Council Highlights for May 9, 2019
The 418th meeting of the RCDSO Council was held in in Toronto on May 9, 2019.
President Flavio Turchet opened the meeting and spoke about the Cayton report on the College of Dental Surgeons of BC. Flavio said that many of the recommendations of that report are already in place at the RCDSO. The fact that none of the items sounds radical or different to us, he said, reflects that we have been moving to this way of thinking for some time - and with good reason. With regulation and regulators under the microscope it helps a lot that we have been out in front of these issues and providing leadership.
Strategic Plan and Consultations
Council approved a draft three-year Strategic Plan. The plan is the result of much engagement with staff and managers. The next step will be a broader consultation with members and stakeholders. RCDSO departments will use the priorities outlined by the plan to generate operational plans and College budgets.
Council also heard about plans for more consultation on all RCDSO initiatives. If we are to meet our mandate of acting in the public interest we need to make sure our stakeholders have real opportunities to comment and provide input on the work of the College. One new step will be a preliminary engagement exercise to get input at the beginning of the project. Council agreed there was also value in more reporting back to stakeholders to demonstrate how their voices had been heard.
Charitable services fee
Council approved a measure to reduce the annual fee for members who wish provide volunteer/charitable dentistry services. The Registration Committee proposed that if a member:
- maintained competency through the Quality Assurance program, including the Practice Enhancement Tool (PET) and continuing education;
- received no compensation inside of Ontario from the practice of dentistry; and
- wanted to provide treatment in underserviced areas anywhere, the member would pay a reduced fee of $250 and be fully covered by the PLP program along as the work was done in Ontario.
Council was told about several new working groups that will providing guidance in some new areas or revising guidance for older documents:
- The Advertising Working Group will be reformed to consider how to modernize our advice on advertising.
- A working group will also look at teledentistry and new ways to give better access to services for the public. The working group will develop a guidance document on use of teledentistry.
- The Electronic Records Management guidelines date to 2012. Since then eRecords have increased exponentially, as have concerns about security issues. The Quality Assurance Committee believes it is critically important that the guidelines are updated to meet current conditions. A working group will look at this issue.
Council heard a presentation on our Complaints Project – the study of 11 years of complaints data analyzed by researchers at the University of Toronto, led by Dr. Carlos Quinonez. The final report has now been completed and will be submitted for publication to a peer-reviewed journal. The statistics show a remarkably similar picture of issues over time, around standards of practice, followed by concerns about patient interaction and interpersonal skills. The College will consider next steps to address these and other concerns raised.
Ongoing College work
Plans for an Access to Care symposium this fall were reported to Council. The November event will draw on a variety of speakers and panelists to help us understand the nature of access problems and what we might do to improve the situation.
Council members learned of the next steps in our work to help deal with the opioid crisis. The latest data on prescribing patterns across the province has now been released to us. The data will be analysed and compare to our previous study results. We have been seeing a positive effect from the College’s updated guidance on opioid prescribing and there is hope we will see this trend continue.
Amendments to guidelines and standards
Proposed guidelines have been drafted on intraoral procedures that are not controlled acts, carried out by third parties. The Guidelines will help dentists to understand their responsibilities when delegating some procedures.
The College’s new Standard on Sedation and General Anesthesia was given final approval. One of the most important changes was building in requirements for dentists wishing to provide minimal sedation. Council had approved in principle some by-law changes which had been previously circulated.
In 2014, Council approved a new by-Law for sedation and general anesthesia that changed the College’s process and created greater flexibility for our members to provide these services to patients. In essence, the new By-Law separated the two parts of the process, so that a member’s authorization to administer sedation or general anesthesia was no longer tied to the facility permit for a specific dental practice location.
Council has now approved that this same approach will be applied in our process for dental CT scanners.
The proposed By-Law #20 establishes a new process for members to be authorized by the College to prescribe, order or take dental CT scans in a dental facility. Under the proposed By-Law, members wishing to obtain authorization from the College will be required to submit a completed application, pay a fee and satisfy the College that they meet the requirements of the Standard of Practice for Dental CT Scanners.
Members may obtain a facility permit from the College to install and operate a dental CT scanner at a specified location. Members wishing to obtain a facility permit will be required to submit a completed application, indicating whether they are requesting a facility permit for a DA scanner or a CF scanner, and pay a fee. The impact should be wider access to CT scanning services across the province.
As we develop and improve our advice and standards of practice one old practice advisory, on the use of latex gloves and cleaning agents, is being retired. It has been replaced by the new Infection Prevention and Control Standard; the old document will be removed from circulation.
Council also approved stronger measures around administrative suspensions. Some dentists do not complete the renewal form in its entirety. Currently the College has limited powers when dentists refuse to provide information – even though the College has an obligation under law to ask many of the questions. One example – we are required to ask if a member of applicant has been found guilty of a criminal offence. Council agreed we should compel members to complete the questionnaire. If they don’t, the College would have the discretion to suspend the member. This issue was discussed at length by previous Council and circulated for input by stakeholders. It is also supported by ODA. It is consistent with many of the other Colleges.
Next Council Meeting
The next Council meeting will be held in Toronto at the Sheraton Centre on Thursday, November 14, 2019.