Posted 2021/05/17 & filed under Updates.

The Work of Specialists of BC Continues…

Thank you for the opportunity to serve as President of Specialists of BC. I am a pediatric rheumatologist practicing primarily in North Vancouver in a community-based clinic. I have a special interest in pediatric sport and exercise medicine.

Over the past four years, I have served as a director at the Doctors of BC and been involved with several of their committees. Dr John Falconer has also welcomed me into the leadership of Specialists of BC and it has been a pleasure to meet such a diverse and passionate group of specialists representing more than 30 specialty sections.

I am fortunate to wear a number of hats, working with pediatricians, rheumatologists, and sports medicine doctors, and I have seen that there are so many issues that we have in common as specialists. The Specialists of BC plays a vital role in creating a forum to share these common issues and to listen to unique vantage points from across the health care system.

Together, we form a network of sections that reaches beyond simply our membership numbers. We have been instrumental in getting the conversation going about specialists’ involvement in the Patient Care Networks (PCNs) and raising concerns about College standards and guidelines that sometimes overreach.

As we enter into this new Physician Master Agreement (PMA), and with the government’s focus on primary care reform, it remains critical that specialists are not forgotten. I have seen how specialists support our colleagues; however, it is incumbent on us to define our own priorities and advocate on behalf of our patients and each other.

We can further engage with and support the Specialist Services Committee (SSC) to ensure that its work reflects issues that are important to specialists. We can participate in the Representative Assembly (RA) so that a strong voice of specialists is present.

We can continue to mentor and support new specialist leaders to get involved with critical organizations such as the Specialists of BC, Doctors of BC, and the sections. We can encourage our specialist colleagues to participate in Facility Engagement activities and Physician Quality Improvement projects.

If you, or one of your colleagues, is interested in getting involved or sharing your priorities with us, please get in touch with me

Community Specialists

Over the past year there have been efforts to reach out and engage with specialists who are working primarily in the community. This group of physicians tends not to be directly involved with Facility Engagement and other facility-based projects. However, they are an integral part of our health care system.

The SSC is recognizing the valuable contributions of community-based specialists. Earlier this year, the SSC-funded Specialist Symposium was an opportunity to listen to specialists from facilities and communities across BC. We are pleased that a second Specialist Symposium in 2020 will build on this success.

As the PCNs roll out, it will be important that specialists are engaged at the local level. The new PMA has particular provisions to support specialist practices outside of facilities by introducing, in 2020, the “Business Premium” (3-5% top-up of daily fees to a maximum of $60/day), depending on practice location.

The recognition of the “business cost” of community and private practice is a step in the right direction, albeit a modest one. We hope that SSC-supported initiatives such as PQI and Physician Leadership development will increasingly become accessible to community-based specialists.

Does your Section have a group of specialists primarily practicing in the community (outside facilities)? If so, let us know as we try to understand better how we can support this growing practice environment.

“A rose by any other name would smell as sweet….”

Or so the College of Physicians and Surgeons of BC seems to believe when it released its proposals for standards relating to “Procedural Pain Management.”

The College felt that there was a strong need to further regulate physicians providing “interventional pain” services. However, they have labelled certain procedures as being “pain management” procedures rather than simply procedures that may have multiple indications.

For example, the proposed draft standards indicate that glenohumeral joint injections are a “pain management” procedure requiring regulation and image-guided injection in an accredited facility.

Several sections have raised concerns with these proposals including the BC Society of Rheumatologists which pointed out that a shoulder injection has indications beyond pain management, such as anti-inflammation.

 This procedure has been done safely for decades in community-based clinics and in some of the most immune-suppressed patients out there. This case illustrates the pitfalls of relying on “expert” committees that may not include the appropriate stakeholders and often come up with recommendations that don’t seem to be supported by peer-reviewed evidence.

Hopefully the College will revise these proposals based on the feedback that has been submitted. It is an important reminder that specialists are content experts for the populations they serve and we hope the College will be careful to regulate for appropriate risk rather than restrict the scope of legitimate practice.

The College continues to be most interested in hearing from individual physicians so I encourage you to keep an eye out for opportunities to provide feedback on College proposals. This feedback can be based on issues that affect you or your section directly or in support of your physician colleagues.

Did you know?

The Specialists of BC is separate from the SSC and the Doctors of BC, though we work closely with both.  We’re a registered non-profit society working for the specialist doctors of the province since 1990, and we rely on your dues to do this work. If you want to support specialists, please join the Specialists of BC now https://www.doctorsofbc.ca/account/dues