secondary school students. This resolution was approved by the Doctors of BC Board of Directors last fall, and the committee is currently working on a motion regarding food security to bring forward to this year’s Canadian Medical Association General Council meeting.

The Nutrition Committee welcomes any suggestions for future advocacy programs to improve the nutritional health of the population of British Columbia.

—Kathleen Cadenhead, MDChair

SECTION 1

“It is essential that physicians

maintain a leadership role

and speak out on issues

regarding nutrition.”

Doctors of BC Board officers & delegates 2013/14

PRESIDENT William Cunningham [email protected]

PAST PRESIDENT Shelley Ross [email protected]

PRESIDENT-ELECT William Cavers [email protected]

CHAIR OF THE GENERAL ASSEMBLY Trina Larsen Soles [email protected]

HONORARY SECRETARY TREASURER Lloyd Oppel [email protected]

CHAIR OF THE BOARD Carole Williams [email protected]

DISTRICT #1Robin Saunders [email protected]

Michael Putland [email protected]

David Harris [email protected]

DISTRICT #2 Robin Routledge [email protected]

Michael Morris [email protected]

DISTRICT #3 Joanne Young [email protected]

Bakul Dalal [email protected]

Alex She [email protected]

Eric Cadesky [email protected]

Shao Hua Lu [email protected]

David Wilton [email protected]

Mark Godley [email protected]

DISTRICT #4 Kevin McLeod [email protected]

Nigel Walton [email protected]

DISTRICT #5 Bruce Horne [email protected]

DISTRICT #6 Kimberly Shaw [email protected]

DISTRICT #7 Ralph Jones [email protected]

Peter Barnsdale [email protected]

DISTRICT #8 Gordon Mackie [email protected]

DISTRICT #9Jannie du Plessis [email protected]

DISTRICT #10Shirley Sze [email protected]

DISTRICT #11Dan Horvat [email protected]

DISTRICT #12 Charl Badenhorst [email protected]

DISTRICT #13 Mark Corbett [email protected]

DISTRICT #15 W. Fraser Bowden [email protected]

DISTRICT #16 Luay Dindo [email protected]

DISTRICT #16 Sanjay Khandelwal [email protected]


ANNUAL REPORTS OF DOCTORS OF BC COMMITTEES AND COUNCILS

recruitment and retention issues within the limitations of the funds available. In doing so, some equity has also been achieved among broad groups, particularly medical specialties and medical subspecialties. As in the past, in making adjustments, the APC has been careful not to introduce disparities.

The parties remained apart on a number of issues. As a result, the end date of the APC was extended, initially to 31 December 2013, and again to 31 March 2014. Options to address the small number of outstanding issues are being explored.

Once a consensus agreement is achieved, the APC will cease to exist, and I expect a new forum will be established, bringing together Doctors of BC, health authorities, and government representatives, to discuss issues related to alternative payment physicians.

—John Mawson, MDCo-chair

ALTERNATIVE PAYMENT PHYSICIANS ISSUES COMMITTEEDRS R. TUKKER, CHAIR; C. BOOTH, J. DOWN, S. FEDDER, C. FITZGERALD, R. MARKHAM, NCG; J. MAWSON, D. MCGREGOR. GUESTS: D. ISRAEL (NCG), D. WILTON (SNC). STAFF: MS T. KEEFE, MR T. MACPHERSON.

Since the 2013 Doctors of BC AGM, the Alternative Payment Physicians Issues Committee (APPIC) has met on three occasions and held two teleconferences.

The first area of APPIC focus over the past year was with respect to the allocation process for the Alternative Payments Committee (APC) funds awarded in the 2012 Physician Master Agreement. Given the short time period that the APC was dealing with, APPIC members were asked for their input and help in evaluating and ranking the submitted proposals. This input was then given to APC for their consideration in the allocation process.

In this past year APPIC reviewed the committee’s terms of reference with the goal of making them reflect the structure and process

ALLOCATION SUPPORT COMMITTEEDRS D. BRABYN, CHAIR; C. BELLAMY, S. DJURICK-OVIC, R. JONES, Y. BAWA. STAFF: MR P. MELIA, MR J. AIKMAN, MR R. TIAGI, MS L. GRIME.

The Allocation Support Committee was established by the Doctors of BC Board in 2009 to provide ongoing support to the new allocation process. The committee’s terms of reference include a responsibility to determine an appropriate full-time equivalent (FTE) model required for Stage 1, as well as to provide data for Stage 2 of the allocation process to the Sectional Allocation Forum.

In the last allocation, the FTE model was used for the distribution of negotiated funds. Since that time, each section has been asked for feedback regarding the FTE methodology. The committee received and considered constructive input. Some minor changes have been proposed to better utilize the data sets available to the committee and have been forwarded to the Doctors of BC Board for approval.

The committee has meanwhile been busy collecting and reviewing data and methodologies to meet the committee’s obligations under Stage 2 of the allocation process.

Once again I would like to thank the committee members for their diligence in developing this model, and Doctors of BC staff for helping guide the committee and providing all the necessary data and calculations.

—David Brabyn, MB, ChBChair

ALTERNATIVE PAYMENTS COMMITTEEDRS J. MAWSON, CO-CHAIR; J. CHRONES, D. WILLIAMS. ALTERNATE: DR H. OSIOVICH. STAFF: MR T. MACPHERSON.

The Alternative Payments Committee (APC) continued to meet through 2013 to make adjustments to the salary and service contract ranges.

Consensus was achieved on a number of range adjustments to move partway to addressing


that will help APPIC better serve the needs of alternative payment physicians.

Finally, recognizing that many alternative payment physicians may not even be aware of our committee, we are working on some strategies and actions to increase the profile of APPIC and its role in representing the interests of alternative payment physicians.

APPIC would like to acknowledge and thank the Doctors of BC staff for their hard work and efforts over the past year.

—Roderick Tukker, MDChair

ARCHIVES AND MUSEUM COMMITTEEDRS B. TAMBOLINE, CHAIR; DR D. FARQUHAR, MR J. GILMORE, DRS E. KANE, D. WOODHOUSE. STAFF: MS W. HUNT, MS. H. KINGSLEY, MR J. SANFORD (CONTRACT).

In 2013/14, the Archives and Museum Committee continued to provide support and oversight over the operations of the Doctors of BC archives and the Doctors of BC Medical Museum.

The Doctors of BC archives continued its administrative role in preserving records of corporate and historical significance, and making these accessible to Doctors of BC officers, staff, and members. The focus of the archives over the last year has been the ongoing archival processing of minutes, reports, agreements, and other important administrative and operational records of the Board and Executive, together with accessioning, arranging, and describing records of the Audit and Finance Committee, the Constitution and Bylaws Committee, the annual general meetings, Council on Public Affairs and Communications, the BCMJ Editorial Board, the WorkSafeBC Liaison Committee, the Committee on Diagnostic Services, and the Northern and Isolation Committee.

The reconstruction of the fifth floor of the Doctors of BC building resulted in the transfer of an additional 100 boxes (150 linear feet), plus those records controlled by retention schedules. Funding permitted the archives to offer a short-

term contract to a professional archivist to assist in these activities. Through the year, the archives serviced more than 300 reference requests involving records in its holdings. The com-mittee continues to be most appreciative of the volunteer efforts at the archives of Mr Jim Gilmore in identifying and processing photographs created by the Doctors of BC over the last 30 years.

The Doctors of BC Medical Museum continued the development of its online system, consisting of digitized representations (images) of artifacts in the museum collection. This much acclaimed resource is available on the Internet at www.doctorsofbcmedicalmuseum.org.

—B. Tamboline, MD Chair

AUDIT AND FINANCE COMMITTEEDRS M. CORBETT, CHAIR; C. BADENHORST, W. CAVERS, M. CURRY, L. OPPEL, MS M. CHUI, MR M. HARTWICK. STAFF: MS C. AHPIN, MS A. KEEBLE, MR A. SECKEL, MS S. VERGIS.

Doctors of BC continues to maintain a good financial position. The committee met four times during the year and fulfilled its duties and responsibilities by:• Reviewing the monthly financial reports and

monitoring the expenditures of various committees and projects to ensure they were within budget.

• Making recommendations to the Board regarding membership fees.

• Reviewing and recommending approval of Doctors of BC annual financial statements and reports to the Board of Directors.

• Overseeing policies and ensuring governance is in place for the financial management of all funding, ensuring the funds are segregated and accounted for in compliance with financial best practices, and providing a framework for administration of the programs.

• Overseeing compliance with government regulations; recently, the Canada Revenue Agency (CRA) has shown a greater interest in

SECTION 2


AUDIT AND INSPECTION COMMITTEEDR K. HENDERSON, MSC REPRESENTATIVE AND CHAIR; MR S. ABERCROMBIE, AUDIT MANAGER, AUDIT AND INVESTIGATIONS BRANCH; DR W. AMIRAULT, DOCTORS OF BC REPRESENTATIVE; MR E. DOLHAI, PUBLIC REPRESENTATIVE; DR V. DAVIS, MEDICAL CONSULTANT, AUDIT AND INVESTIGATIONS BRANCH; MR D. FAIRBOTHAM, EXECUTIVE DIRECTOR, AUDIT AND INVESTIGATIONS BRANCH; MS K. KICKBUSH, LAWYER, MINISTRY OF JUSTICE; MS S. MONTEIRO, SECRETARIAT; MS M. THELISMA, DIRECTOR, AUDIT AND INVESTIGATIONS BRANCH; DR M. VANANDEL, CPSBC REPRESENTATIVE.

The Audit and Inspection Committee (AIC) is a panel of the Medical Services Commission. Over the last fiscal year, the AIC met seven times. Highlights from the year are:• The Billing Integrity Program is now up to full

capacity and has been working to decrease the time from notification of audit to its final report. There has been a 40% decrease in the last year.

• A third lawyer has been retained to assist with audit hearings and mediation. In addition, a special constable has been hired in cases where fraud is suspected.

• The AIC has approved the first Section 15 for a physician who was audited. A Section 15 under the Medicare Protection Act results in de- enrolment of the physician, either permanently or temporarily.

• The Patterns of Practice Committee is now represented at the AIC meetings to improve communications and provide better alignment of the two committees.

—Wendy Amirault, MD Doctors of BC Representative

BC MEDICAL JOURNALDRS D. RICHARDSON, EDITOR; D.B. CHAPMAN, A. CLARKE, B. DAY, S.E. HAIGH, T.C. ROWE, C. VERCHERE, W.R. VROOM. STAFF: MS M. ADAIR, MR J. DRAPER, MS J. JABLKOWSKI (FROM JANUARY 2014), MS T. LYON (TO DECEMBER 2013), MS K. SURALIWALLA.

reviewing the accounting practices of not-for-profit organizations, and in that context Doctors of BC was audited. The audit brought to our attention that the manner in which we reported honoraria was not in accordance with the views of the CRA. We then sought accounting advice and were advised by our outside accountants and auditors that all such payments had to be paid to individuals, not corporations, and must be reported as taxable income to the individual holding the office. This change was implemented 1 January 2014.

• Reviewing the honoraria and expense policy; the Board of Directors requested that the committee review the honoraria rates, particularly for those members serving on the joint clinical commit-tees. In recognition of the responsibilities of joint clinical committee members, a rate increase was recommended and approved to take effect 1 January 2014. The Audit and Finance Committee continues to review the policies for preparation time and the compensation package for the elected executive.

• Meeting with our external auditors, KPMG LLP; the committee meets twice a year with the auditors, first to review and approve the audit planning document, then to receive the audited financial statements and discuss any changes to accounting practices that may affect Doctors of BC.

• Establishing that building management will become the responsibility of the Audit and Finance Committee.

• Reviewing and approving an update to the investment policies that confirms Doctors of BC capital is preserved and allows a modest ability to earn interest on the funds invested.

My thanks and appreciation to the committee members for their thoughtful and engaging deliberations, and to the staff for their excellent work and support.

—Mark Corbett, MD Chair



COLLABORATIVE UTILIZATION AND SYSTEMS IMPROVEMENT COMMITTEEDOCTORS OF BC: DRS C. SHERLOCK, CO-CHAIR; R. CLEVE, J. CUPPLES, G. HOAG, M. MOSS. MINISTRY OF HEALTH: MS J. CRICKMORE, CO-CHAIR; MR J. HIGGS, MS J. PHILLEY, MR J. ANDRUSCHAK, MR E. RATNARAJAH, MR M. WOODS. DOCTORS OF BC STAFF: MR P. MELIA, MS L. GRIME. MINISTRY OF HEALTH STAFF: MS F. WONG, DR I. DUBE, MS D. JANES.

The committee met on 27 June 2013, 8 October 2013, and 10 January 2014. This committee’s task is to monitor and manage annual growth in expenditures of laboratory services in accordance with the terms of the Second Renewed Laboratory Agreement between the British Columbia Medical Association and the Government of British Columbia. This includes any required attention to growth rates for non-high-volume fee items. Several changes have been made to fee items to ensure that expenditures remain on track to reach the agreed target for the year and to keep the fee schedule in line with medical, technical, and cost changes.

—Christopher Sherlock, MD Co-chair

CONSTITUTION AND BYLAWS COMMITTEEDRS G. MACKIE, CHAIR; L. OPPEL, L. DINDO, P. WHITE. STAFF: MS C. CORDELL.

The role of the Constitution and Bylaws Committee, among other things, is to review all proposals to amend the bylaws properly submitted in order to determine whether the proposed amendments meet legal requirements and are consistent with the rest of the bylaws. The committee met over the past year to review and discuss bylaw amendments, including a number of governance changes proposed by the Board, and one amendment proposed by a member in good standing.

A referendum was sent to the membership for vote in October 2013 that sought to alter the process by which an individual member can initiate

The request for this report comes every year and I am quite surprised that none of the Editorial Board members resigned in the last year, considering they have to attend monthly meetings chaired by me. These meetings remain one of the highlights of my month, as it is a privilege to oversee the intellectual input from such a wide variety of physicians from different communities. Each Editorial Board member brings a unique perspective to the Journal, and I would like to thank each of them for their hard work and diligence. They strive to make the Journal a publication that the doctors of BC can be proud to call their own.

The BCMJ hosted another CME cruise, this one sailing through French Polynesia and the Cook Islands, 1–12 March 2014, which included 21 hours of excellent CME. A fabulous time was had by all. Stay tuned and make sure you scour the Journal and our website on a regular basis so you don’t miss the next opportunity of a lifetime.

The real heroes of the BCMJ are the amazing staff that keep everything (particularly me) on track. Jay Draper, managing editor, has my gratitude for overseeing the whole process while managing to fix my many mistakes. Kashmira Suraliwalla, senior editorial and production coordinator, should be thanked for getting everything organized and meeting deadlines despite having to put up with my jokes. Tara Lyon, assistant editor, deserves a special thank you for her dedicated years of service to the BCMJ, particularly her work on the website and social media. Tara has recently moved on to a new position in the Communications Department, and she will be sorely missed. I would like everyone to extend a warm welcome to her replacement, Joanne Jablkowski. Joanne filled in admirably when Tara was on maternity leave some years ago, and she is a great addition to the full-time staff.

The Editorial Board and Journal staff thank you for your continued support, and we remain committed to bringing you an excellent Journal written by the doctors of BC for the doctors of BC. Remember, we would love to hear from you.

—David R. Richardson, MDEditor

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activities by all BC physicians. This year we are canvassing our membership on the “top three ways to engage doctors in your community.” We are also making a special effort to connect with Lower Mainland continuing medical education (CME) coordinators, inviting them to attend the 2014 conference. Their participation is generally low, and an increase in their representation will allow their voices to be heard.

All community CME coordinators from around BC are invited to the spring AGM in Vancouver. It is a combined educational conference and business meeting, funded by Doctors of BC.

The AGM educational event is a networking opportunity for CME coordinators to learn from and build on each other’s experience, identify the gaps in available CPD activities, and advocate for activities and resources. The focus is usually on novel CPD topics, techniques, and technology. This year’s conference is scheduled for 23–25 May at the Metropolitan Hotel.

For the last 3 years we have appended an increasingly popular 2-day Project Management Institute leadership course to our AGM. This year’s Project Management Institute course, Self-Aware-ness and Effective Leadership, sold out 2 months before the course. It has a wait list of more than half the enrolment. The course generates approximately $50000 in revenue.

The CPD Nucleus Committee carries out the actions arising from AGM motions and plans the spring education event and AGM. The committee is composed of four GP members (elected at the AGM for rotational 3-year terms) plus two specialist members. As was approved in 2010, one surgical and one nonsurgical specialist are to be selected through the Governance and Nominations Committee. In 2012 the committee was success-ful in engaging Dr Colleen Northcott, psychiatrist. We have been unable to retain a surgical specialist representative. The GP member, Dr David Arnold, elected in 2013, has since resigned, as he has decided to retire from practice.

Outstanding action items include:Motion 2 (2012)That the BCMA CPD Nucleus Committee expand its mandate to include planning, facilitating, and

the bylaw amendment process, and did not pass. Another referendum was distributed to members in April 2014. This referendum asked the membership to vote on a number of governance changes, including a restriction on the number of consecutive terms a Board district delegate may serve, a split of the Governance and Nominating Committee into two committees, a change to the effective time that the Board chair assumes office, and lastly a change to the process of appointing members to committees. All resolutions have been passed by the membership except for the Board chair appointment resolution.

In closing, I would like to thank committee members Drs Lloyd Oppel, Luay Dindo, and Phil White, as well as Doctors of BC staff for their contri-butions over the past year.

—Gordon Mackie, MDChair

CONTINUING PROFESSIONAL DEVELOPMENT NUCLEUS COMMITTEE DRS I. SCHOKKING, CHAIR; B. HUFF, J. FISHER, C. NORTHCOTT (SPECIALIST REP); S. SZE. HEALTH AUTHORITIES (EX OFFICIO): DRS R. MCFADYEN (VIHA), D. STOGRYN (FHA); G. BOURGEOIS-LAW (UBC CPD); S. JOHN-STON (RURAL COORDINATION CENTRE OF BC). STAFF: DR S. BUGIS, MR R. HULYK, MS G. LYNCH-STAUNTON.

The Continuing Professional Development (CPD) Nucleus Committee has grassroots, boots-on-the-ground participation, separating it from other committees that draw from a nominations process. The CPD leaders annual conference is becoming a most inclusive gathering of provincial players, providing an opportunity not found elsewhere for all voices to be heard.

With revalidation for licensure looming, the committee envisions a big educational (not punitive) role in advocating for and supporting physicians in maintaining and improving their competence and personal/professional growth. We also strive to increase engagement in CPD



currently facing the profession. The council met on 13 September 2013, 29 November 2013, 14 February 2014, and 9 May 2014.

Following is a brief summary of the projects and topics the council addressed during this past operating year.

Development of policy reportsA major policy paper that explores professional relationships in medicine was approved by the Board and released in September 2013. New evidence was developed through a stakeholder forum and a Doctors of BC membership survey, and the key findings were used to direct the commitments and recommendations, which are intended to foster an environment where professionalism is encouraged and supported. Dr Alan Ruddiman made presentations on this paper to all of the joint collaboration committees as well as to the Rural Centre of BC, and all have been well received.

An advance-care planning policy paper was released in the spring of 2014. This paper explores opportunities to improve end-of-life care in BC. Advance-care planning was identified as a priority because of the straightforward nature of the process and beneficial outcomes, including improved patient and provider experience.

In the coming year, major policy papers will be developed on the topics of genomics/personalized medicine, and measurement and improvement of BC’s health system performance.

Policy updatesA policy update newsletter is e-mailed to health care stakeholders on a regular basis. This update highlights the work of CHEP and the Policy Department and raises the profile of the council. It includes links to our policy papers, policy statements, news articles, and other relevant documents.

Doctors of BC policy statementsThe Doctors of BC policy statements continue to be produced and/or reviewed by CHEP on a regular basis for final approval by the Board. Most recently, policy statements on nurse practitioners and

coordinating CME delivery across the breadth of BC physicians’ educational/development needs. This would include engaging PSP, PITO, UBC CPD, BCCFP, BCMA CPD, GPSC, SSC, Divisions of FP, Health Authorities, etc.

Action: This motion is now included in the committee’s revised terms of reference, which were updated at our last AGM.Motion 1 (2013)That the BCMA advocate for paid physician CPD coordinators for each health authority to address the lifelong professional development, growth, and wellness needs of all BC physicians.

Action: JSC allocated some funding for CME coordinators, which RCCbc has been tasked with distributing and administering.Motion 2 (2013)—reiteration of Motion 1 from the 2012 AGM.That the JSC be requested to fund CPD administrative coordinators in each rural health authority from nonreverted funds.

Action: At the 2014 CPD leaders conference, have coordinators discuss what supports are needed and create a wish list from what’s working.

—Ian Schokking, MD Chair

COUNCIL ON HEALTH ECONOMICS AND POLICYDRS D. MILLIKEN, CHAIR; A. ATTWELL, D. ATTWELL, T. GERSCHMAN, B. GREGORY, J. HARRIES, T. LARSEN SOLES, L. OPPEL, J. OTTE, A. RUDDIMAN, K. SHAW, D.F. SMITH, R. VAN HEEST. GUESTS: MS T. BHATE, MUS; DR V. VARSHNEY, PAR-BC. STAFF: MS M. ADAIR, DR S. BUGIS, MS M. GEORGE, MS L. GRIME, MS K. SAUNDERS, MS S. SHORE, MS H. THI, MS D. VICCARS.

Under the guidance of the Board, the Council on Health Economics and Policy (CHEP) directs the activities of Doctors of BC concerned with assessment and formulation of policy options relating to the economics, organization, and management of the health care system. In addition, the council examines the most important challenges

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meaningful relationships with government at a grassroots level.

The council actively monitors political and legislative activities and advises the Board on likely developments that could directly or indirectly affect physicians and the public. At the direction of the Board, the council undertakes advocacy activities as needed to support the goals and priorities of Doctors of BC.

This past year of BC politics has certainly proven to be the most unpredictable and dynamic of my tenure. The largely unexpected win of the Liberals in the provincial election, much to the surprise of both pollsters and pundits alike, produced for us a government relations direction much different than what we had envisioned even a week before the election took place. That our organization responded seamlessly and nimbly to this outcome is in no small measure due to our excellent staff, who thoroughly prepared us for any eventuality that would present itself, even before a vote was cast.

CPAC’s role this year has focused primarily on the expansion and enhancement of scope of our MD-MLA Contact Program, and we have had good success with re-energizing and new recruitment activities. The effectiveness of this program lies in its ability to inform our elected officials of the success of our collaborative programs and in making them aware of the resulting improvements. Our conversations are also valuable tools for us in terms of gathering information about government priorities and local concerns to use in responding strategically to the political environment.

Our mission through the MD-MLA program is to have a “Doc for every MLA” by the end of this year, and I hope you will see fit to join us in this worthwhile and enjoyable activity.

This is my sixth year as chair of CPAC, and it’s been an honor and a pleasure to work with our great team of physicians and Doctors of BC staff, and to fulfill our service to the Board and help further its goals as identified in the strategic plan. I would like to thank everyone for their superb work.

—Barry Turchen, MDChair

physician assistants have been developed:• Ensuring Seamless Information Delivery to BC’s

EMRs• Nurse Practitioners• E-mail Communication with Patients• Direct-to-Consumer Advertising of Prescription

Drugs

Other activitiesSome of CHEP’s other activities in the past year include consideration of:• The activities of the Canadian Medical

Association (CMA) relating to policy issues.• The provincial political scene.• Scope of practice changes across health

professions.• Health human resource issues across the country.• Development of peer-reviewed journal articles.• Motions for the CMA’s General Council meeting.• Inclusion of speakers at CHEP meetings to

address topical issues.The council continues to play a major role in

ensuring that Doctors of BC is acknowledged as an authoritative voice on health policy issues and health system redesign. It has been my great pleasure to chair this council during the past year. I would like to thank the council members for their valued commit-ment and dedication, and the Doctors of BC staff for their continuous support and outstanding work.

—Donald Milliken, MD Chair

COUNCIL ON PUBLIC AFFAIRS AND COMMUNICATIONSDRS B. TURCHEN, CHAIR; E. CHANG, M. CORBETT, T. GERSCHMAN, A. GOW, S. JETHA, S. LU, L. OPPEL, M. PUTLAND, J. YOUNG. STAFF: MS. M. ADAIR, J. CAVERS, S. SHORE, E. TIMMERMAN.

The Council on Public Affairs and Communications (CPAC) coordinates the Doctors of BC’s grassroots advocacy and government relations programs. This member-appointed council oversees the MD-MLA Contact Program, which matches physicians with their local MLAs to foster long-term trusting and



DOCTORS OF BC–WORKSAFEBC PROJECTS AND INNOVATION COMMITTEEDRS T. GOETZ, CO-CHAIR; C. AKIZUKI, C. MARTIN, CO-CHAIRS. DOCTORS OF BC: DRS I. CONNELL, E. WEISS. WORKSAFEBC: DRS M. DELGARNO, G. DALMER, W. GALLASCH. STAFF: MR R. HULYK, MS C. MYLES.

This year the Projects and Innovation Committee (PIC) was struck in accordance with the Doctors of BC–WorkSafeBC agreement ratified in July 2013. After completing the search and confirmation of Doctors of BC representatives, the PIC met in November 2013 and February 2014.

The PIC was created as a mechanism for improving the quality and efficiency of care for injured workers by developing and testing initiatives and care models, and for making refinements to existing care models. This process can support the evolution of care provided to injured workers and respond to new types of work-related injuries, treatment protocols, and care pathways.

For physicians, the benefit of the PIC lies in the opportunity to propose new care models and to be rewarded with new fee codes. For WorkSafeBC, the benefit of the PIC lies in the opportunity to develop and evolve care models that improve the clinical and functional outcomes of injured workers, decrease workdays lost, and improve return-to-work rates. The development of initiatives and care models allow for inefficient, costly programs to be phased out.

Prior to the formation of this committee, no mechanism existed that allowed for meaningful physician input into the refinement of existing pathways and fee code or for the development of new care models and fee codes. As a result, new care models could be developed ad hoc or unilaterally by WorkSafeBC. It is hoped that this new committee will allow for the development of new projects and models of care with input from physicians and suggestions through the Doctors of BC–WorkSafeBC Liaison Committee.

To date, the PIC has finalized its terms of reference and developed a work plan in which it was agreed that at least one proposal be accepted

DOCTORS OF BC–WORKSAFEBC LIAISON COMMITTEEDRS J. SEHMER, CO-CHAIR; P. ROTHFELS, CO-CHAIR. DOCTORS OF BC: DRS C. AKIZUKI, T. GOETZ, C. HAMBLETON, E. WEISS. WORKSAFEBC: MR G. DALMER, DRS C. DUNN, C. MARTIN. STAFF: MR R. HULYK, MS C. MYLES.

The Doctors of BC–WorkSafeBC Liaison Committee met four times in 2013.

This committee provides consultation and input into WorkSafeBC policies relevant to clinical practice and dispute resolution between physicians and WorkSafe BC.

WorkSafeBC presented concerns regarding clinical physicians providing poor quality information on medical reports. The issue of mandatory use of safety scalpels and safety needles is a topic for ongoing discussion. The number of claims for work-related shoulder injuries and the time off work related to this is now exceeding low-back claims. A pilot project is underway to expedite assessment and treatment by shoulder specialists.

As per the Doctors of BC–WorkSafeBC agreement ratified in July 2013, a new Projects and Innovation Committee was formed with members from both Doctors of BC and WorkSafeBC. This new committee’s function will be to identify specific areas for optimizing disability management of injured workers.

Any Doctors of BC members with concerns or frustrations about their interactions with WorkSafeBC are invited to contact this committee either directly or by way of Cindy Myles at [email protected].

We welcomed Dr Elliott Weiss (physical medicine) as a new member of this committee in 2014.

—John Sehmer, MD Co-chair

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meeting at a Vancouver hotel. From that meeting, GPs stated four things: pay us, value us, train us, and support us. Those statements were the beginning of the foundation that led to the GPSC. It was formed through the Physician Master Agree-ment as a collaborative committee of Doctors of BC and the Ministry of Health and has continued to support full-service general practice.

The Physician Master Agreement outlines the membership: six members from Doctors of BC and six from the Ministry of Health. As the work is so dependent on collaboration with health authorities, representation is invited from the five regional health authorities and the First Nations Health Authority. There has been great interest in serving on GPSC due to the work that has been accomplished. This year four of the Doctors of BC members are new to the committee.

The portfolio is large and works on the principles of the Institute for Healthcare Improvement’s triple aim of better population health, patient and provider satisfaction, and reducing the per capita cost of health care.

It has been said that the GPSC fees for chronic disease and complex care saved general practice. While the fee structure appropriately compensated physicians for looking after complex patients, the results showed that managing patients proactively resulted in fewer emergency visits and fewer complications from their diseases, resulting in better experiences for the patients and savings for the health care system.

GPSC’s reach has expanded greatly since the first work on chronic disease and complex care into other areas such as mental health, maternity, palliative, and end-of-life care.

Likely the biggest impact on primary care was the creation of the Divisions of Family Practice, independent societies but funded by GPSC and working hand in hand with GPSC. There are 33 divisions throughout the province, with a member-ship of approximately 95% of the province’s GPs.

This year has seen big initiatives. The In-Patient Care Program addressed the hemorrhage of family physicians from in-hospital work. The development of fees for looking after orphaned patients and creating on-call groups has stemmed that flow and

by the end of 2014. A call for project applications by both parties began at the end of January 2013 and ended in mid-April 2014. Using a score card, applications will be reviewed and ranked for relevance, impact, and feasibility at the next meeting in May 2014. The project applicants may be asked to be involved in the development of their proposal. WorkSafeBC reserves the right to decide whether to proceed with implementation of proposals.

—Thomas Goetz, MD Co-chair

GENERAL PRACTICE SERVICES COMMITTEEDOCTORS OF BC: DRS S. ROSS, CO-CHAIR; P. BARNSDALE, B. HEFFORD, K. HENDRY, G. WATSON, J. YOUNG. MINISTRY OF HEALTH: MS K. MCQUILLEN, CO-CHAIR; MR E. BRINGSLI, DRS J. HAMILTON, G. MAZOWITA, MS. S. OOMS. SOCIETY OF GENERAL PRACTITIONERS: DR J. CLARKE. HEALTH AUTHORITIES: MS G. ANTON (NORTHERN HEALTH), MS D. ARSENEAULT (INTERIOR HEALTH), DR B. BURNS (VANCOUVER ISLAND), MS C. PARK (VANCOUVER COASTAL), MS P. PARDY (FRASER HEALTH), DR S. WILLIAMS (FIRST NATIONS HEALTH). DOCTORS OF BC STAFF: MR J. AIKMAN, MS D. BALES AND MS C. GRAFTON (COMMUNICATIONS), MS G. BEKIOU (EXECUTIVE LEAD, GPSC), MS A. GODIN (LEAD JOINT CLINICAL COMMITTEES), DR D. MACCARTHY (MEDICAL CONSULTANT), MS M. RILEY (ACTING EXECUTIVE LEAD, DOFP), MR. G. TAYLOR (EXECUTIVE LEAD, QI AND PSP). MINISTRY OF HEALTH STAFF: MS A. MICCO (SECRETARIAT). CONSULTANT IN SUPPORT OF GPSC, DR C. CLELLAND,

The General Practice Services Committee (GPSC) began in 2002 following an all-time low morale in general practice. Family physicians were dealing with increasingly complex, time-consuming patients, while those patients with straightforward non-complex complaints had disappeared to the world of the walk-in clinic. This unhappiness resulted in a forum of GPs from around the province



Columbia. These guidelines are published under the brand BC Guidelines, available on www.bcguidelines.ca, a mobile-friendly website.

GPAC’s mandate follows a triple-aim philosophy: improved health outcomes, promotion and education, and optimized clinical care.

The following sections outline how GPAC met these objectives in 2013/14:

Improved health outcomes • Maintained an evaluation plan that measures the

success of the published guidelines and protocols. This plan relies on the regular production and use of evaluation data and reports from a variety of data sources and agencies.

• Collaborated with and participated on other MSC committees, such as Patterns of Practice and Audit and Inspection.

Promotion and education Achieved increased exposure for BC Guidelines through participating in the following events:• The Society of Rural Physicians of Canada

Conference.• Family Medicine Forum of St. Paul’s Hospital.• University of BC (UBC) workshops for residents.• Practice survival skills workshops.• International medical graduate orientations

organized by the CPSBC.• Introducing the guidelines to fourth-year UBC

medical students. We continued to strengthen partnerships with the

following stakeholders: • General Practice Services Committee.• Specialist Services Committee.• Divisions of Family Practice.• Health Authorities.• UBC Medical School and Department of Family

Practice.• BC Children’s Hospital and Child Health BC.• BC Centre for Disease Control.• St. Paul’s Hospital.• BC Cancer Agency and Family Physician

Oncology Network.• Trauma BC.• Heart and Stroke Foundation.• BC Association of Laboratory Physicians.

encouraged some GPs to return to hospital work. The GPSC is currently looking at opportunities to strengthen care to vulnerable populations, such as the frail elderly in residential care.

By far the biggest project for the GPSC is the A GP for Me initiative. It recognizes the importance of ongoing doctor-patient relationships in improving outcomes and reducing costs. Announced in February 2013 by Doctors of BC and the Government of BC, the initiative is designed to confirm and strengthen the relationship between family physicians and patients, better support the needs of vulnerable patients, and increase capacity within primary care to better enable patients to find a family doctor. The Divisions of Family Practice throughout the province are at various stages of making their plans at a local level into reality.

As I complete my first year as co-chair, I am thank-ful for the opportunity to be part of a committee that has done so much for full-service general practice and will continue to encourage innovative ways to bring quality health care to our patients.

—Shelley Ross, MD Co-chair

GUIDELINES AND PROTOCOLS ADVISORY COMMITTEEDOCTORS OF BC: DRS B. DALAL, CO-CHAIR; M. DAWES, A. GARG, M. GOECKE, J. GRAY, A. HARRIS, T. PARNELL, H. RANCHOD, J. STEWART, A. TEJANI (PHARMD), P. WHITE. MINISTRY OF HEALTH: MS T. COLLINS/ MS S. POWER, CO-CHAIR; MR. W. PANG (PHARMD); DRS K. HENDERSON, S. LEE, D. MCTAGGART (CONSULTANTS); MS B. SEALEY; MR J. WATSON (SECRETARIAT). STAFF: DRS S. BUGIS, D. MACCARTHY/A. GARG; MS T. DEVENISH.

In 2013/14, the Guidelines and Protocols Advisory Committee (GPAC), advisory committee to the Medical Services Commission (MSC), continued to fulfill its role in developing and promoting guidelines and protocols to support high-quality, appropriate patient care and the effective utilization of medical services in British

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INSURANCE COMMITTEE DRS M.A. MCCANN, CHAIR; M. CURRY, A. FRAYNE, R. JONES, L. VOGT. STAFF: MS C. AHPIN, MS S. BRAID, MS S. MALINOWSKI.

This is my 15th year as chair of the Insurance Committee. As always, I would like to take this opportunity to recognize the contributions of the committee members to our deliberations this year. I especially thank Drs Doug Grant and Dr Patricia Warshawski, who finished their service on the committee in 2013, for their contributions over the last many years. I would also like to recognize the retirement of Sandie Braid, our Benefits Manager, with sincere thanks for her many years of contributions and support.

The Insurance Committee has met throughout the year to study, review, and enhance the various insurance plans offered to our members. The committee believes that all of our insurance plans are financially sound.

A summary of our various insurance plans and some of the changes that have occurred in the past year follow. For full plan details, please contact the Insurance Department.

Physicians’ Disability Insurance (PDI) PlanThe provincial government, through the Medical Services Commission (MSC), sponsors this plan. Eligible physicians must apply for this insurance and have their coverage approved before they are able to receive benefits. It is extremely important that all medical history be disclosed on the application, as failure to do so may result in the policy not being issued or being null and void at the time of claim. The premium paid by the MSC on each member’s behalf is documented by the issuance of a Canada Revenue Agency (CRA) T4A slip, the value of which should be declared as the physician’s personal income. Because the premium is taxable, the benefits are not. Over the past year, the Insurance Committee reviewed reserves held in the plan. With the assistance of an actuarial consultant, the Insurance Committee and the Joint Benefits Committee successfully negotiated a significant decrease in reserves with the insurance carrier, resulting in a much improved financial position of the plan.

• Canadian Association of Radiologists.

Optimized clinical careThe following refreshed and new guidelines and protocols were published: • Antinuclear Antibody Testing Protocol• HFE-Associated Hereditary Hemochromatosis—

Investigations and Management• Ambulatory ECG Monitoring• Major Depressive Disorder in Adults: Diagnosis

and Management• Ankle Injury—X-ray for Acute Injury of the Ankle

or Mid-Foot• Breast Cancer—Management and Follow-Up• Breast Disease and Cancer—Diagnosis

Work began or continued on the following guidelines and protocols:

• Cognitive Impairment: Recognition, Diagnosis, and Management in BC

• Stroke: Transient Ischemic Attack• Cardiovascular Disease: Primary Prevention• Hypertension: Detection, Diagnosis, and

Management• Adult Asthma: Diagnosis and Management• Erythrocyte Sedimentation Rate• Chronic Kidney Disease: Identification, Evaluation,

and Management of Patients• Diabetes Care• Stroke: Atrial Fibrillation• Stroke: Novel Oral Anticoagulants GPAC received accolades for the following

guidelines: • Diabetes Care—voted best work flow sheet by

the Canadian Diabetes Association• Problem Drinking—received perfect marks by

the Centre for Addiction and Mental Health in its 2013 report, Strategies to Reduce Alcohol- Related Harms and Costs in Canada: A Comparison of Provincial Policies

—Bakul Dalal, MD Co-chair



surplus is being held in reserve as a temporary measure to protect against a possible deficit and corresponding premium increase over the next plan year.

Office Overhead Insurance PlanThis plan is also underwritten by the Sun Life Assurance Company. Office expenses as presented to CRA must support the amount of eligible insurance. Unlike the disability programs, office overhead benefits are taxable when received and a T4A will be issued to claimants by the insurer. However, as your expenses can be used as deductions, the net effect should be negligible. Coverage under this plan is available up to age 80. This can be especially useful if a member becomes totally disabled and decides to retire, as the benefits can help defray the expenses incurred while winding up the practice. Members should be aware that this plan includes a parental leave benefit that can be claimed in addition to the negotiated PLP benefit. Over the past year the Insurance Committee reviewed reserves, expenses, and interest rates in the plan. With the assistance of an actuarial consultant, the Insurance Committee successfully negotiated decreases. Unfortunately, the claims experience has been unfavorable and the plan is generating a small deficit.

Critical Illness Insurance PlanThis plan is also underwritten by the Sun Life Assurance Company. The plan provides a lump sum payment in the event an insured member or spouse contracts one of the 25 listed conditions, such as heart attack, stroke, or cancer. Coverage up to $250 000 is available to members and their spouses, up to age 75. This benefit bridges the gap between life and disability insurance, at very competitive rates, and a substantial number of policies have been sold under the plan.

Accident Insurance PlanIndustrial Alliance underwrites this plan, which pays a lump sum benefit in the event of death or dismemberment resulting from an accident. Members can purchase up to $1 million of this insurance for themselves and can also extend this

Doctors of BC Group Disability PlanThis plan is sponsored by Doctors of BC and provides disability insurance that the members pay for. This plan, underwritten by Sun Life Assurance Company, allows members to buy additional disability insurance to supplement the coverage provided by the PDI plan. The plan is fully portable and allows physicians who decide to opt out of MSP to transfer their PDI coverage to this plan immediately, with no change in coverage and with no medical evidence of insurability. This plan also has many attractive built-in and optional features, including:• Partial disability benefit.• Assumed total disability benefit.• Survivor benefit.• Cosmetic and transplant benefit.• Own occupation rider.• Guaranteed insurability benefit rider.• Cost-of-living adjustment rider.• Retirement protection rider.

The financial position of the plan has been improving. Over the past year, the Insurance Committee reviewed reserves, expenses, and interest rates in the plan. With the assistance of an actuarial consultant, the Insurance Committee successfully negotiated decreases contributing to the improved financial position of the plan.

Group Life Insurance PlanThis plan is underwritten by the Sun Life Assurance Company. Coverage is available to members and their spouses up to age 75. During 2013 the plan’s coverage limit was increased from $3 million to $5 million for qualifying practising physicians. The Doctors of BC plan has over $2 billion in coverage insured. Since 2012 the plan was amalgamated with those of Alberta and Saskatchewan, resulting in enhancements and reduced premiums. These improvements make our plan an even better option for members needing term life insurance.

The plan experience has been favorable and generated a modest surplus over 2013. Considering the amalgamated plan is still relatively new, a conservative approach to the plan’s funding is in place for the first few years until credible plan experience is established. As a result, the 2013

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age of 70 or who retired from practice and lost their coverage under either the Standard or the Core-Plus Plan.

Office Contents and Liability, Homeowners’ Insurance Plans, Optional Automobile Coverage, Directors and Officers CoverageThe Mardon Group is offering these programs with underwriting from Canadian Northern Shield or Intact Insurance Co. and Chubb Insurance Co. for office contents and liability and homeowners’ insurance, and from Family Insurance Solutions for automobile coverage. They offer comprehensive policies at very competitive rates. These products continue to be very popular with members.

Personal Liability Umbrella PolicyThis plan can also be obtained through the Mardon Group. This policy covers third-party liability over $1 million on home, vehicle, and watercraft. There are cost savings over buying additional coverage for each individual policy, and the policy also covers third-party liability for areas not covered by the individual policies.

Travel InsuranceThe MEDOC plan provided through Johnson Inc. offers comprehensive travel insurance at very competitive rates to all members, regardless of age or health. It has experienced strong growth in participation since its introduction in 2007.

Insurance Advisory ServicesIn 2011 Doctors of BC, together with other provincial medical associations, entered into a revitalized insurance alliance with MD Physician Services Inc. As an outcome of this alliance, the participating provincial associations, including Doctors of BC, have taken responsibility for fulfilling all lifestyle insurance products, (e.g., term life, disability, critical illness, and office overhead) including individual products. To facilitate this activity, BCMA Agencies Ltd., a wholly owned subsidiary of Doctors of BC, began operations in 2011, offering members access to the complimentary insurance review and planning services of licensed, noncommissioned insurance advisors. The goal of

protection to their families. Evidence of good health is not required and the premiums are extremely competitive.

Medical Student and Resident Insurance Programs These programs provide specialized life and disability coverage for medical students and residents and no-cost coverage for first-year medical students. Both programs ensure future insurability through the Doctors of BC Disability Income Insurance Plan and the Office Overhead Plan when the student/resident enters practice.

HEALTH BENEFITS TRUST FUNDStandard Plan (formerly the Medical Office Benefit Plan)This plan operated throughout 2013 but was redesigned and enhanced for 2014. The plan in its original state was closed as of 31 December 2013. It was replaced by the new HBTF Plan effective 1 January 2014. During its operation in 2013, the Standard Plan was a comprehensive plan intended to offer protection to the members’ office staff. It included life insurance, accidental death and dismemberment, disability benefits, extended health, and dental benefits. Eligible Doctors of BC members only have access to extended health and dental benefits. This plan is underwritten by Sun Life Assurance Company and Industrial Alliance.

Core-Plus PlanThis plan operated throughout 2013 and was closed to new entrants effective 31 December 2013. This plan is a combination of an insured “core” component and a self-funded health and welfare trust (the “Plus” component), which allows for comprehensive coverage of health and dental expenses paid for out of pretax earnings. The plan’s experience in 2013 resulted in a small increase in the health premiums.

In addition, the Senior Plan operated throughout 2013 but was redesigned and enhanced for 2014. The Senior Plan in its original state was closed as of 31 December 2013 and replaced by the new HBTF Plan effective 1 January 2014. During its operation in 2013, the Senior Plan offered extended health and dental coverage to plan members who reached the



allocate funds between the negotiated benefit programs: the Physicians Disability Insurance (PDI), the Contributory Professional Retirement Savings Plan (CPRSP), the Continuing Medical Education Fund (CME), the Parental Leave Program (PLP), and the Canadian Medical Protective Association (CMPA) Dues Rebate Fund.

While the Physician Health Program is the other benefit program outlined in the Benefits Subsidiary Agreement, its budget does not fall under the jurisdiction of this committee.

The 2012 Benefits Subsidiary Agreement outlines specific funding envelopes to be allocated to the benefit programs over the period 2012/13 to 2013/14, as well as an additional $4.69 million for the committee to allocate as needed. The committee has been directed to use surplus funds in any of the benefit programs, using the CMPA Rebate surplus last, to maintain the benefits at their 31 March 2012 levels. After that, surplus funds in any of the benefit programs (with the exception of CMPA Rebate) can be used to supplement the levels of any of the benefit programs.

For 2013/14 the maximum CPRSP basic benefit and length of service benefit was $4204 and $3396 respectively, with a minimum income threshold of $60 000 gross income. This minimum income will be reviewed by the Benefits Committee on a biannual basis.

The maximum CME benefit for 2013/14 was $1800. The entitlement amount will be paid automatically to physicians provided they have been revalidated by the College of Physicians and Surgeons to ensure that they have completed their educational requirements for licensing.

The PLP maintained its maximum benefit of $1000/week for 17 weeks. The program allows physicians who work up to 15 hours/week to claim a half benefit and/or to claim their 17 weeks of benefit over a 1-year period, making the benefit more accessible.

The CMPA Rebate program continues to provide full reimbursement of CMPA dues over the 1985 level, even though the CMPA dues have increased. Surplus funds can now be transferred to other benefit programs if needed, as noted above.

The PDI benefit has been maintained at the

the advisors is to provide members with objective advice regarding their Doctors of BC and other third-party insurance programs. This service has been extremely well received by members.

I want to thank all the committee members for their work and efforts in making this committee function so effectively. Our Insurance Department staff continue to do exceptional work. Thank you to all of you: Julie Kwan, Sinden Malinowski, Erin Higgins, Paula Rooney, Ivy Woo John, Karen Paul, Lorie Lynch, Darlene Laird, Ann Marie O’Driscoll, Laura McLean, Tara Smedbol, and Miriam Burden.

Once again, best wishes in retirement to Sandie Braid.

Premiums Received in 2013 No. Insured $ PremiumPDI 7149 14 000 000Doctors of BC Group Disability 2809 2 245 188Group Life 4657 3 430 109Office Overhead 996 856 897Accident Insurance 1357 232 478Health Benefits Trust Fund 3013 8 840 452Critical Illness 1765 801 288Office Contents/ Homeowners 4 850 281MEDOC Travel Plan 574 517Total 35 831 210

—Michael A. McCann, MDChair

JOINT BENEFITS COMMITTEE DOCTORS OF BC: DRS M.A. MCCANN, CO-CHAIR; MR J. COOK, DRS M. CORBETT, S. RABKIN. MINIS-TRY OF HEALTH: MR K. WARREN, CO-CHAIR; MR V. BERSENEV, MS W. LO. STAFF: MS C. AHPIN, MS S. BRAID, MS A. KEEBLE, MS S. MALINOWSKI, MS S. VERGIS.

The Benefits Committee is responsible for general oversight and administration of the benefit plans as outlined in the Benefits Administration Agreement. The committee’s primary function is to oversee and

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REPRESENTATIVES: MR R. FRECHETTE, CO-CHAIR; MS J. DIAMOND (RURAL SECRETARIAT), MR J. ENGLISH, DR. B. TEMPLE, MS S. WALKER, DR. J. SLATER. HEALTH AUTHORITY GUESTS: DR. R. LUPTON, MS V. POWER, DR. S. WATERS. STAFF: MR J. AIKMAN, MS M. CORMIER, MS M. CREW, MS T. HOOPER.

The Joint Standing Committee on Rural Issues (JSC) is a joint committee of Doctors of BC and the Ministry of Health (MOH) that manages the Rural Subsidiary Agreement (RSA) and has been in place since 2000.

The goal of the JSC is to enhance the availability and stability of physician services in rural and remote areas of British Columbia by addressing some of the unique, demanding, and difficult circumstances attendant upon these physicians and by enhancing the quality of the practice of rural medicine.

The JSC is responsible for managing the following programs: • Rural Retention Program (RRP). • Recruitment Contingency Fund (RCF).• Rural Continuing Medical Education (RCME). • Isolation Allowance Fund (IAF).• Northern & Isolation Travel Assistance Outreach

Program (NITAOP). • Rural Locum Programs (GP, Anesthesia,

Specialist). • Rural Coordination Centre of BC (RCCbc).• Rural Education Action Plan (REAP). • Recruitment Incentive Fund (RIF).• Rural Emergency Enhancement Funding (REEF).

Cumulatively, these programs are supported financially by approximately $115 million annually.

The JSC also provides guidance to the rural aspects of Health Match BC.

Since 2000, the bipartite JSC collaborative committee has had a consensus-based decision-making modus operandi. The committee has had difficulty over the last while in coming to agreement on the expenditure of all of the negotiated physician funds. In part this is due to a shared caution about overspending the budgeted fund for each program, and in part due to an inability to come to agreement on new programs to

$6100/month maximum. In years of positive experience, PDI has transferred some surplus funds to support the other benefit programs. The PDI benefit provides a 1-year maximum benefit payment for disabilities occurring between age 65 and 70 as well as a partial residual benefit. The committee commissioned an actuarial firm to negotiate better terms with the current insurance carrier, which resulted in a one-time release of surplus funds and a reduction in expenses charged to the plan.

The following table outlines the benefit levels over recent years.

Program Year Benefit Program Maximum Funding (millions) PLP 2011/12 $1000/wk $ 4.90 2012/13 $1000/wk $ 4. 30 2013/14 $1000/wk $ 4. 30CME 2011/12 $1800 $ 17. 10 2012/13 $1800 $ 17. 32 2013/14 $1800 $ 17. 10PDI 2011/12 $6100/month $ 14. 00 2012/13 $6100/month $ 14. 00 2013/14 $6100/month $ 14. 00CPRSP 2011/12 $7754.80 $ 55. 37 2012/13 $7730.80 $ 51. 87 2013/14 $7600.00 $ 52. 37CMPA 2011/12 n/a $ 16. 00 2012/13 n/a $ 17. 00 2013/14 n/a $ 20. 50

—Michael A. McCann, MDCo-chair

JOINT STANDING COMMITTEE ON RURAL ISSUES DRS G. AVERY (PORT MCNEILL), CO-CHAIR; A. ALEEM (CRANBROOK), OUTGOING MEMBER; G. APPLETON (TERRACE), OUTGOING MEMBER; S. MOOLA (CRANBROOK), J. SOLES (CLEARWATER), E. MARQUIS (PRINCE GEORGE), A. RUDDIMAN (OLIVER). ALTERNATES: DRS C.S. JOHNSTON (OLIVER), M. JOHNSTON (BLIND BAY), G. APPLETON (TERRACE). GOVERNMENT



to the attention of the JSC and others, and efforts were made to plan for the expected reduction in recruitment from some countries. Health Match BC estimates that over the last 2 years rural BC has had a net loss of approximately 160 physicians due to the bylaw change. The JSC has agreed to provide funding up to $2.8 million to work with the province to develop an appropriate assessment tool to ensure that a process is in place for those physicians coming to BC on provisional licences and who wish to work in rural BC. As well, the JSC will be implementing a program of ongoing funding to provide up to $6.2 million to physicians acting as supervisors to provisionally licensed physicians in rural BC.

Most of the research into rural recruitment and retention has, for a number of years, focused on the importance of where physicians are from, as being an integral component in determining where they practise. People growing up in rural areas are more likely to end up as physicians practising in rural areas. For this reason and many others, the JSC is pleased with its decision to provide 4 years of ongoing funding at $250 000 per year to support the new Rural Pre-medicine Program at Selkirk College beginning in the fall of 2014. Other pre- medical colleges may learn and benefit from this program and develop additional “pipelines,” such as those that are in very effective use in countries like Australia.

The RCCbc continues its work supporting the JSC and rural medicine through rural surveillance and nimble intervention, a rural think tank, and specific projects as requested by the JSC. It has had a successful year in raising rural profile through building and developing valued relationships, and continues to develop and enhance relationships with rural physicians (and other rural health providers), rural communities, health authorities, the Ministry of Health, UBC, and other rural and health organizations.

The strengthening of the relationship between UBC, Doctors of BC, and government, and the next evolution of preparation for rural practice, is eagerly anticipated with the development of a chair in rural medicine and meaningful input into the Faculty of Medicine around rural medicine, generalism, and

assist rural physicians and rural health care delivery. The JSC thus has unexpended monies that have become designated as “one-time funds,” which are used for new programs that do not require ongoing funding.

To address the first problem in the long term, the JSC has set aside $1 million from the one-time funds as a contingency so that more realistic assessments for program expenditures may be taken, and any spending in excess of the budgeted amount may be covered.

In 2013 the JSC implemented a new program using $2 million from one-time funds to recruit physicians to rural communities in crisis and communities at risk (those communities that have lost an essential service—often emergency medicine—and communities that are about to do so). This program, Rural Physicians for BC (RPs4BC), provides $100 000 to each physician who is recruited to fill one of 20 identified vacant positions (including both specialist and generalist physicians) in exchange for a 3-year return-of-service to that community. As of March 2014, 14 positions have been filled.

At the time of writing, an additional program to encourage rural physician retention is in the final stages of agreement. The committee thanks all those rural physicians who demonstrate strong commitment in their rural practices.

Also from one-time funds, the JSC set aside $2.5 million to aid communities that face repeated challenges maintaining a sustainable health service delivery system. Pilot projects in each health authority—developed collaboratively by communities, community physicians, health authorities, and local First Nations, assisted by RCCbc—will take place over 3 years. These will further the understanding of the JSC, Doctors of BC, and the Ministry of Health in what does work in rural physician recruitment and retention and the long-term provision of rural and remote health care.

In late 2011 RCCbc members became aware of the bylaw change made by the College of Physicians and Surgeons regarding the requirements to determine eligibility for those physicians entering BC on provisional licences, which has had a significant impact on rural BC. This was brought

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Authority. The addition of the health authorities to the JSC continues to be invaluable and builds on the collaborative nature of the committee. We anticipate extending this invitation to include RCCbc/REAP.

I would like to once again thank the committee members for their enthusiastic commitment, creativity, and patience. All our committee members are rural physicians, and scheduling and travel present significant difficulties. These colleagues continue to devote considerable time and effort to ensure that all of the rural programs are managed and maintained at the highest level possible. I would particularly like to acknowledge those members who have retired from the committee, Drs Geoff Appleton and Abdul Aleem, for their ceaseless and erudite work over the last many years.

It is always difficult to acknowledge our Doctors of BC staff sufficiently. Jim Aikman, Meredith Cormier, Tania Hooper, and Mallory Crew have provided outstanding, consistent, and timely work in support of the committee. We are indebted to them.

I will be resigning from the position of co-chair of the JSC this year and would like to say what a pleasure it has been to work for rural physicians and rural medicine in this way. Rarely does one get the opportunity in life to work with such a competent, thoughtful, collegial, hardworking, and thoroughly friendly group of people—our JSC members, our RCCbc and REAP consultants, and our Doctors of BC staff. Thank you.

—Granger Avery, MBBSCo-chair

LAB REFORM COMMITTEEDRS C. BELLAMY, CHAIR; J. O’CONNELL, C. SHERLOCK. STAFF: MS C. CORDELL, MR. P. MELIA.

Government representatives have consulted with lab doctors over the past 2 years regarding lab reform initiatives, many of which are published in the 2013 Lab Reform Committee Report.

The current Lab Reform Committee more recently

social responsibility as applied to rural health care.One of the more important recent issues

challenging rural medicine is the Provincial Privileging Project. Endorsing the need for a meaningful public competency process, a better understanding of generalism in medicine, and the team-based competencies that exist in rural communities, RCCbc has brought this issue to the attention of JSC and others.

The JSC and RCCbc co-sponsored the Society of Rural Physicians of Canada (SRPC) Rural and Remote Health Conference in Victoria in April 2013. It was hugely successful and had the highest attendance of any rural medicine conference internationally. RCCbc looks forward to reestablishing the Rural Emergency Continuum of Care Conference (RECC) in Penticton in May 2014.

For the last two years, through RCCbc, the JSC has been working steadily with the GPSC and GP divisions on issues relating to rural health care and is very pleased to support the development of the Rural and Remote GP Division. The committee looks forward to the development of a virtual individual rural division in 2014.

REAP was able to accommodate the increasing student enrolment in 2013/14, with 71% of third-year students and 54% of fourth-year students participating in rural rotations in RSA communities. REAP was also able to support more than 31 family practice and specialty residents to spend elective time in rural communities. Additionally, rural physicians were supported through various advanced skills programs and received training in areas of need, including oncology, anesthesia, dermatology, and emergency medicine.

The RCCbc is indebted to the many dedicated and knowledgeable physicians who have given their time and expertise to assist the advancement of rural health care.

The seventh annual JSC meeting in a rural area took place in Fort St. John in September 2013. The venue for 2014 will be Nelson.

The JSC expanded its membership in the last couple of years to include health authority representatives as permanent guests on the committee, and we particularly welcome Dr Shannon Waters from the First Nations Health



the committee, without comment by the chair, for resolution. The committee generally meets twice a year.

The resolution process is informal, but care is taken to ensure that all have opportunities to make their cases or defences as appropriate. Participants are given copies of the complaints, invited to make any further written comments or submissions they see fit, and are given copies of anything submitted by the other participants. The committee then meets, without oral argument from participants, and comes to a nonbinding resolution, which the chair then distributes, in writing, to participants.

While the resolution of disputes is nonbinding, the results are almost invariably respected by the participants. Other issues arising before the committee, such as expert opinion, reasonability of fees for medical-legal work, and propriety, best practices, and behavior of professionals to one another, are canvassed when appropriate. On occasion, matters coming before the committee clearly outside its mandate (e.g., complaints relating to matters of professional competence or discipline), are referred to the appropriate professional body.

Submission of matters to the committee should be referred to the chair.

—Jack Webster, QC Chair

MSC SEARCH AND EVALUATION COMMITTEEDR M. DAHL, CHAIR; DRS W. CAVERS, C. CLELLAND, B. GREGORY, W. CUNNINGHAM, MS A. ELVIDGE. STAFF: MR J. AIKMAN, DR S. BUGIS, MS L. GRIME, MR A. SECKEL.

The MSC Search and Evaluation Committee has not met, and during this past year was disbanded. In future, new appointments to the Medical Services Commission will be managed by the Governance and Nominating Committee.

—Marshall Dahl, MDChair

met with government representatives over several months to consult on impending legislation intended to consolidate British Columbia’s laboratory services, allowing them to be managed in a more consistent and streamlined way, with cost savings made through agreements with providers and consolidation of some services. The Laboratory Services Act was passed by the legislature in the spring session but has not yet been proclaimed.

Physician engagement was and continues to be a fundamental principle of our participation in the lab reform project, and the government has assured us that physicians will have an influential and decision-making role within the new governance and operational structures. We will continue working with the government on this initiative.

—Chris Bellamy, MD Chair

MEDICAL-LEGAL LIAISON COMMITTEEMR J. WEBSTER, CHAIR. LAW SOCIETY OF BC: MR C. BRANSON, MS B. BUCHANAN, MR D. MARTIN, MR M. SLATER, MR M. THOMSON, MR S. VECCHIO. DOCTORS OF BC: DR S. BUGIS, MS C. CORDELL. COLLEGE OF PHYSICIANS AND SURGEONS: DRS A. MCNESTRY, H. OETTER.

The Medical-Legal Liaison Committee is a joint committee composed of appointed representatives of the College of Physicians and Surgeons, the Doctors of BC, and the Law Society of BC. The committee’s mandate is to assist the professions generally by whatever means are appropriate to foster and encourage superior communication, interaction, and resolution of disputes touching on medical-legal matters involving members of the respective professions.

The committee accepts complaints or suggestions on referral from the College, the Doctors of BC, or the Law Society, and directly from members of the respective professions.

The chair normally attempts off-the-record resolution of most complaints by direct discussion with the participants. If that effort fails to reach a satisfactory accord, then the matter is referred to

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The commission is a co-signatory to many of the agreements between government and Doctors of BC, including the Physician Master Agreement (PMA).

ActivitiesThe MSC oversees and/or receives reports from the Reference Committee, the Guidelines and Protocols Advisory Committee, the Advisory Committee on Diagnostic Facilities, the Audit and Inspection Committee, and the Patterns of Practice Committee.

The commission functions as an administrative tribunal for beneficiaries and practitioners in such matters as disputes about nonresident and out-of-country MSP coverage.

The commission’s issues during the past year have included extra-billing audit and legal concerns, and laboratory and diagnostic facility regulations that have been under some change with the consolidation of the private labs. The commission also dealt in detail with other audit and inspection items and continues to examine its own role in the PMA and the MSP.

PublicationsThe MSC Annual Report provides an annual accounting of the business of the MSC, its subcommittees, and other delegated bodies.

A detailed record of MSC activities is available in the most recent annual report at www.health.gov .bc.ca/msp/legislation/pdf/bluebook2013.pdf.

The MSC Financial Statement (Blue Book) contains an alphabetical listing of payments made by the MSC to practitioners, groups, clinics, hospitals, and diagnostic facilities for each fiscal year.

The work of the MSC is superbly supported by staff of Doctors of BC, the Ministry of Health, and the MSC. Their diligent and admirably competent work remains much appreciated.

—Brian Gregory, MDSenior Doctors of BC Representative

MEDICAL SERVICES COMMISSION OF BRITISH COLUMBIADOCTORS OF BC: DRS B. GREGORY, B. NORTON, B. RIFE. GOVERNMENT: MR T. VINCENT, CHAIR; DR R. HALPENNY, MS S. TAYLOR. PUBLIC MEMBERS: MS C. COLLINS, MS I. MACKENZIE, MS M. MAHLMAN.

The Medical Services Commission (MSC) is a nine-member statutory body composed of three representatives from government, three members nominated by Doctors of BC, and three public members who are nominated jointly by Doctors of BC and government to represent MSP beneficiaries. Appointments to the commission are made by the lieutenant governor in council.

The MSC manages the Medical Services Plan (MSP) on behalf of the Government of British Columbia in accordance with the Medicare Protection Act and Regulations. The MSC schedules approximately 10 one-day meetings annually in either Victoria or Vancouver; an annual planning day has been added to the meeting schedule in each of the last 2 years.

MandateThe mandate of the MSC is to facilitate reasonable access throughout BC to quality medical care, health care, and diagnostic facility services for BC residents under MSP.

ResponsibilitiesThe responsibilities of the MSC are twofold: to ensure that all BC residents have reasonable access to medical care, and to manage the provision and payment of medical services in an effective and cost-efficient manner.

The MSC directly oversees physicians’ fee-for-service budget of approximately $2.6 billion. About 99% of these funds go directly for payment of medical services insured under MSP. The other 1% covers administrative and operational costs of the MSP, including salaries of MSP employees. The MSC also signs off on over $1 billion of services that are not within the fee-for-service budget, and over which the MSC has less direct responsibility and oversight.



Further updates will be provided as negotiations progress. I would like to thank the Negotiations Department staff for supporting the negotiations committees over the past year. Thank you to the NCG and SNC members who sacrifice many days and have to reschedule their offices and personal lives in order to accommodate the rigorous demands of attending the negotiations meetings.

—David Attwell, MDChair

NEGOTIATIONS FORUMDRS D. MCTAGGART, CHAIR; Y. BAWA, C. BOOTH, I. COURTICE, J. CUNNINGHAM, S. GOODCHILD, B. GREGORY, D. HAUGHTON, B. HENRY, A. RUDDIMAN, K. SCHULTZ, W. SIU, N. WALTON, I. WATERS. NON-VOTING MEMBERS: DR D. ATTWELL, MR P. STRASZAK. STAFF: MR J. AIKMAN, MS T. KEEFE, MR T. MACPHERSON.

Reporting to the Doctors of BC Board, the Negotiations Forum (NF) is charged with developing recommendations on mandates for ne-gotiations between Doctors of BC and any external organization, including the provincial government and WorkSafeBC. Additionally, the NF conducts a review of each set of provincial negotiations once they are concluded.

The NF met three times in 2013, in May and October, to develop input for the Board regarding the compensation reopener negotiations.

At the first meeting Mr Paul Straszak (executive director of negotiations) reviewed member input into the negotiations process, including themes that arose from individual meetings and the results of the compensation reopener survey. He reviewed the components of a mandate, the process to create a negotiations mandate, an assessment of the negotiations environment, and the approval process. The NF discussed several core objectives recommended by the Negotiations Coordinating Group (NCG) and reviewed a comprehensive list of proposals recommended by the NCG. The NF discussed in depth the submissions received from sections, individual Doctors of BC members, joint

NEGOTIATIONS COORDINATING GROUPDRS D. ATTWELL, CHAIR; P. ASQUITH, H. FOX, D. ISRAEL, F. KOZAK, G. MACKIE, A. RUDDIMAN, H. STRECKER, D. WILTON (SNC). GUEST: T. LARSEN SOLES. STAFF: MR J. AIKMAN, MS T. KEEFE, MR T. MACPHERSON, MR P. STRASZAK.

The Negotiations Coordinating Group (NCG) reviews the general negotiations strategy and mandate, makes specific proposals, and provides input into the negotiations as they progress. The NCG meets regularly during negotiations and as required at significant decision points during the negotiating process. The group’s members represent a wide constituency of the profession and advise the negotiating team to ensure that every constituency is considered fairly.

The year 2013 saw the development of a comprehensive negotiating position consistent with what was gleaned from the extensive consultation process with almost every specialty section, General Practice, and our representatives on the Specialists Services Committee, the General Practice Services Committee, the Joint Benefits Committee, Rural and APP representatives, and formal proposals from many. In October the Doctors of BC Board of Directors approved the negotiations mandate and strategy based on those consultations.

I can assure the membership that the negotiating team is very well prepared for the negotiations, with a comprehensive set of proposals to address the needs of physicians and the health care system in which we work. The current fiscal climate presents significant challenges for our profession, and this requires us to be creative in our approach.

In this context, the Statutory Negotiating Committee (SNC) has been active in meeting with government to achieve a new PMA as part of the mandate from the Doctors of BC Board of Directors. The table has met almost weekly, and progress has been slow as each side tries to understand and respond to the other’s positions.

At this juncture it is not possible to predict if the current negotiations will succeed; however, this uncertainty is part and parcel of all negotiations, and time will tell.

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PATTERNS OF PRACTICE COMMITTEEDRS K.J. WHITE, CHAIR; L. VERHULST, VICE-CHAIR; E. PAETKAU. COLLEGE OF PHYSICIANS AND SURGEONS: DR A. SEAR. BILLING INTEGRITY PROGRAM: DR V. DAVIS. STAFF: DR S. BUGIS, MS J. GRANT, MS T. HAMILTON, Mr R. HULYK.

The Patterns of Practice Committee (POPC) identified three objectives it wished to pursue in 2013. These were presented to the Doctors of BC Board of Directors and the Medical Services Commission (MSC) and were supported at both levels.

These objectives are: • Re-engage the POPC as an advisory committee

to the MSC.• Explore and develop education opportunities.• Improve the audit process, communications, and

oversight.Several activities occurred in 2013 in support of

these objectives. The POPC has requested and been granted permission to send a representative to any and all Audit and Inspection Committee meetings as a guest, in addition to the Doctors of BC representative. This will allow for better communication and alignment between the two committees.

One concern expressed by both the POPC and the Billing Integrity Program (BIP) regarded the length of time it was taking to complete audits. There will always be exceptions and fluctuations; however, with several changes, the time of completion has dropped on average to around 9 months or less. We will continue to work with the BIP on improving the process and providing communications to physicians regarding the process.

Improvements were made in terms of the timing of communications with physicians during the audit process. A column was written in the October 2013 issue of the BC Medical Journal, providing a description of the process.

Looking ahead to 2014, the POPC will pursue three key activities:• The significant development of billing and audit

information that will appear on the new Doctors of BC website.

committees, and staff to confirm that all submissions had been dealt with appropriately in the 2014 reopener proposals. The NF approved the 2014 compensation reopener core objectives and proposals as presented. While the discussions ended with clear consensus, the core objectives and proposals were put to a formal vote and passed unanimously.

In October the NF met in a combined meeting with the members of the NCG to update and refine core objectives and proposals. After a fulsome discussion, the combined group agreed by consensus to approve the framework for negotiations and to support the updated core objectives. The mandate and core objectives were presented to the Doctors of BC Board on 25 October 2013, and after additional discussion they were approved.

All recommendations of the NF were reached by consensus and had the unanimous support of the members.

To achieve balance and complete input into the work of the NF, members are selected for staggered renewable 3-year terms. They are selected to offer insight and experience from varied constituencies, but then work effectively to represent the interests of all BC physicians.

In the course of the year, Drs Shukin, Hughes, Dykstra, and Larsen Soles stepped down. I would like to thank them for their years of service on the committee.

New members joining the committee for 3-year terms are Drs Yusuf Bawa (GP, mid-size community), Ian Courtice (specialist at large), Johann Cunningham (specialist, surgical), Steven Goodchild (GP, urban), and Dr William Siu (specialist, diagnostic).

In conclusion, I would like to offer thanks to my fellow NF members for their diligent and constructive participation, and to the Doctors of BC staff for their excellent support.

—Douglas W.R. McTaggart, MDChair



quarterly this past year. Three of the four meetings were teleconferences, and one was an all-day workshop in person. In August 2013 Dr Samantha Kelleher, who had represented the College of Physicians and Surgeons on the committee, relocated to Manitoba and was replaced by Dr Ailve McNestry, who is now the deputy registrar responsible for physician monitoring.

Although meeting frequency decreased, intensity increased, as the committee grappled with difficult decisions regarding the refinement and approval of a strategic plan for the program. Many good ideas are circulating in the community about services the program could provide. However, there are not enough resources with the current funding to implement all these ideas sustainably. At this point, the committee does not have enough certainty about the wishes of stakeholders to make those decisions responsibly. Therefore, the committee instead approved an interim strategic plan: maintain existing services while gathering the information needed to make important and difficult decisions in future. The plan calls on the program to speak individually to representative stakeholders through semi-structured interviews supplemented by other informal input-gathering activities. The results of these conversations will be summarized and reported. By completing the activities contained in the interim plan, the committee will be able to make important and difficult decisions with clarity and transparency. The three key objectives in this interim plan are:• Continue to refine and improve client services.• Enhance program governance and administration. • Strengthen relationships between the Physician

Health Program and those it serves.The program made an important transition this

year by selecting a new organization as a strategic partner to provide its member-assistance service. Now the program is able to implement service-level agreements so that the quality of member services can be monitored and continually improved.

—S.H. Lu, MDDoctors of BC Representative

• The move of the mini-profiles online in 2013. Previously, profiles were mailed to members. The launch of the new Doctors of BC website achieved cost savings and easier access for our members. In 2014 we intend to enhance the online version to make it more user-friendly.

• The production and promotion of billing articles and tips. Working with the BIP, we have identified the top 10 billing errors, and we will produce articles on each topic. The POPC will have a regular column in each edition of the BC Medical Journal for 2014, designated for issues identified by both the POPC and the BIP. In May 2013 the POPC was asked to send a letter

to the top 50 physicians whose ordering patterns were between 3 and 9 standard deviations above the mean on certain lab tests. The educational letter was sent with a request for a response from the physicians as to the reason for the high ordering. These letters resulted in a 40% reduction in the utilization of outpatient lab tests for these physicians.

From the responses, the committee identified a series of common gaps and/or reasons that need to be investigated further. This could indicate the need for guidelines or other educational resources to address these gaps.

The POPC believes there are opportunities to do things better. Foremost among these is the need to improve and expand physicians’ training and education about billing. We must also continue to improve the processes in place and ensure they are fair and reasonable.

—Keith J. White, MDChair

PHYSICIAN HEALTH PROGRAM STEERING COMMITTEEDRS D.L. WILLIAMS, CHAIR; Y. BAWA, S.H. LU, A. MCNESTRY, MR. K. WARREN. STAFF: DR A. CLARKE, EXECUTIVE DIRECTOR.

The Physician Health Program Steering Committee reduced the frequency of meetings from monthly to

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Integration of chronic disease management practices into EMRs has been assessed through the Clinical Usability and Sustainability Project (CUSP), a collaborative effort between PITO and PSP, using diabetes mellitus as the model disease to identify and try to address gaps in EMRs’ abilities to most effectively support chronic disease management by physicians. The CUSP project was expanded to develop processes to embed the PSP’s musculoskeletal and pain module tools, resources, and workflow into a number of EMR products.

Nine BC physician communities completed innovation and diffusion projects (IDPs), to stretch the capability of EMR into new areas. These projects established and evaluated new functionality to support electronic referral (e-referral) between GPs and specialists using different EMRs; patient portals allowing patients to access and contribute to their charts, schedule visits, and communicate online with their doctors; producing primary care indicators to support practice self-reflection in support of quality improvement and population health assessment; patient data sharing between a nurse practitioner and a family physician; data sharing between family physicians on call; and developing the technology to use data from EMRs to provide information about patient and population health. These projects have provided immediate value within their communities; moreover, they have provided valuable insights into future opportunities for IT support in the areas of referral management, patient access, team-based care, and practice reflection.

Objective Data Dashboard conformance is complete by five EMRs and rolling out, with two others in progress. The EMR-2-EMR data transfer specification conformance is complete with at least one vendor, and in progress with five other vendors. The Joint Integrated Practice Support Task Group interim report was finalized and endorsed, providing recommendations for an integrated practice support model, including practice coaching, self-reflective learning, and Practice Support Program module integration into multiple EMR platforms. The program evaluation report was completed by independent consultants and showed that PITO met or exceeded all of the goals and

PHYSICIAN INFORMATION TECHNOLOGY OFFICE STEERING COMMITTEEDOCTORS OF BC: DR B. HOBSON, CO-CHAIR; DRS C. COLLINS, D. RICCI. GOVERNMENT: MS L. KISLOCK, CO-CHAIR; MR P. BARKER, MR K. WARREN.

In 2013/14, the Physician Information Technology Office (PITO) surpassed the goal of 85% of target full-service family practice (FSFP) and specialist physicians in BC having implemented an EMR. Dur-ing this same time, there was significant progress toward maximizing the effective use of those EMRs through post implementation support and communications interfaces (“interoperability”).

PITO wound up its EMR adoption mandate with 91% of all target physicians on EMR by 31 March 2014. Of targeted GPs, 92% are now on EMRs, and 89% of targeted specialists are now on EMRs. Most gaps in EMR adoption have been addressed, with physicians nearing retirement in one- or two- physician offices in large urban centres, and physicians in walk-in clinics being the majority of those not yet on EMRs. With natural attrition due to retirement alone, it is anticipated that 95% of all BC physicians will be on EMR within the next 3 to 5 years.

There has been great success in the Post Implementation Support (PIS) Program, established in collaboration with the Practice Support Program (PSP) and local Divisions of Family Practice. The PIS Program provides support in the form of PITO/ Doctors of BC staff, physician and MOA peer mentors, user groups, advanced vendor training, and compensation for time out of practice to learn and adapt new and powerful areas of the EMR, with a focus on supporting proactive preventive care and chronic disease management, and practice self- reflection in support of quality improvement. Over one-third of physicians on EMRs are now involved in post implementation support with an aim to achieving Meaningful Use Level 3. With the conclusion of the PITO project, the PIS program will be continued under the auspices of GPSC, with a goal over the next year to get most of the province’s physicians to this meaningful level of EMR use.



The mandate of the Provincial Surgical Advisory Council (PSAC) is to share expert knowledge and provide strategic advice on a broad range of projects that relate to surgery. Strategic guidance from the council may involve but will not be limited to:• Reviewing provincial surgical utilization data to

identify and/or advise on emerging trends and patterns.

• Advising on and reviewing strategic direction and framework documents.

• Advising on and reviewing the recommendations of expert panels and task groups related to surgery, including the Surgical Patient Registry.

• Identifying and advising on future areas of focus.Membership on the council includes clinical and

administrative leads from each of the health authorities’ surgical councils and will be co-chaired (on a rotating basis) by a representative of the Ministry of Health Services and a designated health authority clinical lead. The council also includes representation from Doctors of BC, the BC Patient Safety and Quality Council (BCPSQC), and the Provincial Musculoskeletal Advisory Group.

PSAC continues to try to actively engage the Ministry of Health Services, health authorities, and surgeons in the care of surgical patients.

A review of the Patient Prioritization Codes (waiting time recommendations based on diagnoses and their urgency), started in 2010, is underway. Preliminary reviews have begun with Orthopaedics and General Surgery.

Electronic booking of elective OR slates continues to be an area of focus, though it is not yet near the implementation stage.

BCPSQC continues to be a partner in the oversight of surgical care. It is offering two programs that address various aspects of perioperative care—the Productive Operating Theatre and the Coordinated Unit Based Safety Program.

PSAC continues to monitor wait times for surgical procedures, using the Surgical Patient Registry. This has allowed attention to be brought to some of the most serious problems.

PSAC wants to address Wait One—the time from referral to consultation. Through the Specialist

deliverables set out in the 2007 and 2012 Physician Master Agreements.

One of the enduring values of the project beyond EMR adoption will be the data that PITO has gathered and maintained. PITO has established the only comprehensive database of all physicians in the province that is organized by clinic, with up-to-date information on clinic type, status, physicians, MOAs, etc. Continuing to maintain and integrate this information on an ongoing basis will be important for all of the joint programs.

With the conclusion of the EMR adoption project and the PITO program office, ongoing EMR post implementation support programs will continue with funding from GPSC and SSC. Ongoing administration of the government’s Private Physician Network will transfer to Health Shared Services BC.

The full potential of EMR use has yet to be realized, with challenges yet to be overcome. Work must continue to address interoperability, leveraging EMR data to help measure health care outcomes, support physicians’ learning, and improve health care provider and patient satisfaction.

—Bruce Hobson, MDCo-chair

PROVINCIAL SURGICAL ADVISORY COUNCILDRS M. BHALLA, CO-CHAIR; A. HAMILTON, CO-CHAIR; HEALTH AUTHORITY REPRESENTA-TIVES FOR SURGERY: DRS P. BLAIR (FHA), D. BROSSEUK (IHA), N. VAN LAEKEN (VCHA). DRS J. ARNEJA (BC CHILDREN’S), R. DYKSTRA (MINISTRY OF HEALTH), C. BALISKI (BC CANCER AGENCY), K. HUGHES (PROVINCIAL MUSKULOSKELTAL ADVISORY GROUP), B. MASRI (PROVINCIAL MUSKULOSKELTAL ADVISORY GROUP), E. SKARSGARD (BC CHILDREN’S), M. STANGER (DOCTORS OF BC). REPRESENTATIVE FROM PHSA (SURGICAL PATIENT REGISTRY): S. SAINAS. REPRESENTATIVE FOR ADMINISTRATION FROM EACH HEALTH AUTHORITY. REPRESENTATIVE FROM BC PATIENT SAFETY AND QUALITY COUNCIL.

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RURAL ISSUES COMMITTEEDRS A. RUDDIMAN, CHAIR; G. APPLETON, G. AVERY, C. JONES, P. MACKEY, E. MARQUIS, J. SOLES, M. JOHNSTON (ALTERNATE), C.S. JOHNSTON (ALTERNATE), P.-D. WAUTHY (MEDICAL RESIDENT). STAFF: MR J. AIKMAN, MS M. CORMIER, MS M. CREW, MS T. HOOPER.

The Rural Issues Committee (RIC) is a standing committee of the Doctors of BC Board that advises on issues affecting rural medicine and the working conditions of physicians practising in rural areas of BC. Through the Doctors of BC Board, the committee is also responsible for providing direction for rural negotiations with government. This was certainly the case for 2013/14, as the RIC set a number of priorities for the Doctors of BC negotiations team to consider with the Physician Master Agreement negotiations.

The RIC was instrumental in assisting the Joint Standing Committee on Rural Issues (JSC) to set aside funding to aid communities that continue to face challenges maintaining a sustainable health service delivery system. Pilot projects in each of the health authorities will take place in 2014.

The bylaw change made by the College of Physicians and Surgeons regarding requirements to determine eligibility for those physicians entering BC on provisional licences has had a significant impact on rural BC. Health Match BC estimates that over the last 2 years rural BC has had a net loss of approximately 160 physicians due to the change. The RIC continues to work with the province to develop an appropriate assessment tool to ensure that a process is in place for those physicians coming to BC on provisional licences who wish to work in rural BC. As well, the RIC recommended that the JSC provide funding to help support supervising physicians, and the JSC will implement the recommendation sometime in mid-2014.

The RIC continues to debate various critical issues affecting rural physicians, including the current process underway with provincial privileging and patient transport in rural areas.

As chair of the RIC, it has been a pleasure to work with a knowledgeable and resourceful committee

Services Committee, the Provincial Musculoskeletal Advisory Group, along with General Surgery, also has a project going on Wait One. If successful, this will be expanded to other groups.

—Michael Stanger, MDDoctors of BC Representative

REFERENCE COMMITTEEMEMBERSHIP: CONFIDENTIAL

The Reference Committee acts upon requests from physicians, in an advisory capacity to the Medical Services Commission, on the adjudication of billing and payment disputes between physicians and the Medical Services Plan of BC (MSP).

During 2013, 43 new cases were referred to the Reference Committee. Of these cases, five were resolved prior to review and four were re-reviewed at the request of the MSP. Fifteen cases were carried over to 2014 and will be reviewed at the June meeting.

For the first time a case has been referred to the MSC for review, as the Reference Committee and MSP could not agree on the final recommendation. As per the terms of reference, if, following the appeal process, the physician or MSP continues to disagree with the opinion from the Reference Committee, the case may be referred to the Medical Services Commission for final adjudication.

The committee would like to express its appreciation for the support of the Doctors of BC staff: Dr Sam Bugis, Mr Rob Hulyk, Ms Juanita Grant; the Tariff Committee; and MSP personnel: Ms Valerie Johnson, billing rules advisor, for preparing the cases for the committee’s review. Dr Ray Dykstra has taken on the role of medical consultant, replac-ing Dr Abe Karrel. The committee looks forward to working with Dr Dykstra in his new capacity.

—ChairReference Committee



Family Development—as well as the RCMP, seven Divisions of Family Practice, the Interior Health Authority, school districts, Aboriginal services, youth, and their families. The focus is on communication barriers, service delivery gaps, and coordination of care for children and youth with mental health issues.

Lessons learned and discussions of next steps have taken place at three learning sessions since the start of the collaborative. A final summit, Spread and Sustainability, will take place in the fall of 2014.

Polypharmacy Phase 1 Wrap-Up The first phase of this initiative achieved significant traction in residential care facilities in several communities. The interim evaluation for the residential care prototype phase has been finalized and results will be shared shortly. The next phase in acute care began with discussions at the health authority level, and is now being prototyped.

Information Management and Supporting Technology (IMAST) Working Group This group was established to create an inventory of current IM/IT projects under the Joint Clinical Committees and provincial e-health initiatives. The goal is to prevent duplication of efforts, identify gaps, ensure alignment, and provide opportunities to leverage existing prototypes for cost-effective-ness and efficiencies of future projects. A final report on the project is currently in development.

Partners and Transitions in Care initiatives These initiatives have been successful in bringing specialists and family physicians together to help streamline and bridge gaps in care for their patients; in addition to engaging other partners, including health authorities, 25 local Divisions of Family Practice, postsecondary institutions, and nonprofit organizations.

Rapid Access to Psychiatry initiative This initiative continues to see positive results from its group medical visits program at the Mood Disorders Association of BC. This program has expanded to include Langara College, which is now hosting group medical visits for students with ADHD.

this past year. Drawn from across the province, this diverse group of rural physicians represents a true repository of expert knowledge on all matters.

Doctors of BC, through the RIC, is well resourced with both GP and specialist representation on the provincial JSC. It is my pleasure to thank the committee members for their work over the past year. Because of our scattered geography, some of our meetings are held by teleconference rather than face to face, but even so, they take up a significant amount of time for busy physicians.

As always, our staff support has been excellent, and for this my thanks go to Jim Aikman, Meredith Cormier, Mallory Crew, and Tania Hooper.

—Alan Ruddiman, MDChair

SHARED CARE COMMITTEEDR G. HOAG, CO-CHAIR; MS K. MCQUILLEN, CO-CHAIR; MR K. BROWN, DRS K. HUGHES, G. MAZOWITA, S. ROSS, G. WATSON.

In 2013 Shared Care Committee (SCC) projects continued to expand across the province, demonstrating increased physician engagement and participation in a wide range of improvement activities. To date, over 2500 family physicians and more than 240 specialists are engaged in Shared Care initiatives.

The collaborative and grassroots approach of the projects funded by the SCC has proved very successful in bringing together the health care community and strengthening relationships that improve both the health care system and the patient experience.

Child and Youth Mental Health and Substance Use Collaborative (CYMHSU) One of the largest initiatives under the SCC portfolio is CYMHSU, formed to address the lack of timely access to mental health services for many children, youth, and their families. The collaborative brings together more than 150 individuals representing three ministries—Ministry of Health, Ministry of Education, and the Ministry of Child and

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SPECIALIST SERVICES COMMITTEE DOCTORS OF BC: DRS S. VIRANI, CO-CHAIR; I. COURTICE, G. HOAG, K. SEETHRAM, A. ATTWELL (ALTERNATE), A. KARIMUDDIN (ALTERNATE), K. HUGHES (SHARED CARE REPRESENTATIVE). GOVERNMENT: MS K. MCQUILLEN, CO-CHAIR; DR T. BAIDWAN, MR K. BROWN, MR J. HIGGS, MS E. HENRY (ALTERNATE). HEALTH AUTHORITIES: DRS T. BAIDWAN, R. CHAPMAN (ALTERNATE), S. GRAY (ALTERNATE), R. MORTON (ALTERNATE), A. STEWART (ALTERNATE), B. WAGNER (ALTERNATE). GUESTS: MR C. BARBER, MS A. GODIN, MR G. TAYLOR. SSC STAFF: MS A. ADAMS, MS C. BECK, MR A. LEUNG. GOVERNMENT STAFF: MS C. HARPER, MS N. JOHANSEN, MS S. ROBIN-SON. DOCTORS OF BC STAFF: MS M. ADAIR; MR J. AIKMAN, DR S. BUGIS, MS M. CORMIER, MS M. CREW, MS K. FRITZ, MS T. HOOPER, M. R. HULYK, MS A. MACDONALD.

The Specialist Services Committee (SSC) was created in the 2006 Physician Master Agreement. It is a joint committee between Doctors of BC and Ministry of Health Services, with participation of the health authorities. Under the 2012 Physician Master Agreement and the Specialists Subsidiary Agree-ment, the SSC’s allocation for 2013/14 was $52.3 million in ongoing funding.

The SSC developed a work plan for 2013/14 based on a strategy promoting specialist quality and innovation. The work plan focuses on three priority areas:• Stakeholder engagement and strategic planning,

which aims to increase ongoing SSC communication and consultation with specialists, and to improve engagement and relationships between specialists and health authorities.

• Support delivery of specialist services, which maintains and improves existing SSC fees such as telephone advice, group medical visits, discharge care planning, advance care planning and labor market adjustment fees, as well as SSC initiatives such as health system redesign funding and leadership training scholarships.

• Advancing quality improvement in specialty care, which funds local and provincial specialist-led quality improvement initiatives and projects and

Teledermatology initiative With the addition of six new dermatologists over the past year, this initiative has exceeded 1000 consults. Ten dermatologists are now participating in the program, and many more communities throughout BC have access to this service.

Youth Transitions initiative This initiative continues to see progress in ensuring that youth with chronic health conditions and disabilities have ongoing access to primary care providers and appropriate specialists from age 12 through transfer to adult care.

Practice Support Program (PSP) The Shared Care Committee supports three PSP modules: Pain, Musculoskeletal, and CORD/HF. The Pain Management module helps physicians to iden-tify, assess, manage, and better communicate with patients who have persistent pain, helping them return to a higher level of function. EMR templates have been developed for all pain tools; these are currently being beta tested by the physicians, with the aim of having final versions of these tools ready for the roll-out in early fall. The Pain Management module held its first provincial session in the fall of 2013 and is now proceeding through the action period phase and preparing for the second provincial session on 30 April.

The Practice Support Program Musculoskeletal module is being piloted in four health authorities, and the PSP for patients with COPD and heart failure is being delivered across the province. Funding and scholarship initiatives for physician participation in health system redesign and leadership training are continuing with the addition of some enhancements.

On 24–26 October 2013 the Shared Care Committee held its second provincial showcase in Vancouver to highlight each of the initiatives and to show how they are enabling family and specialist physicians to work together to provide coordinated, continuous, and comprehensive patient care.

—Gordon Hoag, MD Co-chair



STATUTORY NEGOTIATING COMMITTEEDRS D. ATTWELL, CHAIR; H. FOX, F. KOZAK, T. LARSEN SOLES (GUEST), G. MACKIE, D. WILTON. STAFF: MR J. AIKMAN, MR T. MACPHERSON, MR P. STRASZAK.

The year 2013 saw the development of a compre-hensive negotiating position consistent with what was gleaned from the extensive consultation process with almost every specialty section and General Practice, as well as with our representatives on the Specialists Services Committee, the General Practice Services Committee, the Joint Benefits Committee, Rural and APP representatives, and formal proposals from many. In October the Doctors of BC Board of Directors approved the negotiations mandate and strategy based on those consultations.

The negotiating team is very well prepared for the negotiations, with a comprehensive set of proposals to address the needs of physicians and the health care system in which we work. It is clear that the current fiscal climate presents significant challenges for us as a profession, and this requires us to be creative in our approach. In this context, the Statutory Negotiating Committee (SNC) has been meeting actively with government to achieve a new Physician Master Agreement as part of the mandate from the Doctors of BC Board. The table has met almost weekly, and progress has been slow as each side tries to understand and respond to the other’s positions.

At this juncture it is not possible to predict if the current negotiations will succeed; however, this uncertainty is part and parcel of all negotiations, and time will tell. Further updates will be provided as negotiations progress.

I would like to thank the Negotiations Department staff for supporting the negotiations committees over the past year. Thank you to the SNC members who sacrifice many days and have to reschedule their offices and personal lives in order to accommodate the rigorous demands of attending the negotiations meetings.

—David Attwell, MDChair

develops regional quality improvement infrastructure and resources to support specialists in participating and leading quality improvement efforts and initiatives.In 2012/13 the SSC approved funding for 21

quality and innovation initiatives, using $8 million in one-time funding. The funding supported specialist physician-led initiatives that improve the quality and efficiency of specialist care, as well as improved access for patients. In 2013/14 the SSC continued to support and work with approved projects, which are beginning to demonstrate very positive outcomes.

Leveraging some of these positive and innovative projects, the SSC worked on opportunities to scale up and spread some of the promising initiatives and also planned to launch another round of one-time funding to support specialist-led quality improve-ment ideas.

SSC hired dedicated staff and established three working groups with expanded representation and participation of specialists, Ministry of Health representatives, and health authority representatives to support the further development and implementation of the SSC’s work plan.

The committee’s Doctors of BC co-chair transitioned from Dr Ken Seethram to Dr Sean Virani. On behalf of the SSC, we would like to thank Dr Seethram for his contributions and leadership as SSC co-chair over the years. The SSC would also like to thank Ms Kelly McQuillen for her role as Ministry of Health co-chair, which ended in April 2014.

The 2014/15 year, promises to be very active, with considerable new opportunities to further enhance supports for specialists and continued efforts to implement the SSC’s current strategy and work plan.

—Sean Virani, MD Co-chair

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fee structure more clearly.• Reviewing recommendations from MSP to de-list

or revise suggested fee codes in order to manage the MSP available amount. This task was completed with input from the sections. Generally, the tasks make for monthly meetings

with very full agendas.Once again, thank you to all involved who help

with the successful functioning of this committee.

—Brian Winsby, MD Chair

WORKING COMMITTEE TO REVIEW OUTPATIENT DIAGNOSTIC REQUISITION FORMS (REQUISITION COMMITTEE) DRS C. CLELLAND, CO-CHAIR; J. PHILLEY, CO-CHAIR (MINISTRY OF HEALTH); DOCTORS OF BC: DRS P. WHITE, T. MAUNG, R. WELSH (GP ALTERNATE); MINISTRY OF HEALTH: MR W. TOURNQUIST; MINISTRY OF HEALTH STAFF: MS D. JANES; DOCTORS OF BC STAFF: DR S. BUGIS, MS F. FERDOWSI.

The Requisition Committee has been active over the past year through one in-person meeting in September and three teleconference meetings in each calendar quarter. The committee continues to work closely and collaborate with the Ministry of Health team as well as with the BC Association of Laboratory Physicians, the BC Radiology Association, the College of Midwives of BC, and the Provincial Colon Cancer Screening Program on the development and revision of standard outpatient forms.

The committee has drafted a revised terms of reference and is actively reviewing its strategic direction with a goal of clarifying the committee’s mandate in view of the ever-changing landscape of e-health. To improve efficiency of workflow, the committee has developed a workplan template, a tracking tool for monitoring the progress of the development of or revisions to standard outpatient requisitions, as well as a requisition development/revision request form. The committee has worked to align its processes with other committees, such as

TARIFF COMMITTEEDRS B. WINSBY, CHAIR; D. BRABYN, E. CADESKY, J. MAHY, R. MOORE, E. SHUKIN, P. STEINBOK, M. SZPAKOWICZ. MSP: DR R. DYKSTRA, MR J. HIGGS, MS C.A. MCNEILL. STAFF: MR J. AIKMAN, MS L. HARTH, MS J. OFFICER, MR R. TIAGI.

The Tariff Committee welcomed new member, Dr Mikolaj (Nick) Szpakowicz, and MSP advisor, Dr Ray Dykstra. We bid farewell to Dr Ross Chang with our thanks and gratitude for his many years of service to the committee.

We, as a committee, rely totally on our staff for agenda and guest presentations, report and application guidance and structure, background information, liaison with sections, connecting with MSP, and all other workaday functions. This in turn allows the committee to be the usual fiscal connection with the Ministry of Health.

We attempt to meet monthly, or as required, with MSP staff attending the meetings in an exercise of mutual persuasion as we try to advance the commercial liaison between doctors, sections, staff, and government. The committee reviews new procedures and fees, changes to fee levels, and interpretation of the payment policies and preambles to come to common understanding between parties. We encourage sections to meet directly with MSP representatives on proposed changes to work out differing opinions, come to agreement on what is doable in accordance with current guidelines, address expected fiscal impact, and determine appropriate funding to streamline our formal tariff presentations. Some of the committee’s accomplishments over the past year include:• Implementing of the 2012 Recruitment and

Retention funds.• Establishing of a working group to review the

payment policies related to multiple consultations and transfer of care.

• Meeting with the Society of General Practitioners of BC to review changes to the GP Telehealth fee schedule.

• Approving major revenue-neutral revisions to the plastic surgery fee guide.

• Revising the medical-legal fee guide to define the



WORKSAFEBC NEGOTIATIONS COORDINATING GROUPDRS B. CHEYNE, CHAIR; P. ASQUITH, E. CHANG (AS OF MARCH 2014), S. DJURICKOVIC, H. FOX (TO FEBRUARY 2014), T. GOETZ, C. KOTZÉ, J. MASON, E. WEISS. STAFF: MS T. KEEFE.

The WorkSafeBC Negotiations Coordinating Group (NCG) comprises eight physician members and is supported by the Doctors of BC Negotiations Department staff. Dr Hymie Fox, SGP representative, stepped down in February 2014, and I would like to thank him for his years of service on the committee. Dr Ernest Chang has replaced Dr Fox as of March 2014. On behalf of the committee, I would like to thank Mr Peter Kafka, a consultant to Doctors of BC, who was instrumental in assisting with the negotiations in 2013 in the capacity of chief spokesperson.

Consistent with its terms of reference, the WSBC NCG developed the mandate and oversaw the negotiations that took place in 2012/13. Negotiations were for both formal agreements with WSBC: the fee-for-service/sessional agree-ment and the salaried physicians agreement. After negotiations were finalized in early summer 2013, the WSBC NCG forwarded both agreements to the Negotiations Forum and the Board of Directors with an endorsement for ratification. Both agreements were successfully ratified in August 2013.

Both the current fee-for-service/sessional and salary agreements have terms through to 31 March 2014. Therefore the WSBC NCG is currently in the process of being reconvened to commence the development of the mandate for the upcoming round of negotiations.

—Robert Cheyne, MD Chair

the Guidelines and Protocols Committee. I would like to thank the committee members for

their hard work, insight, and diligence during the past year. I would also like to give a special thank-you to both the Ministry of Health and Doctors of BC staff, whose hard work makes our committee’s efforts effective.

—Catherine Clelland, MDCo-chair

WORKSAFEBC FEE-FOR-SERVICE AND SALARY NEGOTIATING COMMITTEEDRS B. CHEYNE, CHAIR; P. ASQUITH, S. DJURICK-OVIC, T. GOETZ, C. KOTZE. STAFF: MS T. KEEFE.

The WorkSafeBC Negotiating Committee comprises five physician members and is supported by Doctors of BC Negotiations Department staff.

The Negotiating Committee was active in 2013, participating in direct negotiations with WSBC for both the fee-for-service/sessional agreement and the salaried physicians agreement. After several weeks of discussions through spring, the committee finalized draft agreements in early summer of 2013. The WSBC Negotiations Coordinating Group then recommended the agreements to the Negotiations Forum and the Board of Directors with an endorse-ment for ratification. Both agreements were successfully ratified in August 2013.

On behalf of the committee, I would like to thank Mr Peter Kafka, a consultant to Doctors of BC, who was instrumental in assisting with the negotiations in 2013 in the capacity of chief spokesperson.

Both the current fee-for-service/sessional and salary agreements have terms through to 31 March 2014. Therefore, the WSBC Negotiating Committee is currently in the process of being reconvened for the upcoming round of negotiations.

—Robert Cheyne, MD Chair

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events like this and that they would attend one again in the future.

The following reports were submitted by individual sections.

SECTION OF CLINICAL FACULTY DRS D.H. SMITH, HEAD; D. WENSLEY, PAST PRESIDENT; K. EMMOTT, TREASURER. MEMBERS-AT-LARGE: DRS D. ETCHES, N. FINDLEY-SHIRRAS, D. HAUGHTON, A. RAE.

This has been a relatively quiet year in that I cannot remember a single issue of controversy being raised by any of our members. This is a positive sign, as in the past, we faced many crises on an annual basis.

My biggest concern is that we have been unable to establish any significant negotiating forum with the University of British Columbia. Through our work with Doctors of BC, it has been decided that there will be “discussions” between Doctors of BC and the Faculty of Medicine, but these discussions are nonbinding. There has been little enthusiasm for carrying on these discussions this year. We have been represented by Dr David Haughton, but the committee has not met in many months. This may be due to there being a change in the associate dean for clinical faculty.

It has now been established that individuals from the clinical faculty stream are eligible to apply for emeritus status upon their retirement. This would have to be initiated through the department head.

We have participated in the Canadian Association of University Teachers Committee on Clinical Faculty and Academic Freedom for the past 10 years. Its mandate is to protect academic freedom at all 17 Canadian medical schools. This committee has been active in defending the Therapeutics Initiative and has just published a report looking at relationships between universities, hospitals, and industry, including the Vancouver Prostate Centre.

I want to thank outgoing associate dean for Clinical Faculty, Dr Rob Liston, and welcome the incoming associate dean, Dr Gurdeep Parhar. We look forward to working with Dr Parhar.

—Derryck H. Smith, MD Head

SECTION SERVICESThrough the Department of Physician and External Affairs, Doctors of BC provides support to 42 sections and affiliated societies. Services are provided at no cost to the sections and include a range of meeting, accounting, and other support. In 2013 the department supported 24 section annual general meetings as well as 22 executive meetings. A total of 28 sections completed evaluations of Section Services with 90% of responses received indicating they were satisfied—breakdown rate: 36% satisfied and 54% very satisfied with the support they received from their coordinators.

In addition, in 2013 the department held three section events. The topics and evaluation results were as follows:

Privileging Information Seminar— Saturday, 2 February 2013 The seminar’s objective was to provide background on the Provincial Privileging Steering Committee’s Expert Panel stemming from the Cochrane Reports. Thirty physicians from 25 sections attended, and 100% of the physicians stated that it was informative and they would attend similar seminars held by Doctors of BC in the future.

SSC Workplan Overview—Thursday, 18 July 2013 This event was hosted to provide section representatives with information on the Specialist Services Committee’s 2013/14 work plan and funding. A total of 29 physicians from 20 different sections attended, and evaluations indicated that 89% of participants found the seminar informative and 95% would attend a similar seminar in the future.

Negotiations Workshop—Saturday, 5 October 2013 Hosted by the Negotiations and Physician and External Affairs departments to discuss and gather input for the PMA negotiations, this workshop included 41 attendees representing sections, the Doctors of BC Board, the Society of General Practice, the Society of Specialists, and the Statutory Negotiating Committee. The workshop was very successful, with 100% of attendees stating that it was useful for Doctors of BC to hold

ANNUAL REPORTS OF SECTIONS AND SOCIETIES


cap. The codes are meant to recognize the complex care provided by general internal medicine (GIM) and to help with recruitment and retention of GIM specialists. Unfortunately, the codes will have to be significantly scaled back in the near future because we are significantly over budget. This is due partly to recruitment of physicians into the many vacancies in the province and partly due to the number of fee codes created with an underestimation of their use.

Our AGM is scheduled for 30 May 2014 and will include academic sessions in collaboration with UBC.

The section is still brainstorming regarding possible pilot projects for the next set of funding coming through the SSC.

I wish to acknowledge my executive colleagues for supporting and assisting me in transitioning into this role as president of the Section of Community and Rural Internal Medicine.

—Jennifer Grace, MD President

SECTION OF DERMATOLOGYDRS E. TUYP, PRESIDENT; C. HONG, PAST PRESIDENT AND ECONOMICS REPRESENTATIVE; M. WITHERS, TREASURER; S. AU, SECRETARY.

Dermatology still has the largest number of posted opportunities on the Health Match BC website relative to both size of the section and the length of time it would take for the UBC Department of Dermatology and Skin Science graduates to fill these positions (at least 8 years). By that time, a similar number of dermatologists can be expected to have retired, considering that their average age is currently 58 years, the oldest of any specialty in BC. Recruitment is hamstrung because BC has the lowest dermatology fees in the country.

Despite these statistics, there has been no concerted action by the government, UBC Medical School, or Doctors of BC toward solving the prob-lem. The Eric Harris recruitment and retention pro-cess saw a small award of 5% to dermatology, but fees still failed to even keep pace with those in the

SECTION OF COMMUNITY AND RURAL INTERNAL MEDICINEDRS J. GRACE, CHAIR; A. ABDALLA, MEMBERSHIP REPRESENTATIVE; S. GILL, EDUCATION REPRESENTATIVE; D. MEYERS, ECONOMICS REPRESENTATIVE; R. SHAW, WEBSITE REPRESENTATIVE.

The bedside echocardiography program supported through the Specialist Services Committee (SSC) was a huge success, with much interest among section members. Dr Danny Myers conceived and organized the program, and Dr Jean Paul Lim is teaching the sessions to a group of eight general internists. The feedback thus far has been excellent.

The section also attained funding through the SSC to help support a rotation of general internal medicine (GIM) specialists to provide care in the community of Williams Lake, with coverage for approximately 2 weeks per month. The service to date has mostly focused on outpatient work. Interior Health has not yet secured MOCAP for internal medicine in the community, and this issue is currently at the forefront of negotiations between the section and Interior Health. We had hoped that the program would help recruit permanent help in Williams Lake, as the community is in need of two and more likely three full-time internists to cover the region and support hospital care. Funding for the program is in place until the end of September 2014.

The most pressing current issue is that of negotiating with Doctors of BC and the Tariff Committee, such that subspecialists will be blocked from billing the complex care GIM-designated fee codes even though the preamble in the Fee Guide explains which physicians are eligible to bill the codes. It is important that the section has control over our fee codes, to help with distribution of retroactive money earmarked for general internal medicine as per the Modified Adjusted Net Daily Income (MANDI) document. We currently have over $6 million that we have not been able to distribute exclusively to our members from retroactive funding garnered from the 2013 ruling that provided new funds to our group.

The fee codes were developed in conjunction with the SSC-LMA funding and have a firm budget

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APP COMMITTEE; P. BALCAR (RCH), APP COMMITTEE; P. HERSELMAN (COMOX) APP COMMITTEE (CHAIR AS OF JANUARY 2014); R. STREET (RCH), OVERCROWDING, HEALTH AUTHORITY/IT; E. GRAFSTEIN, (SPH), OVERCROWDING, HEALTH AUTHORITY/IT; J. MCGROGAN, (LGH) HEALTH AUTHORITY/IT; J. BRAUNSTEIN (RCH), HEALTH AUTHORITIY/IT/WEBSITE; A. GANSTAL (KAMLOOPS), HEALTH AUTHORITY/IT; J. HEILMAN (CRANBROOK), HEALTH AUTHORITY/IT; J. GHUMAN (SMH), HEALTH AUTHORITY/IT; Q. DOAN (BCCH), PHYSICIAN EXTENDERS AND CONFERENCE PLANNING; G. LAXDAL (CAMPBELL RIVER), SMALL SITE LIAISON. DRS D. DIGNEY (NANAIMO), B. MIR (VICTORIA), AND K. CLARK (KELOWNA—STEPPED DOWN FROM THE EXECUTIVE IN SPRING 2014 AFTER EXCELLENT SERVICE), DR W. CUNNINGHAM (FORMER ECONOMICS REPRESENTATIVE), EX-OFFICIO WHILE IN DOCTORS OF BC EXECUTIVE ROLE.

Ongoing crises in emergency departmentsLast year, at the 19 clinical service contract (APP) ER sites, over 40 000 more patients came for care than physician staffing could handle (increased utilization at APP sites).

Last year, at all the ERs across the province, hundreds of patients were left languishing in ER hallways—sometimes for days—waiting to be admitted for inpatient care (access block/ overcrowding).

Both factors result in an ER that doesn’t work: waiting rooms packed with sick patients with potentially dangerous symptoms, not enough doctors to see them in a timely manner, and no place to see them properly because there is no clean, monitored stretcher location for them to be examined and treated. So far, the new “collaborative” spirit of the new Minister of Health does not feel much different than the confrontational response of earlier administrations. Government so far will not commit to addressing overcrowding and access block equitably across BC, or to addressing increases in patient utilization of APP emergency departments, or to engaging in any regularly scheduled rational planning for APP physician staffing.

rest of the country, so BC slipped from ninth to 10th position overall. As well, this money is now 2 years past due and there is still no sign as to when it will be forthcoming.

If all of the dermatologists practising in BC who are over 65 retired today, we would be short 50% of the required workforce. The people of BC should be thankful for these committed folks who are even into their 70s and 80s.

Unfortunately for the citizens of Prince George, their only dermatologist retired last year. They now have a 7½-hour drive and 6-month wait to see the only dermatologist in Kelowna.

A dermatologist in Kamloops continues commuting to his practice in Newfoundland. Until he moves his family, there is a ray of hope that he could be lured to practice in Kamloops again. Meanwhile the remaining 73-year-old dermatologist is preparing to start commuting to Grand Prairie, Alberta, to practise. The local MLA is also the Minister of Health, but has been ineffective.

The population that has yet to get into dermatologic difficulty is blissfully unaware as waiting lists continue to grow.

The medical community that the public trusts to administer and deliver the appropriate resources for adequate medical care appears to have misplaced its social accountability.

Dermatology is one of the first specialist sections to experience severe workforce shortages. The response does not augur well for other sections about to experience the same.

—Evert Tuyp, MDPresident

SECTION OF EMERGENCY MEDICINE EXECUTIVE: DRS D. HAUGHTON (BCCH), PRESIDENT; S. FEDDER (RICHMOND), SECRETARY AND APP COMMITTEE MEMBER; K. LINDSAY (SPH), TREASURER. MEMBERS-AT-LARGE: DRS M. ERTEL (KELOWNA), FFS CHAIR; N. SZPAKOWICZ (SMH), FFS COMMITTEE AND MEMBERSHIP; M. HOLLOWAY (LANGLEY), FFS COMMITTEE; G. MCINNES (KELOWNA), FFS COMMITTEE; A. CHAHAL (VGH),



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Fee-for-service (FFS) issuesDrs Nick Szpakowicz and David Haughton met with the Patterns of Practice Committee and will be working collaboratively with them to clarify billing rules and best practices to avoid unintentional discrepancies that lead to stressful audits. We will also provide ER physicians to volunteer as auditors so that our peers may review us.

SSPS and SSCDrs Michael Ertel and Gord McInnes set up a system to distribute SSC funding for additional intense CME and training for ER doctors.

Support for PMA negotiations We submitted our two priorities to the Negotiations Department, priorities consistent with our public campaign: (1) focused funding to improve emergency department (ED) flow and decrease access block, and (2) focused funding to address utilization increases. We see the reality of “collaboration” will be tested by the good faith (or lack thereof) of negotiations.

Provincial privileging projectA number of emergency physicians (EPs) in the province have been asked to provide advice to Dr John Slater during the creation of a province-wide credentialing process for EPs.

Reaching out to smaller rural sites/GP-run EDsThe section represents the interests of many GPs who work primarily in emergency in smaller sites across BC by negotiating for fees and funding for emergency, and now regarding the province-wide credentialing process for EPs.

Many of these GPs are not members of the Section of Emergency Medicine and have little or no contact with us. Dr Grant Laxdal (Campbell River) has begun a process of reaching out to such semi-ER physicians to get their input and inform them of the section’s actions and plans.

—David Haughton, MDPresident

We supported the Canadian Association of Emergency Physicians’ National Emergency Medicine Day in Canada on 20 November, bringing this key issue to the forefront. See www.caep.ca/advocacy/overcrowding.

Attempts to engage government Throughout the year we worked assiduously through all channels at Doctors of BC to contact government. In December 2013 we met with assistant deputy ministers Ted Patterson and Doug Hughes in an attempt to regenerate trust by offering government ideas by which emergency medicine can help make the health care system more accountable and hence more cost-efficient. As a result of this meeting, two members of the section will be added to the government- organized Emergency Services Advisory Committee in late spring of 2014.

Actual collaborative efforts to address increased utilization and access block will be determined by the outcome of the Physician Master Agreement (PMA) negotiations.

APP issues: new contracts at Cranbrook, Richmond, and BCCHA number of APP sites across the province have been offered new contracts containing language that threatens the definition of a full-time equivalent (FTE) that has stood for over a decade and was re-established in the 2012 PMA and the 2012 APP subsidiary agreement: 1340 direct clinical hours with up to 340 indirect (nonclinical hours) for a total of up to 1680 total hours. Unfortunately, the government has never been happy with the idea of “up to” 1680 hours and has been attempting, through misinformation and pressure, to manipulate health authorities into commencing negotiations with groups in Richmond, Cranbrook, Kelowna, and BC Children’s Hospital, using contract language inconsistent with the 2012 PMA and the 2012 APP subsidiary agreements. This process is ongoing and tends to give a sharp reality check to some more optimistic views of what “collaboration” with government will look like moving forward.


EconomicsThis past year, the section has continued to work with the Doctors of BC Tariff Committee to establish a fee guide that reflects modern surgical practice, including the latest laparoscopic procedures.

We focused our 2012/13 allocation to create complex care fees for malignancy acknowledging the extra time it takes to care for these patients.

The Section of Plastic Surgeons has revised its fee guide and we have been involved to ensure a smooth transition for the items that are billed by our members. We are also working on printing a billing guide for general surgery for distribution to our members.

A list of new fees and other updates will be presented at our AGM in conjunction with the BC Surgical Society annual spring meeting this May in Victoria.

AdvocacyOur executive members have attended several meetings on your behalf, including meetings with two MLAs and a special meeting with the assistant deputy minister in Victoria. We outlined issues that general surgeons face each day, focusing mainly on the lack of resources to get our work done.

The provincial privileging process has started and general surgery has broad-based representa-tion both geographically and through the various subspecialties in our section. We have met several times, communicated openly with the membership, and continue to strive to find a fair and equitable document that will serve our profession. We are thankful for the services of Dr Nam Nguyen, who is the representative from our executive.

We continue to be active on Doctors of BC committees whenever possible, nominating general surgeons to the roles. A special thanks to Dr Jean-Noel Mahy for his work with the Tariff Committee over the past 7 years.

We would like to congratulate Dr Buzz Scudamore for receiving the Order of BC and Dr Ray Dykstra for his appointment to the Medical Services Plan as senior medical advisor.

SECTION OF ENDOCRINOLOGY AND METABOLISMSOCIETY OF ENDOCRINOLOGY AND METABOLISM OF BC

DRS M. DAHL, PRESIDENT; M. FUNG, ECONOMICS REPRESENTATIVE; G. TEVAARWERK, TREASURER.

British Columbia faces a shortfall of 15 full-time equivalent endocrinologists. Wait lists for care can be long—from 3 to 18 months, depending upon geographic location. We appreciate the probable boost in recruitment made possible through the Specialist Recruitment and Retention Fund arbitration process and are pleased that these funds have recently been made available.

We hope that we can also address this care gap through future innovative projects such as the Specialist Services Committee’s next initiative, and hope to explore pooled referral processes, wait list management, more virtual care, and telemedicine.

We are grateful to Doctors of BC for their expert assistance in terms of keeping us informed, offering economic analysis, and expediting the technical details or running an entity under the Society Act.

—Marshall Dahl, MDPresident

SECTION OF GENERAL SURGERYEXECUTIVE COMMITTEE: DRS A. KARIMUDDIN, PRESIDENT; DR R. VAN HEEST, PAST PRESIDENT; M. DICKESON, PRESIDENT-ELECT; H. HWANG, ECONOMICS REPRESENTATIVE; N. NGUYEN, TREASURER; MS T. BUGIS, EXECUTIVE DIRECTOR. ECONOMICS COMMITTEE: DRS H. HWANG, A. KARIMUDDIN, S. SAMPATH, S. MALIK, M. DICKESON, N. CAUSTON. REGIONAL REPRESENTATIVES: DRS D. BIBERDORF (VIHA); B. DUBOIS (NHA); D. KONKIN (FHA); S. HISCOCK (IHA); A. MENEGHETTI (VCHA); D. JENKIN (RESIDENT MEMBER).

The Section of General Surgery has had a busy and very successful year.



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medical training for UBC’s family practice residents working toward an R3 experience to enrich hospital-based skills.

—Michael Paletta, MD President

SECTION OF INFECTIOUS DISEASESBRITISH COLUMBIA INFECTIOUS DISEASES SOCIETYDRS D.A.N. FERRIS, PRESIDENT; Y. ARIKAN, TREASURER; W. GHESQUIERE, VICE-PRESIDENT; A. HAMOUR, MEMBER-AT-LARGE; T.S. STEINER, SECRETARY.

The British Columbia Infectious Diseases Society represents approximately 48 infectious diseases specialists practising in the province. We have 26 full voting members, which includes Royal College certified specialists, and four associate nonvoting members, which include retired, student, and noninfectious diseases physicians.

Our society continues to be an active participant in both Doctors of BC and the Society of Specialist Physicians and Surgeons of British Columbia. Despite some gains in allocations from the Physician Master Agreement for infectious diseases fee items, a significant disparity continues between those of our specialty and of our colleagues in general internal medicine. This has led to some difficulties, particularly among some of our subspecialists who participate in general internal medicine on-call groups. As well, the Medical On-Call Availability Program continues to be applied unequally in the various health authorities in British Columbia. We call on our administrative leaders to help support a unified approach to this program for all specialists across the province. This will help balance the recruitment and retention issues that face many specialists when they consider moving outside the Lower Mainland. There is potential one-time funding coming through the Specialist Services Committee, and we hope to provide some advice and input with regard to improving the care of all patients in British Columbia.

MembershipWe are pleased to report that most general surgeons in the province pay their annual dues to the section—so we truly do represent you. Membership dues were decreased by $100 this year. Residents can join our section at no cost and we are delighted to host an annual reception for them at our AGM. Retired members can stay in touch with section matters for a $100 fee.

It has been my privilege to be your president for the past 3 years. I feel confident that Dr Mark Dickeson will represent us well in his role as new president and I look forward to working with him and Dr Hamish Hwang, our economics representative. Please continue to bring your ideas forward. Your executive is a committed group working together to represent you and your profession.

—Ahmer Karimuddin, MDPresident

SECTION OF HOSPITALIST MEDICINEDRS M. PALETTA, PRESIDENT; T. ARNOLD, TREASURER; D. HARRIS, PAST PRESIDENT; MEMBERS-AT-LARGE: DRS D. WILTON, W. DEMOTT, R. DINDO, S. KHANDIWAL, R. TUCKER.

The Section of Hospitalist Medicine represents more than 260 members throughout BC.

Hospitalist members have been extremely active within the organization, playing leading roles in negotiation committees and in those involving alternative payment physicians and general physicians.

The section has embarked on efforts to delineate core competencies for hospital medicine as required by the Ministry of Health. This project will be completed in the coming months.

Hospitalists are increasingly involved in providing both undergraduate and residency training opportunities for medical students and family practice residents. Programs in Victoria, Kelowna, Surrey, and in Royal Columbian Hospital are providing a greater share of in-hospital


sistance to the BC Infectious Diseases Society. We acknowledge the support provided by Ms Kathy Bishop at the UBC Division of Infectious Diseases in maintaining our current membership list.

Our specialty addresses some of the most challenging medical issues facing modem society, including antibiotic-resistant organisms and antimicrobial stewardship. Our world has become a smaller place, with international travel allowing communicable diseases to cross country boundaries within a matter of hours. We will continue to be on guard and face the challenges of infectious pathogens such as H7N9 influenza A and MERS-CoV as we provide clinical infectious diseases services to the population of British Columbia.

—Dwight A.N. Ferris, MDPresident

SECTION OF OPHTHALMOLOGYBRITISH COLUMBIA SOCIETY OF EYE PHYSICIANS AND SURGEONSDRS E. CORNOCK, PRESIDENT; D. ALBIANI, D. DHANDA, W. JOHNSTON, L. WITTENBERG, B. ZACK, P. ZAKRZEWSKI.

This society has strong membership involvement and is active in the process of working out how to best provide medical services to the public under the constraints of limited budget and federal and provincial political philosophy regarding medicare.

Advances in technology and treatment options in ophthalmology continue to allow for the treatment of an expanding range of conditions, with more treatment options and/or improvement of existing treatment for different disease conditions. This allows for treatment of many patients whose conditions have been previously untreatable. The benefits to society are both direct to individuals and care provider/patient support networks, and economically via the public purse. The economic data in respect of the cost of blindness is staggering, and the data on the fiscal benefits of sight-saving procedures is clear.

Quality-adjusted life years (QUALY) measures rank high for ophthalmic procedures. Ophthalmic

The infectious diseases privileging dictionary has been approved by the Provincial Credentialing and Privileging Project in British Columbia. As part of our annual renewals, the application of our privileging dictionary to our day-to-day clinical practice should standardize the privileging process across BC. This should also improve quality patient care in our province and address the conclusions reached in the Cochrane Report in 2012.

Our 2013 annual general meeting (AGM) was held in association with the 16th annual Infectious Diseases Update on 8 November in Victoria and was attended by nine of our voting members.

The 2014 AGM will be held in association with the 17th annual Infectious Diseases Update on 7 November in Victoria. At that time, we look forward to inviting Dr Sam Bugis and Mr Robert Hulyk of Doctors of BC Physician and External Affairs Department to update our membership on the member services provided by Doctors of BC. I acknowledge and thank Dr. Wayne Ghesquiere for his ongoing commitment to the BC Infectious Diseases Society and for providing space for our AGM at the Infectious Diseases Update.

Our financial status is stable and improving, and our annual fees therefore continue to be frozen for 2014.

I acknowledge all of the hard work and support of my executive colleagues over the last year, including Dr Wayne Ghesquiere, vice- president; Dr Yasemin Arikan, treasurer; Dr Ted Steiner, secretary; and Dr Abu Hamour, our member-at-large and representative of the Northern Health Authority. We will continue as the voice of the professional association of infectious diseases specialists within British Columbia and provide leadership and guidance to Doctors of BC and the Society of Specialist Physicians and Surgeons. We look forward to working closely with the Specialist Services Committee to improve the care and treatment of infectious diseases in our province.

We extend our deepest gratitude to my administrative assistant, Ms Dianne Laurie, who provides an invaluable service to our membership. We also extend our gratitude to Ms Alyson Thomas at Doctors of BC, who provides administrative as-



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The British Columbia Orthopaedic Association (BCOA) continues to address issues to improve patient care, disparity correction, fee guide modernization, retention, recruitment, wait list reduction, and on-call issues.

The following is a brief summary report of the past year:

BCOA Tariff Committee This committee continues to address issues of concern for our members and is working on a strategy to modernize the fee guide. Dr P. Dryden chairs this committee.

BCOA Wait One CommitteeThis committee was developed in January 2012 and has representatives from the BCOA, Provincial Muskuloskeletal Advisory Group (PMAG), and the Ministry of Health. It was agreed that reliable and accurate Wait One data needed to be collected to gain a more comprehensive understanding of this issue. This project is examining wait times from referral to consult, using the electronic medical record to track these waits. This is a collaborative project with general surgery. The pilots are complete and the software is being finalized. Thanks to Dr Kevin Wing, the lead of this project for the BCOA.

Privileging dictionaryA panel has been working on a new “dictionary” for the setting of privileges for orthopaedics, with input from orthopaedic surgeons in the province. Thanks to the following orthopaedic surgeons who have joined me on the expert panel: Drs Peter Dryden, Derek Plausinis, Bas Masri, Trevor Stone, and Christopher Reilly.

Transfer-of-care consultsThis is a priority issue for orthopaedic surgeons, and the BCOA has been addressing the issue of being denied 51010 payment when a trauma case is handed over from one on-call surgeon to the next. This was brought forward by the BCOA to the Doctors of BC Tariff Committee and was also discussed at the SSPS. A consultation working group has been formed and has asked sections

procedures are also achieved with a minimum load on the associated hospital costs compared with medical procedures overall. Costly diagnostic and testing technology remains office-based in ophthalmology (versus hospital-based), and high overhead cost is an ever-increasing issue.

During 2013/14 the Section of Ophthalmology provided a budget for the establishment of a fee specific to pediatric cataract surgery, as this onerous procedure had become untenable with the drastic reduction in cataract fees overall. The Ministry of Health has approved, in recent months, establishment of two fee items to support new treatment options in the field of corneal disease.

Challenges remain with the continued blurring for the public of the definition between physicians and non-MDs. The Section of Ophthalmology has begun meeting with the professions of optometry and opticianry, following the lead of the interdisciplinary Eye Health Council of Ontario, whose mandate is “to support the provision of accessible, quality eye care to the population of Ontario by ensuring the most effective use of the continuum of eye care professionals in the interests of patient safety, quality of care, and cost-effective delivery.”

The society’s annual meeting was held on 24 May 2013, with the educational topics of retina and ocular oncology.

—E. Cornock, MDPresident

SECTION OF ORTHOPAEDICSBC ORTHOPAEDIC ASSOCIATIONDRS M. MORAN, PRESIDENT; D. WICKHAM, PAST PRESIDENT; K. WING, PRESIDENT-ELECT; D. PLAUSINIS, ECONOMICS. REGIONAL DIRECTORS: DRS P. DRYDEN, R. VELAZQUEZ (VIHA); C. JACKSON, R. SCHWEIGEL (FHA); R. PURNELL (NHA); K. WING, A. YOUNGER (VCHA); S. KRYWULAK, K. BALL (IHA). DIRECTORS-AT-LARGE: DRS T. GOETZ, WSBC LIAISON; K. HUGHES, COPEF; V. JANDO, J. SPLAWINSKI.


2014 highlights:• A commitment from both the Section of

General Practice (SGP) and the Section of Palliatiave Medicine (SPM) to work toward a joint membership.

• Ongoing work with Doctors of BC and the Shared Care Committee to develop proposals aligned with the Blue Matrix Triple Aim guidelines.

• Ongoing support for the GPSC PSP end-of-life module by members in all health authorities.

• Involvement of our members with the provincial privileging and accreditation process.

• Ongoing work being done with Doctors of BC to develop a fee code for palliative care, supported by a resolution of the SGP.

• Ongoing support for the dispute in some regions regarding implementation of the December 2010 consensus decision of the Alternative Payments Committee regarding adjustments of the service contract grid rates for physicians providing palliative care in either a primary or supportive role.

• Membership support and involvement in the newly formed Division of Palliative Medicine within the Division of Medicine at UBC.

• Members of the SPM put forward a number of the motions adopted by the CMA regarding end-of-life care and have been actively involved in the CMA’s End-of-Life Dialogue. Drs Doris Barwich and Romayne Gallagher hosted a public forum in March 2014 as well as a members’ forum in April 2014.

• Members were involved with the development and support of the Centre of Excellence for Palliative Care funded by the Ministry of Health. Dr Barwich has been named the executive director.

• The Canadian Society of Palliative Medicine and the Royal College of Physicians and Surgeons of Canada, have officially approved the recognition of palliative medicine as a two-year subspecialty. There will be multiple entry routes, including family medicine and a practice-eligible route.

• A twice-yearly newsletter informs members of activities of Doctors of BC and the CMA. Topics range from updates on relevant issues, such as Bill 52 in Quebec, as well as practical

to make submissions outlining the issues related to consultations, subspecialty consultations, and transfer of care. The BCOA has made a written submission, and Dr Kevin Wing will be making a presentation to the consult working group.

Manpower audit follow-upThe BCOA is in the process of conducting a follow-up survey of current BC orthopaedic surgeons to establish the manpower needs for BC. This data will be important planning information for people considering orthopaedics as a career, for students already in an orthopaedic program trying to determine their subspecialty area, and for academic institutions to help plan for the education needs of future orthopaedic surgeons.

BCOA annual general meetingThis meeting was held in conjunction with the UBC Orthopaedic Update on 2 May 2014.

The BCOA continues to participate on the PMAG and the SSPS. We also continue to work with the Canadian Orthopaedic Association to identify provincial issues to be addressed at the national level.

—Michael Moran, MDPresident

SECTION OF PALLIATIVE MEDICINEDRS W. YEOMANS, PRESIDENT; D. MCGREGOR, PAST PRESIDENT; G. KIMEL, TREASURER AND SECRETARY. EXECUTIVE MEMBERS: DRS N. APOSTLE (PROVIDENCE), P. EDMUNDS (VCH), S. MINHAS (FRASER HEALTH), I. REDDY (NORTH-ERN HEALTH), M. JACOBSEN (INTERIOR HEALTH) B. FELAU (VIHA), P. HAWLEY (PHSA), D. BARWICH (MEMBER-AT–LARGE, FHA). MS M. HUDSPITH, EXECUTIVE DIRECTOR.

In the past year our membership increased from 85 to 106, six of whom are specialists. Our annual general meeting (AGM) was held on 2 November 2013. Members agreed to increase membership fees to $180 for 2014. A resolution was passed, changing the term of presidency to 2 years instead of 1 year.



• Mental Health—Partnering with the Ministry of Children and Family Development Child and Youth Mental Health Services, we are working on concerns regarding access to mental health services for children and youth with serious mental illness. We are working actively with the Interior Health Authority Child and Youth Mental Health Collaborative. We are also a founding member of the provincial task force on ADHD.

• Education—We are currently working on a project to “match” pediatricians and elementary schools.

• Immunization—We are currently working on three projects that focus on increasing the up-take of nonpublicly funded vaccines.

• Childhood obesity—We are focusing on SipS-mart, a school-based program for grades 4 to 6, aimed at the reduction of sugar-sweetened beverages. In addition to having this program in BC schools, we have licensed versions of it to the Northwest Territories, Quebec, Ontario, and New Brunswick, with a Newfoundland pilot in the works.

• Learning disabilities—A task force has completed a project to provide physicians with a template diagnostic verification letter to schools to assist in supporting children and youth with special education needs.

• EMR—We have assessed various EMR software packages and recommended one to our members. We are currently developing further education and user groups in this area.In terms of education opportunities, we have a

blanket CME accreditation for evening journal club dinners. We present a dinner approximately every 2 months. We are also partnering with the Children’s Hospital Division of Infectious Diseases for our annual 2-day CME event in early October 2014.

—Aven Poynter, MDPresident

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issues, such as the new marijuana laws and methadone formulation.

• Ongoing commitment to a yearly “master class” involving a specialty and palliative medicine. The class in November 2013 dealt with cardiology, and the 2014 plans are for nephrology.

—W. Yeomans, MDPresident

SECTION OF PEDIATRICSBC PEDIATRIC SOCIETYDRS A. POYNTER, PRESIDENT; M. BEIMERS, PAST PRESIDENT; W. ABELSON, SECRETARY/ TREASURER; T. SOROKAN AND W. ABELSON, ECONOMIC REPRESENTATIVES; W. ARRUDA, ADVOCACY CHAIR; A. EDDY, DEPARTMENT OF PEDIATRICS REPRESENTATIVE; G. WARD, MEMBER-AT-LARGE; K. SCHULTZ, AFP REPRESENTATIVE; J. SIMONS, DIRECTOR, NORTHERN BC; K. GROSS, DIRECTOR, OKANAGAN; A. LEE, RESIDENTS’ REPRESENTATIVE.

The vision of the BC Pediatric Society (operating as the Section of Pediatrics of Doctors of BC) is that all BC infants, children, adolescents, and their families will attain optimal physical, mental, and social health. To accomplish this vision, the society will:• Work with allied care providers, government,

regional, provincial, and national organizations.• Support the professional needs of its members.

This year we focused on the goals of advocacy (for pediatricians and for children and families) and provision of accredited CME opportunities for pediatricians. Our advocacy work centred on the following themes:• Economics—We have been active at the SSPS as

well as with Doctors of BC. The Section of Pediatrics is currently in discussion with the Tariff Committee and MSP in regard to pediatric funding from the recruitment and retention funding. We have also submitted a letter regarding consultation fee payments.


members so chosen were Drs Carol-Ann Saari (chair), Nelson Collins, and Arun Jagdeo.

Accomplishments• Participation in Psychiatric Privileging Panel with

the College of Physicians and Surgeons of British Columbia.

• Successful negotiation by the economics team, working with the SSPS and with a major contribution from Dr Steve Wiseman, of a reversal of arbitrary MSP changes to psychiatrists’ payments that were causing significant hardship to our members.

• BCPA website (www.psychiatrybc.ca) completed by Dr Ram Randhawa.

• Ongoing negotiations with MSP over development of new and modified fee items funded by successful application for recruitment and retention monies in 2012. Negotiations are directed toward better support of indirect patient care, outpatient services, and child/ adolescent and geriatric psychiatry.

• Organization restructuring and comprehensive bylaw revisions in progress under the direction of Dr Carol-Ann Saari.

• Annual resident dinner Thursday, 13 March 2014, at the Teahouse in Stanley Park, to engage the future of psychiatry.

Plans• Complete governance review.• Increase resident integration into BCPA.• Recruit nonmembers to membership status.• Enhance BCPA’s connection to patients and

communities through advocacy.• Collaborate with Doctors of BC to advocate for

the role of psychiatry in both the medical and mental health of BC citizens.

• Continue negotiations with MSP over recruitment and retention funding and other billing/payment issues pertinent to psychiatrists of BC.

—C. Gorman, MD President

SECTION OF PSYCHIATRYBC PSYCHIATRIC ASSOCIATIONDRS C. GORMAN, PRESIDENT; C. BOOTH, ECONOMICS REPRESENTATIVE; P. CHAN, GERIATRIC PSYCHIATRY; N. COLLINS, PATTERNS OF PRACTICE/PSYCHOTHERAPY; S. FITZPATRICK, ECONOMICS REPRESENTATIVE; A. JAGDEO, RESIDENT REPRESENTATIVE; B. KANE, NORTHERN REPRESENTATIVE; S. MARK, RESIDENT REPRESENTATIVE; B. MATHEW, CHAIR, NOMINATIONS/AWARDS COMMITTEE, REPRESENTATIVE TO CPA PROFESSIONAL STANDARDS AND PRACTICE COMMITTEE; F. MCGREGOR, SOCIAL/LEGISLATIVE REPRESENTATIVE TO CPA, CPA BOARD OF DIRECTORS, CPA EXECUTIVE MEMBER; S. MOHAMED, FRASER VALLEY REPRESENTATIVE; R. RANDHAWA, VANCOUVER REPRESENTATIVE/WEBSITE CHAIR; M. RILEY, FORENSIC REPRESENTATIVE; C.SAARI, PRESIDENT-ELECT/SECRETARY/CHAIR, BYLAWS COMMITTEE; S. SHRIKHANDE, VANCOUVER ISLAND REPRESENTATIVE; W. SONG, BC MEMBER ON CPA STANDING COMMITTEE ON EDUCATION; K. STEVENSON, TREASURER/INTERIOR REPRESENTATIVE; S. WISEMAN, ECONOMICS CHAIR/CPA STANDING COMMITTEE ON ECONOMICS REPRESENTATIVE. RETIREMENTS HAVE RESULTED IN THE FOLLOWING VACANCIES: REPRESENTATIVE TO CPA COUNCIL OF PROVINCES; REPRESENTATIVE FOR ADDICTIONS PSYCHIATRY; REPRESENTATIVE TO CPA SCIENTIFIC COUNCIL.

The following report summarizes the work of our committee over the last year.

Resolutions• 9 September 2013 executive meeting:

That the BC Psychiatric Association (BCPA) create a strategic plan.

• 4 February 2014 executive meeting: That the BCPA executive agreed that an ad hoc

governance committee be formed to evaluate the structure and organization of the BCPA and conduct a thorough bylaw review. Committee



administrative and practising radiologists from each health authority, as well as government staff and a consultant. The committee met over the period November 2013 through February 2014 to complete the draft to be presented to the Medical Imaging Advisory Group later this spring.

In 2014 the BCRS continues to be active in many areas, including:• Developing accredited CME programs for

radiologists.• Developing a quality-assurance program for

radiologists.• Health human resource planning.• Provincial e-health strategies.• Facilitating the transition from analog diagnostic

mammography to digital mammography and developing a modernized breast imaging fee schedule.

—R. Peter Tonseth, MDPresident

SECTION OF RHEUMATOLOGYBC SOCIETY OF RHEUMATOLOGISTSDRS J. KUR, PRESIDENT; J. WADE, TREASURER; D. COLLINS, ECONOMICS REPRESENTATIVE; M. BAKER, MEMBER-AT-LARGE.

The BC Society of Rheumatologists (BCSR) has once again had a very active year. The society continues to work on the primary issues of shortages of rheumatologists in the province and enhanced support for community rheumatology practices.

Shortage of rheumatologist servicesThe society continues to struggle with the demand for rheumatology services in the province, complicated by the shortage of practising rheumatologists, documented in the BC Medical Journal in 2010. The society is in the process of updating this review; however, there have been some small successes, with new rheumatologists starting practice in Nanaimo, Victoria, and Penticton in recent years.

Helping further alleviate the issue has been the gradual introduction of outpatient nursing support

SECTION 3

SECTION OF RADIOLOGYBC RADIOLOGICAL SOCIETY DRS R.P. TONSETH, PRESIDENT; M. BUTCHART, J. DUFTON, A. HARRIS, B. HOMAYOON, P. KURKJIAN, N. LAMB, E. LEE, M. MARTIN, R. RASTEGAR, W. SIU, P. TREPANIER. MR B. RAUSCHER, MS C. RENTZ-BENNETT.

Changes to Executive CouncilDr Pete Tonseth is now in his second and final year as president of the section, and Dr Will Siu is president-elect. The position of Women’s Imaging Representative remains vacant at this time. Finally, the executive council welcomes two radiology resident representatives, Drs Behrang Homayoon and Rashin Rastegar.

CME sessionsThe BC Radiological Society (BCRS) is placing an increasing emphasis on providing continuing medical education (CME) for the membership. In 2013 a successful half-day CME event on risks in radiology was presented at St. Paul’s Hospital. Additionally, a weekend workshop for cardiac CT angiography was held in February in conjunction with an online learning component for completing Level 2 training. The BCRS is planning another CT colonography simulation workshop in April 2014, along with a multidisciplinary CME event in May, focused on oncology imaging.

SponsorshipsThe Section of Radiology continues to sponsor three BCIT awards: two entrance scholarships for students in the Medical Radiography and Diagnostic Medical Sonography Programs and one first-year achievement award for a student entering the second year of the Diagnostic Medical Sonography Program.

24/7 contemporaneous reporting of diagnostic imaging studiesThe BCRS was involved with the Ministry of Health in developing a draft policy on after-hours radiology services. The Contemporaneous Reporting Advisory Committee was established, chaired by Dr Tonseth, and composed of


SOCIETY OF GENERAL PRACTITIONERS OF BRITISH COLUMBIADRS L. WELSH, PRESIDENT; T. MONK, PAST PRESIDENT; K. BURNS, PRESIDENT-ELECT; E. CHANG, TREASURER; P. ASQUITH, ECONOMICS CHAIR; E. RHOADES, SECRETARY; P. BARNSDALE, GPSC; H. FOX, SNC; S. GOODCHILD, BOARD CHAIR; G. WATSON, GPSC; J. YOUNG, GPSC.

The Society of General Practitioners (SGP) continues to work for excellence in the health care system to enhance and strengthen provision of primary care in BC.

Some of the SGP’s most significant activity in the last year involved the Provincial Privileging Project. Its work is to define credentials required for privileges in acute and residential care settings. By reaching out to and working together with the Doctors of BC Rural Issues Committee and the Joint Standing Committee on Rural Issues, as well as with the BC College of Family Physicians, the SGP ensured that GPs will define credentials for GPs, respecting the specific value that generalism brings to our work in all contexts.

The SGP continued to collaborate with Doctors of BC and the Ministry of Health through GPSC to support Divisions of Family Practice in the Herculean task of patient attachment. The GPSC package of attachment incentives is improving compensation for being “someone’s doctor.” In committing to providing continuous coordinated care over time, GPs can now utilize the GPSC telephone and simplified telephone conferencing fees to improve access and care delivery. The in-hospital incentives recognize the important contribution of GPs working to care for their patients in medium and small hospitals and have been well received.

for community practitioners. Since its inception approximately 2 years ago, 28 community rheumatologists have begun using nurses in their practices to help manage complicated inflammatory patients in a chronic disease care model. Bearing in mind there are only approximately 40 full-time equivalent rheumatologists in BC, this has been a resounding success story.

In 2013 a provincial study compared the delay for a rheumatology consultation among patients, referred at the same time, with suspected early rheumatoid arthritis (RA) and with osteoarthritis. Despite the challenges of access to rheumatology services, this study showed that most rheumatologists triage RA patients earlier and usually within 4 weeks of referral. This satisfies the Canadian Rheumatology Association guidelines for treatment of early RA. However, wait list times varied between regions and between specialists in the same region. In addition, it was not uncommon for median wait times for osteoarthritis to be more than a year in most circumstances.

Member supportThe society continues to place a greater focus on membership engagement. Practice resources, educational tools, and member communications can now be found at www.bcrheumatology.ca. In addition, a number of seminars on practice redesign were offered in the past year in Kelowna, Vancouver, and Victoria to help members with integrating nursing into office practice.

The major meeting of the BCSR will occur in conjunction with the BC Rheumatology Invitational Education Series to take place 26 September 2014 in Vancouver.

—Jason Kur, MDPresident


www.pspbc.ca


SOCIETY OF SPECIALIST PHYSICIANS AND SURGEONS OF BRITISH COLUMBIADRS A. ATTWELL, PRESIDENT; B. DALAL, PAST PRESIDENT; M. STANGER, CHAIR OF COUNCIL; S. MA, SECRETARY-TREASURER. MEMBERS- AT-LARGE: DRS M. BAKER, MEDICINE; R. BISSONNETTE, DIAGNOSTICS; D. WICKHAM, SURGERY; J. CUPPLES, ALTERNATIVE PAYMENT PHYSICIANS. COUNCIL OF SPECIALISTS REPRESENTATIVES: DRS D. STARK, ALLERGY/ IMMUNOLOGY; E. AYMONG, CARDIOLOGY; W. HENDERSON, CRITICAL CARE MEDICINE; J. BASHIR, CARDIOVASCULAR SURGERY; M. ERTEL, EMERGENCY MEDICINE; M. DAHL, ENDOCRINOLOGY/METABOLISM; M. FISHMAN, GASTROENTEROLOGY; A. KARIMUDDIN, GENERAL SURGERY; S. COMEAU, GERIATRIC MEDICINE; D. FERRIS, INFECTIOUS DISEASES; J. O’CONNELL, LABORATORY MEDICINE; G. GANZ, NEPHROLOGY; J. FALCONER, NEUROLOGY; D. WATERMAN, OBSTETRICS/ GYNECOLOGY; D. ALBIANI, OPHTHALMOLOGY; M. MORAN, ORTHOPAEDIC SURGERY; S. MORZARIA, OTOLARYNGOLOGY; W. ABELSON/A. POYNTER, PEDIATRICS; E. WEISS, PHYSICAL MEDICINE/REHABILITATION; S. WISEMAN, PSYCHIATRY; K. WONG, RADIOLOGY; I. WATERS, RESPIROLOGY; D. COLLINS, RHEUMATOLOGY; O. NAZIF, UROLOGY; K. KAZEMI, VASCULAR SURGERY.

This year the SSPS executive met on six occasions and the council four. We appreciate the input of the council representatives and executive, as well as that of our executive director, Andrea Elvidge. Membership remains steady but significantly below target levels, with certain sections not participating in the council. We welcomed a new section, Community and Public Health, to the fold this year.

This year we have spent significant time and energy gearing up for the Physician Master Agreement (PMA) reopener negotiations, with sections and executive engaged in this process. We have helped populate key committees with a mix of specialists.

We continue to support the work of the Specialist Services Committee (SSC), which has multiple

SGP recognizes the importance of encouraging and rewarding provision of medical services centred within the key attributes of primary care (accessible, continuous, coordinated, comprehensive, person- rather than disease- focused), and sustainable within our publicly funded system. The SGP is proactive in and supportive of the adoption of new tools and technologies, including enhanced EMR use and telemedicine within a longitudinal care setting. As part of our mandate as the Section of General Practice, responsible for the GP fee schedule, SGP reviewed the provisional telehealth fees and proposed changes to encourage their appropriate use within primary care.

A completely redesigned and very fast SGP website went live in March, featuring an intuitive, searchable, simplified Guide to Fees. Positive feedback was immediate: “Indispensible!” “I LOVE LOVE LOVE the website! Looks great. Simple, clean, and easy to navigate.” “The billing guide is fantastic and . . . very helpful!” Check out the SGP and the new interactive billing guide for yourself at www.sgp.bc.ca.

—L. Welsh, MDPresident

SECTION 3

Specialist Services Committee (SSC)

SSC provides a platform for specialists to work with key partners, achieve professional growth, and deliver an

improved health care system for patients.

Learn more: www.sscbc.caGet involved:

[email protected]

SPECIALIST SERVICESCOMMITTEE

Use your timewisely.

www.bcma.org/ssc


We believe focused efforts toward such reforms are needed. We support term limits and continue to promote specialist involvement on the Doctors of BC Board and committees.

The SSPS requires a new strategic plan and way of interacting with doctors and sections. In April there was an executive retreat to plan the way forward. We sought input from numerous parties on the future of the SSPS and plan to align the society to better support the SSC and section involvement while advocating for physicians on economic issues and engaging specialists in facilities.

My term as president has come to an end. It has been a privilege to work with so many dedicated section heads, doctors, and staff. I will continue to serve on the SSC, advocating for specialists, the health care system, and patients. Thanks to Ms Elvidge and to Doctors of BC and SSC staff for supporting specialist issues.

—Andrew Attwell, MDPresident

successful initiatives and working groups active in quality improvement, physician engagement, funding one-time and ongoing fee items, leadership training, and supporting physicians in facilities. We are most grateful for the hard work and dedication of Dr Ken Seethram, outgoing co-chair of SSC, and of Dr Sean Virani, who has stepped into this important role.

We dealt with several challenging economic issues, particularly secondary and follow-on consultations. We have been bolstered by Doctors of BC staff on these issues. We increasingly recognize a need to provide economic assistance to specialists, as the level of support within sections is highly variable. We have formed a working group to evaluate the next PMA and we have engaged a health economist to help us. We anticipate this working group will evolve into an SSPS economics committee.

Doctors of BC governance has been front and centre for years. The SSPS seeks a smaller board with separation of governance and representation.


KEY CONTACTS: Directory of senior staff

Mr Allan SeckelChief Executive Officer604 [email protected]

Ms Christiane AhPinChief Operating Officer604 [email protected]

Ms Marisa AdairExecutive Director of

Communications and Public Affairs604 [email protected]

Mr Jim AikmanExecutive Director of Economics and Policy Analysis604 [email protected]

Dr Sam BugisExecutive Director of

Physician and External Affairs604 [email protected]

Ms Amanda BernabeDirector of Human Resources 604 [email protected]

Dr Andrew ClarkeExecutive Director,

Physician Health Program604 [email protected]

Ms Cathy CordellGeneral Counsel604 [email protected]

Mr Peter DennyDirector of Systems604 [email protected]

Mr Rob HulykDirector of Physician

and External Affairs604 [email protected]

Ms Anne KeebleDirector of Finance604 [email protected]

Mr Tod MacPhersonDirector of Negotiations604 [email protected]

Ms Sinden MalinowskiActing Director of Insurance604 [email protected]

Mr Paul StraszakExecutive Director of Negotiations604 [email protected]

Ms Deborah ViccarsDirector of Policy604 [email protected]


ANNUAL REPORTS OF AFFILIATED ORGANIZATIONS

and territories. The council meets twice yearly in Ottawa, in April and October, and holds teleconferences at least twice yearly between meetings. It has been subject to ongoing governance review and will be expanding in the fall of 2014 to include representation from all the provinces and territories.

CHPE reviews and prepares policy papers for the consideration of the CMA Board. This year work is focusing on reviewing and updating the policy on physician resource planning. The council has also been tasked with reviewing emerging data on physician supply requirements and making recommendations in collaboration with CEPD. It is also involved in reviewing the impact of changes in resident duty hours on physician resource planning. Other new policy areas include the impact of emerging technologies and models of care on health human resource planning, and developing a paper on improving efficiency in Canada’s health system.Ongoing priorities include developing a pharmaceutical policy, in particular to help identify strategies for sustainable access to drug coverage, as well as ways to support long-term financing of continuing care options for Canadians.

The council is involved in identifying opportunities to implement activity-based funding in Canada and reviewing the subsequent risks and opportunities that affect physicians. CHPE is also involved in the planning and delivery of the CMA annual Health Policy and Negotiations Conference in Ottawa. This year’s conference was held 20–21 October 2013 and was chaired by Dr Larsen Soles. The topic was physician leadership in system change.

CHPE provides an effective venue for information exchange on a national level and also functions as a clearinghouse for national discussion of health policy and economics issues. Federal and provincial policy changes and economic challenges affect-ing the health care system have an impact on the provision of medical services in all regions of the country. The work of the CMA CHPE is to develop realistic policies to promote and strengthen the provision of medical services to Canadians in the face of these challenges.

BC HEALTH QUALITY NETWORK DR L. FILIATRAULT (DOCTORS OF BC REPRESENTATIVE)

The BC Health Quality Network (HQN) was developed in 2009 by the BC Patient Quality and Safety Council as part of its role in the provision of system-wide leadership and coordination in Health Quality BC. The HQN is a forum of 30 or more organizations across BC that are committed to patient care, quality improvement, and patient safety. Membership includes Doctors of BC, BC’s health authorities, universities, professional associations, and health quality groups.

The HQN meets quarterly, when members talk about their work, share best practices, and solve problems. Over the last year, meetings focused on social media as a tool for health care improve-ment, pay for performance, provincial health technology assessment, Canadian Patient Safety Institute (CPSI) global safety alerts, and the Canadian Medical Protection Association’s Good Practices Guide.

In the past, recommendations have been formed and shared with government, based on HQN’s information sharing.

For more information on HQN, please go to bcpsqc.ca/about-the-council/bc-health- quality-network/.

—Lyne Filiatrault, MD Doctors of BC Representative

CMA COUNCIL ON HEALTH POLICY AND ECONOMICSDRS F. CHAGNON (QC), C. DICKSON (CAIR), M. FONG (PE), MR B. FRID (CFMS), DRS D. HELLYER (ON), D. JOHNSON (CORRESPONDING MEMBER, MANITOBA), C. LANE (AB), T. NICHOLAS (BOARD REPRESENTATIVE), T. LARSEN SOLES (BC).

The Council on Health Policy and Economics (CHPE) is a policy and advisory committee to the Canadian Medical Association (CMA). There are six members representing provincial jurisdictions and corresponding members from the other provinces


First Nations admission goals, diversity of appli-cants selected, and essential skills and abilities needed for admissions.

The meeting on 25 February 2014 reviewed the diversity of applicants in light of UBC’s renewal of its curriculum and its Social and Accountability Framework, which states, in part, that “to meet the health care needs of a diverse population, it is important to have a physician population that is equally diverse.” Also the issue of out-of-province (OPP) applicants was discussed. Currently there are more OPP applicants but a limit to numbers interviewed and accepted, in keeping with a pro-vincially supported medical school program.

Admissions to UBC are critical to the future of providing quality medical care to all of BC and require constant input to adjust to the changing times and needs.

—Mary Johnston, MDDoctors of BC Appointee

PROFESSIONAL ASSOCIATION OF RESIDENTS OF BRITISH COLUMBIADRS A. JAGDEO, PRESIDENT; J. WONG, PAST PRESIDENT; P. HERTZ, VICE-PRESIDENT; M. MASOTTI, DIRECTOR OF COMMUNICATIONS. MEMBERS-AT-LARGE: DRS K. BEADON, A. DELANY, D. HEFFNER, D. HUANG, E. KARACABEYLI, K. MILNE, F. POMERLEAU.

The year 2013 saw the Professional Association of Residents of British Columbia (PAR-BC) successfully implement the negotiated changes to our collective bargaining agreement. The previous round of bargaining was lengthy, and the residents of British Columbia went without a contract for several years. The new round of bargaining began on 31 January 2014, and is underway at present. We continue in earnest to represent the interests of the public and of residents, noting that the residents of British Columbia receive the lowest compensation of all Canadian residents save those in Quebec.

Although bargaining continued unabated, the past 3 years saw many successes at PAR-BC. The operations of the board were streamlined

I served as chair of the CMA CHPE from June 2012 to November 2013. Upon my resignation, Dr Don Milliken has assumed the duties of representing British Columbia at CHPE. Dr Caroline Lane from Alberta is the new chair of CMA CHPE.

—Trina Larsen Soles, MDDoctors of BC Representative

MD UNDERGRADUATE ADMISSIONS POLICY ADVISORY COMMITTEEDOCTORS OF BC APPOINTEE: DR M. JOHNSTON. ADMISSIONS SELECTION COMMITTEE: DR G. AVERY. NORTHERN SELECTION COMMITTEE: DR T. LARSEN SOLES.

The Admissions Policy Advisory Committee has had three committee meetings in the 2013/2014 year, with a fourth planned for May 27, 2014. I was unable to attend the 29 October 2013 meeting as I was attending the World Summit on Gener-alism and Australian Rural Health Conference at that time. On 10 December 2013 a joint meeting all admissions committees was held to exchange information about the role of each component and how they interact. As well, Dean Paul Winward presented on the UNBC medical program and their initial results. Informative and important dis-cussions were held on encouraging and achieving

ANNUAL REPORTS OF AFFILIATED ORGANIZATIONS

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through updates to our governance process. Several committees were struck, and each year has seen these committees bloom. The Advocacy Committee has been active in engaging with government, culminating in meetings between PAR-BC and the Ministry of Health, the Ministry of Advanced Education and Literacy, and the Ministry of Jobs, Tourism, and Skills Training.

On the national front, PAR-BC continues to work alongside the Canadian Association of Interns and Residents (CAIR) in matters of health human resources and physician employment, two issues that directly affect the residents of British Columbia. Through CAIR, we continue our engagement with the Royal College of Physicians and Surgeons of Canada (RCPSC) and the Medical Council of Canada and, alongside CAIR, we continue engagement with the Canadian Medical Association and other provincial house-staff organizations.

The 2013/14 academic year also saw the completion of the RCPSC accreditation survey of all postgraduate medical education programs at

NOTES

the University of British Columbia (UBC). The accreditation process is a large collaborative undertaking between the RCPSC, the College of Family Physicians of Canada (CFPC), CAIR, and PAR-BC. We represented the interests of UBC residents through the distribution and data analysis of the residents’ survey portion of the accreditation process, a crucial step in carrying out the survey.

PAR-BC continues to advocate for residents by increasing awareness of who residents are and what we do for the general public and for allied health professionals. We were successful in having Resident Awareness Day, 18 February 2014, officially proclaimed in the BC legislature. We also continue to support medical student and resident collaboration through mutually beneficial events.

We look forward to continuing to represent the interest of the residents of British Columbia with passion and determination.

—Arun Jagdeo, MDPresident


NOTES

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2013/14 WHITE REPORTDOCTORS OF BC WHITE REPORT. 2013/14. 5. Moved/Seconded Resolution AGM13/06/01-03...

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