Archives > January 2018

New year, new Conflict of Interest form

January 1, 2018 marked the adoption of the National Standard for Support of Accredited CPD Activities. The intent of the Standard is to safeguard the integrity of accredited CPD activities from the influence of sponsoring organizations that could lead to bias and has been approved by the Royal College of Physicians and Surgeons of Canada (Royal College), College of Family Physicians of Canada (CFPC), and Collège des médecins du Québec (CMQ). The implementation of the Standard is equally applied to all CPD Provider Organizations in Canada and, as such, the CFPC guidelines and policies for certified events have undergone changes.

As part of its Mainpro+® certification process, the CFPC requires all presenters and members of Planning Committees to complete the CFPC Mainpro+ Declaration of Conflict of Interest form which now includes all financial or in-kind relationships with for- and not-for-profit organizations.

A conflict of interest might be present in situations where the personal and professional interests of individuals have actual, potential, or apparent influence over their judgment and actions. For more information, visit the CFPC website.

Principle Based Leadership

Read the full January eNews and President’s Message.

Machiavelli said “Never waste the opportunity offered by a crisis” … but we ought to ensure we are consistent and fully in-line with our organizational principles!

A crisis shakes us out of complacency and forces us to challenge conventional wisdom so that we can create transformative change. When things get tough and decisions need to be made quickly, having a set of principles to guide you can allow freedom to create solutions and the structure to hold true to what the membership believes.

The Alberta College of Family Physicians is a principle based organization that prides itself in its role to strive for constant improvement and excellence. In the past several years, we have, collectively as family physicians, been challenged to provide leadership for change. As defined in our Strategic Framework 2017-2019, the principles that the ACFP has held up to guide us are:

  1. Professionalism: The ACFP acts with integrity, respect, and inclusiveness, upholding the social responsibility of family medicine.
  2. Continuous Learning and Professional Development: The ACFP supports and inspires self-directed and lifelong learning, quality improvement, research, and continuing professional development for family physicians so that they may adapt to changes in medical evidence, patient, and community needs.
  3. Patient Centred and Integrated Care: The ACFP is comprised of caring family physician leaders, who ensure comprehensive and integrated care and value excellence in health care inspired by personal interactions and trusting relationships in the communities they serve.
  4. Applied Leadership: The ACFP leads and participates in collaborative, practical, evidence-based initiatives with stakeholders to advance excellence in family medicine and the health care system.
  5. The Views and Needs of Our Membership: The ACFP is inclusive and reflective of its members’ views and needs, building awareness of the value of family medicine through responsive and adaptive communication, advocacy, research, engagement, and education.

It may appear mundane and oversimplified but this set of foundational principles has carried us through some difficult times. It is the leadership and Board of Directors of the ACFP who reflect and strive to live these principles whenever they work together on your behalf.

Let us know what you think.

Are we on the right track? I am always happy to hear from you about where you struggle and where you are succeeding in your practice so that we can continue to support and advocate for what you need to serve your patients well.

 

Motivating Patients to Move—What can you do?

Many people look at the new year as a chance to reset their behaviours by making health-oriented resolutions. A quick look at Google Trends shows marked increases in search terms like “get fit” and “lose weight” around January 1. With patients already motivated to get up and get moving, how do you encourage their continued participation in regular physical activity after the excitement of the new year (and its resolutions) has passed?

What can you do to help them stay on both the figurative and literal track? Turns out, it may be as simple as writing a “prescription” to track their activity with a pedometer. In particular, in patients with chronic disease, the most successful interventions to increase physical activity are those that involve specific behavioural strategies and encourage self-monitoring. And using a pedometer fulfills both of these.

Providing patients with a written, goal-oriented exercise program has been previously demonstrated to increase physical activity levels. A sample “prescription” for activity with a pedometer might look like:

  1. Wear your pedometer every day for one week
  2. Calculate your daily steps (feel free to average to the closest 1,000-step increment)
  3. Add 500 steps per day to your daily average; walk that each day for the next week
  4. Repeat Step 3, adding 500 steps to last week’s daily goal and walk that each day for the next week
  5. Continue to your target of 10,000 steps per day

About the Author

Tina Korownyk, MD CCFP
Associate Professor, Family Medicine, University of Alberta
Assistant Director, Evidence and CPD Program, Alberta College of Family Physicians

Tina is an Associate Professor in the Department of Family Medicine at the University of Alberta. She has worked as a Family Physician for the past 12 years, primarily in Edmonton at the Northeast Community Health Centre.

Tina is a founding member of PEER, an evidence based medicine organization that seeks to improve patient care in the community through evidence synthesis and knowledge translation in the context of primary care. She is actively involved in the development of Tools for Practice and Continuing Professional Development programs within Alberta and nationally. She has many research interests, most of which include practical questions relating to the improvement of primary care and is also involved in the Pragmatic Trials Collaborative, which engages community physicians in clinical trials that seek to answer pivotal questions relating to improved patient outcomes.

Leadership for Where You Are

When physicians hear “leadership”, many think it’s a title for their peers who have been in the system for years and take part in provincial committees; but leadership is being redefined by physicians in all stages of their career. Dr. Dinesh Witharana, a physician in his first five years of family practice, took some time to talk about his leadership journey so far:

As a physician in your first five years of family practice, what pushed you to take on a system leadership role?
As a medical student and resident, I had always told myself to avoid taking on additional responsibility. Medicine has a way of asking more and more of you, and it never seems to stop asking. I wanted to avoid taking on too much leadership and administration responsibilities and end up neglecting my clinical or personal obligations. However, during my first five years of practice, I became increasingly frustrated with gaps/barriers in the medical system for patients and caregivers, including health care professionals, without someone to advocate for them. As a result, I started taking on leadership positions to tear down some of those barriers, and bridge those gaps that I saw in my clinical practice.

What has been your most rewarding experience so far?
I had a palliative patient at home who needed urgent treatment for hypercalcemia. It was incredibly difficult to get her treatment as an outpatient in a reasonable time without sending her through ER. Eventually I was successful, but pushed for change after. Three quick emails and two weeks later, the process changed to allow palliative patients in my community to get urgent treatment as an outpatient quickly and easily. It was incredibly rewarding to see change to a policy so quickly. That change will now improve the quality of life for patients, theirs families, their healthcare providers, and save healthcare dollars all at the same time. Win-Win-Win-Win.

Have you encountered any challenges or barriers in taking on a leadership role? How did you overcome these?
The only barrier to taking on leadership roles is trying to manage that along with clinical practice, teaching, administration duties, and family/personal time. However, leadership roles can light a fire in you that brightens all those other aspects of your life. Your time in leadership roles can improve the quality of your time spent doing activities outside leadership.

What advice would you give to physicians who have considered taking on a leadership role, but are hesitant to do so?
Pick things you are really passionate about. There are so many opportunities for physicians to get engaged, so pick your battles carefully. There is a balance, but taking on leadership responsibilities doesn’t necessarily have to compete with other aspects of your life. Often it can complement and enhance everything else that you do.

 

About the Author

Dinesh Witharana is a family physician in Spruce Grove who primarily focuses on community primary care of palliative patients. He often brings residents with him to his hospice rounds and home visits. He also enjoys participating on The Provincial Palliative Tumor Group as an Executive Member, the AMA Section of Palliative Care Fee Committee, The ACFP’s First Five Years In Practice Committee, and soon the Core Committee for the Cancer Strategic Clinical Network. He lives in Spruce Grove with two amazing children, Nala (3 years old) and Kaius (4 months old) and a extraordinary wife, Wing.

Mainpro+ Tips: Complete an Assessment Activity for 6 Certified Credits

Learn More About Claiming Credits Through Assessment Activities

You may earn certified Mainpro+ credits by completing a number of assessment activities including practice audits, quality assurance programs, Linking Learning to Assessment exercises, provincial Practice Reviews, PearlsTM, and/or medical examiner for certification exams.

Earn Six Certified Mainpro+ Credits With a Step by Step to Completing an Assessment Activity

  1. Go to www.cfpc.ca/login
  2. Click on the large Mainpro+ logo on the centre of the screen to the right of the PROFILE box
  3. Click on ENTER A CPD ACTIVITYgreen button below your name (in the top left of the screen)
  4. Select the Category type and click on Assessment
  5. Click on Certified
  6. Click on Practice Audit/Quality Assurance Programs
  7. Fill out the form and click on submit

Watch the Assessment Activity Tutorial

December’s E-Panel Results Are In!

Results of the December e-panel on digestive health clinical care pathways show that most physicians find them useful and feel there is a way to integrate them into practice before seeking a specialist referral. The sample size of this survey was 29 family physicians from across Alberta.

87% of respondents state that clinical care pathways have a role in practice if used before considering a specialist referral. Over 80% of members agreed or strongly agreed that clinical care pathways are useful, relevant to their practice, and help them provide quality care to their patients.

Participants were asked a total of six questions in an online survey which was open for 10 days. One question asked participants to reflect on what would increase the likelihood of their using a clinical care pathway in their practice.

Full e-panel results are available for download here.

The Alberta Family Medicine E-Panel is an initiative supported by the Alberta College of Family Physicians, Alberta Health Services Clinical Networks, Alberta Health Services Primary Health Care Integration Network, and the Alberta Medical Association. If you have questions about or would like to be a member of this e-panel, please contact Adam Filiatreault.

Mainpro+ Tips: Linking Learning to Research

Claim Mainpro+ Credits for Your Research Work Through Linking Learning Exercises

What Are Linking Learning Exercises

Linking Learning exercises are self-administered, semi-structured exercises. They challenge you to look at day-to-day activities as learning opportunities. The Linking Learning submission forms helps you to identify a question, and then guide you through a series of critical inquiry and practice reflection exercises on your way to answering the question.

Each completed Linking Learning exercise earns five Mainpro+ certified credits and there is no limit on the number of exercises you may complete in a cycle.

For more details on Linking Learning Exercises, visit the CFPC website.

Step by Step to Completing a Linking Learning to Research

Did you know if you review guidelines, you can earn certified credits by completing a Linking Learning exercise. Linking Learning Exercises involve an approach to answering questions through information appraisal and integration, rather than information acquisition.

The form will help you to identify a question, and then guide you through a series of critical inquiry and practice reflection exercises on your way to answering the question. Each completed exercise earns five (5) Mainpro+ certified credits.

  1. Go to www.cfpc.ca/login
  2. Click on the large Mainpro+ logo on the centre of the screen to the right of the PROFILE box
  3. Click on ENTER A CPD ACTIVITYgreen button below your name (in the top left of the screen)
  4. Select the Category type and click on Self-Learning
  5. Click on Certified
  6. Click on Linking Learning to Research
  7. Fill out the form and click on submit

New! CanMEDS-Family Medicine Competency Framework 2017

CanMEDS-FM 2017 is a competency framework designed for all family physicians regardless of practice type, location, or populations served. Together with the College of Family Physicians of Canada’s (CFPC) Family Medicine Professional Profile, it forms an overall picture of the roles and responsibilities of Canadian family physicians along with the competencies required to support their work.

Key changes and new elements in this version compared to CanMEDS-FM 2009 include:

  • An emphasis on generalism, and as part of this, community-adaptive expertise introduced within the Family Medicine Expert Role
  • Cultural safety introduced as an important feature of care provided by family physicians, with a description of related enabling competencies
  • Increased emphasis on patient safety
  • Continuous quality improvement introduced within the Leader, Scholar and Health Advocate Roles
  • The CFPC’s Four Principles of Family Medicine strengthened and reaffirmed
  • The Leader Role replaces the CanMEDS-FM 2009 Manager Role, as per changes made in CanMEDS 2015

All seven Roles were revised; however, the Family Medicine Expert Role underwent the most extensive adaptation, aiming to integrate competencies across all Roles.

How to use CanMEDS-FM 2017

Principles and suggestions for using CanMEDS-FM 2017 are as follows:

  • It applies to all family physicians. The Role descriptions and enabling competencies are independent of practice context, practice type, and population served. Taken as a whole, it captures both the common and distinctive competency requirements for family physicians
  • It defines the abilities needed by family physicians across the educational continuum of undergraduate, postgraduate, enhanced skills training, and continuing professional development
  • It does not define levels of competence, also referred to as benchmarks or milestones
  • It can be used by others who work with family physicians in medical education, family medicine research, quality improvement, and more broadly within the health care system.