End-of-life treatment decisions can be difficult for both physicians and patients, but many issues can be avoided by following the key concepts outlined.
While restraints should be used only in extraordinary circumstances, physicians can take steps to reduce the risks and help ensure patient safety.
For many physicians, a regulatory authority (College) complaint is stressful, but can be managed by speaking with the CMPA, assessing the complaint, and responding professionally and respectfully.
Responsibilities of physicians when planning to close or leave a practice due to retirement, illness, or other reasons.
Physicians working in walk-in clinics face unique challenges and medical-legal risks related to team communication, management of test results, and review of delegated work.
An overview of issues physicians need to consider when conducting treatment or non-treatment capacity assessments.
Physicians should participate in quality assurance activities such as debriefs and should reduce their medical-legal risks by ensuring the debriefs are properly structured.
Advice for physicians working with physician assistants, including issues such as delegation, supervision, and liability insurance.
Text messaging offers the potential for improved communication among physicians and healthcare teams, and using it appropriately can mitigate some of the inherent risks of this channel.
If physicians have reason to believe a child is in need of protection, they are responsible for informing the appropriate authority in a timely manner. Planning what to say to the family is important.
Physicians can successfully manage online ratings using a reasonable and measured approach.
Guidance for specialists on their ethical and professional responsibilities in accepting to care for new patients.
Physicians are advocates for their patients and for healthcare improvements, but this dimension of medical care can be challenging. This article explores what advocacy means and what approaches are most effective and appropriate.
A review of the precautions that physicians can take to address the risk of sever jaundice in newborns.
Advice for physicians for using social media in a way that is mindful of medico-legal risk.
Limiting patients to one issue per visit can lead to negative perceptions if not communicated with respect and diplomacy.
Wellness strategies and resources for physician residents
When physicians offer a clinical comment or opinion that will be relied on to care for a patient, they may owe that patient a duty of care—even if they have never met the patient in person.
Guidance for physicians on assessing whether a chaperone is right for their practice.
Physicians should consider encouraging patients to engage in advance care planning and appointing a substitute decision-maker early, before the patient no longer has the capacity to consent to end-of-life care.
When a patient seeks a second opinion about a diagnosis or treatment plan, the other viewpoint will confirm, modify, or offer alternatives to the initial one, and ultimately the patient is free to decide.
Physicians can take steps to help prevent abuse of the opioids they prescribe, while improving safety for their patients and reducing their own medico-legal risk.
Advice for physicians when a patient presents with an emotional support animal or requests a letter supporting their use of an emotional support animal.
A review of the concept of collateral patient information, and advice for physicians on what to do with this kind of information.
A plain-language review of CMPA’s 2023 research piece about sepsis, featuring key messages and advice for physicians.
Advice for Canadian doctors when their patients seek healthcare outside of Canada as medical tourists.
Suggested ways that physicians can reduce the risk of privacy breaches when using fax to communicate confidential patient information.
Physicians who treat or who are asked to treat transgender individuals should be aware of the ethical and legal considerations in these circumstances to avoid allegations of discrimination.
Guidance for physicians who can not reach a patient.
Physicians can benefit from an early understanding of the potential benefits and challenges that AI brings to patient care, and the possible medical-legal risks associated with using AI technologies.
An outline of key medico-legal considerations for physicians providing care to patients on long-term opioid therapy.
Physicians can take these steps to maintain a safe office environment for their employees.
Key points for physicians to keep in mind if they are providing cosmetic medicine procedures.
Guidance for physicians about addressing the possibility of pregnancy when preparing patients for procedures that could be harmful.
A review of the physicians who treat patients with cognitive decline.
Consulting physicians may be expected to provide appropriate advice to referring physicians even when their facility cannot accept the patient.
The increased availability of genetic testing raises a number of medico-legal questions that physicians should consider.
Highlights from CMPA discussion paper “The role of physician leaders in addressing physician disruptive behaviour in healthcare institutions.”
Considerations for physicians when a prospective patient does not have a health card.
Accepting and refusing new patients is part of managing a primary care practice, and physicians should be aware of their College’s policies on this matter.
The courts expect physicians to provide appropriate care to patients, making effective use of available resources.
Considerations for ending the doctor-patient relationship.
As physicians age or they experience cognitive or health decline, they will want to be familiar with requirements set out by their College, and understand their ability and possible limitations to deliver safe medical care.
Tips for physicians to help prevent drug diversion and related unlawful prescription activity, and avoid potential medical-legal difficulties.
Physicians can be better prepared to transfer patient health information when they understand who has custody of and access to medical records.
Physicians should be aware of the pros and cons of social media and the risks of participating.
Physicians can take steps to mitigate the medical-legal risks of patients taking photos and making video and audio recordings during healthcare encounters.
A just patient safety culture promises the provision of higher quality and safer care. Advice is provided to CMPA members on participation in reporting and reviews of adverse events and close calls in hospitals and institutions.
Physicians should understand the role of coroners and medical examiners in Canada,
and how and when to provide information to them.
The CMPA answers members’ medico-legal questions on the implications of deferring patient care during the COVID-19 pandemic.
This article explores the role of physicians in promoting the exchange of information and active decision-making by patients. It also examines the relationship between decision-making and consent.
Protecting the privacy of patient information when using digital communication channels, including email, portals, and social media platforms.
An analysis of CMPA medico-legal cases involving unintentionally retained foreign bodies during surgery, and suggested approaches to mitigate the risks.
Adherence to credible CPGs can be beneficial and assist in providing quality care, though they do not necessarily establish a standard of care
Whether providing or referring patients to alternative treatments, physicians need to remain mindful of their professional obligations, potential medico-legal risks
What can be done to maintain quality care for patients and reduce medical-legal risks for physicians when patients do not heed medical advice.
A description of the impact of overly limited or absent of physical examination on diagnostic error and patient harm using CMPA cases.
The Colleges outline expectations for continuity of care, and physicians can enhance continuity when they are aware of their professional obligations, and have the necessary systems in place for managing tests, patient transfers, and availability and coverage.
A review of CMPA medico-legal cases showed opportunities for physicians to improve their communication and coordination of care for patients undergoing non-urgent in-hospital surgery.
An overview of communication strategies physicians can use to help resolve conflict with other physicians or other healthcare providers.
Actions physicians can take to mitigate potential risks of using patient portals to communicate clinical information with patents.
While fatigue can negatively affect the performance of individual physicians, systematic and standardized approaches to teamwork and communication may help mitigate patient safety risks.
The CMPA advises on how to reduce medico-legal risks from vaccination, and how to address vaccine hesitancy and refusal.
Communication and conflict resolution skills may help physicians deal effectively and safely with challenging patient encounters.
Effective communication and awareness of legal requirements are key to obtaining consent for treatment of children.
Although communication is identified as an underlying issue in the significant 10-year rise in the number of members asking for CMPA help with College complaints, research suggests physicians can improve their interactions with better communication skills.
Physicians regularly encounter patients or family members who behave aggressively and make demands that may be unrealistic and potentially harmful. In their medical practice, physicians need strategies and tools to manage conflict and such challenging behaviours.
Physicians who are familiar with regulatory requirements governing organ and tissue donations can more effectively meet their obligations and mitigate the potential for complaints.
Professional and ethical obligations to keep in mind when considering offering medical services through online virtual clinics.
An analysis of CMPA medico-legal cases involving lower extremity joint surgery and the non-technical factors contributing to patient harm and medico-legal risk.
Physicians should use their professional judgment when determining whether a virtual assessment, an in-person assessment, or a hybrid of both is best for individual patients.
Ambulance offload delay results from ED crowding and can present unique medico-legal risks for ED physicians.
An overview of the different legal protections attaching to different practice arrangements.
When patients make requests for specific care providers, treatments, or services, physicians should assess whether they can reasonably accommodate such requests.
Physicians considering various arrangements for practising medicine, other than the privileges-based model, need to consider any medico-legal implications.
Focusing on the follow-up phase of clinical testing for office-based family physicians, this article presents actionable advice based on a review of CMPA legal and College cases.
A review of CMPA medico-legal cases and research literature describing the non-technical factors contributing to diagnostic errors by surgeons in hospital operating rooms.
An overview of ways in which physicians can use patient decision aids (PDAs) to encourage shared decision-making.
Care for patients with mental health concerns can be complicated, especially when access to psychiatric expertise is limited. Consider these strategies to address medical-legal risks when managing patients’ mental health needs.
This article discusses infections associated with intravenous drug use. These infections are on the rise and can be diagnostically challenging.
Clarity about who is responsible for the care of a patient at any given time improves patient safety and reduces medico-legal risk.
Physicians working in walk-in clinics face unique challenges and medical-legal risks related to team communication, management of test results, and review of delegated work.
This article offers practical tips and techniques for building a robust system for follow-up of clinical test results that can be applied in both office and hospital practice settings.
DISCLAIMER: This content is for general informational purposes and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. Your use of CMPA learning resources is subject to the foregoing as well as CMPA's Terms of Use.
