Pub Date : 2024-08-09DOI: 10.30770/2572-1852-110.2.5
Katie L. Templeton
{"title":"Physician Well-Being and Patient Safety: The Crossroads to the Best in Medicine","authors":"Katie L. Templeton","doi":"10.30770/2572-1852-110.2.5","DOIUrl":"https://doi.org/10.30770/2572-1852-110.2.5","url":null,"abstract":"","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"51 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141923747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.30770/2572-1852-110.2.34
Susan Lamb
{"title":"Regulating Professions: The Emergence of Professional Self-Regulation in Four Canadian Provinces","authors":"Susan Lamb","doi":"10.30770/2572-1852-110.2.34","DOIUrl":"https://doi.org/10.30770/2572-1852-110.2.34","url":null,"abstract":"","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"5 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.30770/2572-1852-110.2.14
Ai-Leng Foong-Reichert, Sherilyn J D Houle, K. Grindrod
Previous Canadian reviews of physician, pharmacist, and dentist disciplinary action have noted differences in discipline outcomes across professions and provinces. The objective of this study was to compare the disciplinary action process across provinces and professions, and to describe the perspectives of health professional regulatory bodies on the disciplinary action process. Participation from medicine, pharmacy, nursing, and dentistry registrars or complaints directors from 10 Canadian provinces was sought. One-on-one, semi-structured interviews were conducted by telephone or video call. Nineteen interviews with regulators were conducted—8 pharmacy, 5 nursing, 5 medicine, and 1 dentistry. Complaints and discipline processes followed a similar overall pathway with some differences. Differences in process were largely due to differences in health regulation legislation and were noted across professions, across provinces, and within a province. Participants tended to be more aligned with regulators within their province rather than regulators of the same profession across the country. To our knowledge, this paper is the first to describe Canadian health professional regulatory body perspectives on the complaints and discipline process. More research is needed to better understand the factors that affect discipline outcomes and to ultimately improve complaints and discipline processes.
{"title":"Regulatory Body Perspectives on Complaints and Disciplinary Action Processes for Health Professionals","authors":"Ai-Leng Foong-Reichert, Sherilyn J D Houle, K. Grindrod","doi":"10.30770/2572-1852-110.2.14","DOIUrl":"https://doi.org/10.30770/2572-1852-110.2.14","url":null,"abstract":"\u0000 \u0000 \u0000 Previous Canadian reviews of physician, pharmacist, and dentist disciplinary action have noted differences in discipline outcomes across professions and provinces. The objective of this study was to compare the disciplinary action process across provinces and professions, and to describe the perspectives of health professional regulatory bodies on the disciplinary action process.\u0000 \u0000 \u0000 \u0000 Participation from medicine, pharmacy, nursing, and dentistry registrars or complaints directors from 10 Canadian provinces was sought. One-on-one, semi-structured interviews were conducted by telephone or video call.\u0000 \u0000 \u0000 \u0000 Nineteen interviews with regulators were conducted—8 pharmacy, 5 nursing, 5 medicine, and 1 dentistry. Complaints and discipline processes followed a similar overall pathway with some differences. Differences in process were largely due to differences in health regulation legislation and were noted across professions, across provinces, and within a province. Participants tended to be more aligned with regulators within their province rather than regulators of the same profession across the country.\u0000 \u0000 \u0000 \u0000 To our knowledge, this paper is the first to describe Canadian health professional regulatory body perspectives on the complaints and discipline process. More research is needed to better understand the factors that affect discipline outcomes and to ultimately improve complaints and discipline processes.\u0000","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"71 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.30770/2572-1852-110.2.7
Zubin Austin, Aly Háji
Sociologists define “wicked problems” as issues confronting humanity that have no clear right answer or perspective. The issue of climate change is a wicked problem of our age—and an issue that few regulators have explicitly addressed within their remit. The polluting effects of health care work itself have recently been highlighted as a call to action within health professions to address climate change issues more forcefully. Perspectives on how and why regulators should—or should not—prioritize climate change in their activities can be difficult to articulate. An approach to this issue that focuses on appropriate and proportionate use of regulatory levers is essential. Processes to allow for greater transparency in discussions, decision making, and strategic plan development are important for regulators to consider. While regulatory bodies vary in their statutory ability or organizational capacity to lead or address climate change directly within their profession, opportunities may exist to partner with other groups to develop evidence-informed options for practitioners.
{"title":"What Could (Or Should) Be the Regulatory Response to the Wicked Problem of Climate Change?","authors":"Zubin Austin, Aly Háji","doi":"10.30770/2572-1852-110.2.7","DOIUrl":"https://doi.org/10.30770/2572-1852-110.2.7","url":null,"abstract":"\u0000 Sociologists define “wicked problems” as issues confronting humanity that have no clear right answer or perspective. The issue of climate change is a wicked problem of our age—and an issue that few regulators have explicitly addressed within their remit. The polluting effects of health care work itself have recently been highlighted as a call to action within health professions to address climate change issues more forcefully. Perspectives on how and why regulators should—or should not—prioritize climate change in their activities can be difficult to articulate. An approach to this issue that focuses on appropriate and proportionate use of regulatory levers is essential. Processes to allow for greater transparency in discussions, decision making, and strategic plan development are important for regulators to consider. While regulatory bodies vary in their statutory ability or organizational capacity to lead or address climate change directly within their profession, opportunities may exist to partner with other groups to develop evidence-informed options for practitioners.","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"28 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.30770/2572-1852-110.2.26
C. Gallagher, David H. Reissner
This paper presents the case study of a British doctor who posted videos on social media platforms denying the existence of COVID-19. The case examines the approach taken by the UK’s medical regulator in dealing with doctors who espouse conspiratorial views at odds with accepted medical opinion. In such cases, there may be a conflict between the safety of patients and the public (which is the principal function of medical regulators) and the doctor’s freedom of expression (whether under the First Amendment, Article 10 of the European Convention on Human Rights, or another international human rights instrument). During this protracted three-and-a-half-year case, the UK’s Medical Practitioners’ Tribunal, High Court and —latterly—Court of Appeal have each made it clear that doctors remain free to express views contrary to medical orthodoxy except where they lack any supporting evidentiary basis. In September 2023, an order was made revoking the doctor’s licence. Rather than accept the Tribunal’s guidance following his initial suspension, he chose to continue promoting his conspiratorial views in a public forum.
{"title":"COVID-denial Invites License Revocation in the UK","authors":"C. Gallagher, David H. Reissner","doi":"10.30770/2572-1852-110.2.26","DOIUrl":"https://doi.org/10.30770/2572-1852-110.2.26","url":null,"abstract":"\u0000 This paper presents the case study of a British doctor who posted videos on social media platforms denying the existence of COVID-19. The case examines the approach taken by the UK’s medical regulator in dealing with doctors who espouse conspiratorial views at odds with accepted medical opinion. In such cases, there may be a conflict between the safety of patients and the public (which is the principal function of medical regulators) and the doctor’s freedom of expression (whether under the First Amendment, Article 10 of the European Convention on Human Rights, or another international human rights instrument).\u0000 During this protracted three-and-a-half-year case, the UK’s Medical Practitioners’ Tribunal, High Court and —latterly—Court of Appeal have each made it clear that doctors remain free to express views contrary to medical orthodoxy except where they lack any supporting evidentiary basis.\u0000 In September 2023, an order was made revoking the doctor’s licence. Rather than accept the Tribunal’s guidance following his initial suspension, he chose to continue promoting his conspiratorial views in a public forum.","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"86 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.30770/2572-1852-110.1.7
Andrzej Kozikowski, Mirela Bruza-Augatis, D. Morton-Rias, Alicia Quella, Shani Fleming, Carolyn Bradley-Guidry, Sheila G Mauldin, C. Jeffery, Kasey Puckett, Joshua Goodman
Healthcare workforce diversity is essential for increasing access and reducing racial/ethnic health disparities. We examined the growth and trends in physician assistant/associate (PA) workforce demographic composition by initial year of certification. Drawing on data from the National Commission on Certification of Physician Assistants, we aggregated gender, age (1975-2020), race/ethnicity, and underrepresented in medicine (URiM) (2000-2020). Descriptive statistics of demographics were calculated by the initial certification year and assessed for trends using the Cochran-Armitage test. Analyses revealed an 11.7% annual growth rate in PAs earning initial certification and a change in gender composition (23.9% to 74.2% female) from 1975 to 2020. Between 2000 and 2020, we observed significant increases (all p<0.001) in the proportions of PAs who self-identify as Asian (5.7 percentage points), Hispanic/Latino(a) (3.5 percentage points), and multiracial (2.4 percentage points). However, there was a decline (all p<0.001) in the proportions of PAs who self-identify as Black/African American (1.2 percentage points), American Indian/Alaska Native (0.1 percentage points), Native Hawaiian/Pacific Islander (0.1 percentage points), and other race (1.1 percentage points). Trend analyses revealed that the proportion of PAs identifying as URiM decreased over the past 21 years. Ongoing assessment of the PA workforce demographics is essential to track the progress and effectiveness of diversification initiatives.
{"title":"The Importance of Diversity in the Physician Assistant/Associate Workforce: Examining the Profession's Growth and Trends in Demographic Composition","authors":"Andrzej Kozikowski, Mirela Bruza-Augatis, D. Morton-Rias, Alicia Quella, Shani Fleming, Carolyn Bradley-Guidry, Sheila G Mauldin, C. Jeffery, Kasey Puckett, Joshua Goodman","doi":"10.30770/2572-1852-110.1.7","DOIUrl":"https://doi.org/10.30770/2572-1852-110.1.7","url":null,"abstract":"\u0000 \u0000 \u0000 Healthcare workforce diversity is essential for increasing access and reducing racial/ethnic health disparities. We examined the growth and trends in physician assistant/associate (PA) workforce demographic composition by initial year of certification.\u0000 \u0000 \u0000 \u0000 Drawing on data from the National Commission on Certification of Physician Assistants, we aggregated gender, age (1975-2020), race/ethnicity, and underrepresented in medicine (URiM) (2000-2020). Descriptive statistics of demographics were calculated by the initial certification year and assessed for trends using the Cochran-Armitage test.\u0000 \u0000 \u0000 \u0000 Analyses revealed an 11.7% annual growth rate in PAs earning initial certification and a change in gender composition (23.9% to 74.2% female) from 1975 to 2020. Between 2000 and 2020, we observed significant increases (all p<0.001) in the proportions of PAs who self-identify as Asian (5.7 percentage points), Hispanic/Latino(a) (3.5 percentage points), and multiracial (2.4 percentage points). However, there was a decline (all p<0.001) in the proportions of PAs who self-identify as Black/African American (1.2 percentage points), American Indian/Alaska Native (0.1 percentage points), Native Hawaiian/Pacific Islander (0.1 percentage points), and other race (1.1 percentage points). Trend analyses revealed that the proportion of PAs identifying as URiM decreased over the past 21 years.\u0000 \u0000 \u0000 \u0000 Ongoing assessment of the PA workforce demographics is essential to track the progress and effectiveness of diversification initiatives.\u0000","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"33 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141005551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.30770/2572-1852-110.1.20
David Alan Johnson
In 2020, FSMB commenced a closer look at its history to provide a more transparent accounting of past statements, actions and policies evincing bias, discrimination, or racism. There is much in FSMB history that is positive but it is clear that FSMB fell short at times in demonstrating a consistent commitment to values we recognize as integral to a just society. This failure proved especially impactful to international medical graduates (IMGs), osteopathic physicians, women, and persons of color. Vitriolic language, under-representation and bias factored into the FSMB experience of these groups to varying degrees. While some FSMB statements and policies reflected overt bias, more often, inaction or silence characterized FSMB response to discrimination unfolding within the medical profession and society. This can be attributed, in part, to the long period in which FSMB's modest resources created over-reliance upon the profession (eg, the American Medical Association). This dependence resulted in missed opportunities for FSMB to champion priorities committed to the responsibilities and interests of the regulatory community and the public it serves, as opposed to those of the profession. Unsurprisingly, FSMB governance reflected the same power dynamics and lack of diversity seen within leadership in the profession until recent decades. FSMB has taken multiple steps to address past failures: revisiting how it recognizes and honors individual contributors to medical regulation, adopting policy statements and guidelines codifying a commitment to inclusive governance and educational programming. Further actions are possible through naming conventions behind FSMB awards and potential policy addressing the appointive process to state medical boards.
{"title":"Past Imperfect: Revisiting the History of the Federation of State Medical Boards","authors":"David Alan Johnson","doi":"10.30770/2572-1852-110.1.20","DOIUrl":"https://doi.org/10.30770/2572-1852-110.1.20","url":null,"abstract":"\u0000 In 2020, FSMB commenced a closer look at its history to provide a more transparent accounting of past statements, actions and policies evincing bias, discrimination, or racism. There is much in FSMB history that is positive but it is clear that FSMB fell short at times in demonstrating a consistent commitment to values we recognize as integral to a just society. This failure proved especially impactful to international medical graduates (IMGs), osteopathic physicians, women, and persons of color. Vitriolic language, under-representation and bias factored into the FSMB experience of these groups to varying degrees.\u0000 While some FSMB statements and policies reflected overt bias, more often, inaction or silence characterized FSMB response to discrimination unfolding within the medical profession and society. This can be attributed, in part, to the long period in which FSMB's modest resources created over-reliance upon the profession (eg, the American Medical Association). This dependence resulted in missed opportunities for FSMB to champion priorities committed to the responsibilities and interests of the regulatory community and the public it serves, as opposed to those of the profession. Unsurprisingly, FSMB governance reflected the same power dynamics and lack of diversity seen within leadership in the profession until recent decades.\u0000 FSMB has taken multiple steps to address past failures: revisiting how it recognizes and honors individual contributors to medical regulation, adopting policy statements and guidelines codifying a commitment to inclusive governance and educational programming. Further actions are possible through naming conventions behind FSMB awards and potential policy addressing the appointive process to state medical boards.","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"88 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141004228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.30770/2572-1852-110.1.37
{"title":"State Member Board Briefs","authors":"","doi":"10.30770/2572-1852-110.1.37","DOIUrl":"https://doi.org/10.30770/2572-1852-110.1.37","url":null,"abstract":"","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"38 s170","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141003474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.30770/2572-1852-110.1.38
{"title":"International Briefs","authors":"","doi":"10.30770/2572-1852-110.1.38","DOIUrl":"https://doi.org/10.30770/2572-1852-110.1.38","url":null,"abstract":"","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"101 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141003752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.30770/2572-1852-110.1.35
Sarah B. Rodriguez
{"title":"Masters of Health: Racial Science and Slavery in US Medical Schools","authors":"Sarah B. Rodriguez","doi":"10.30770/2572-1852-110.1.35","DOIUrl":"https://doi.org/10.30770/2572-1852-110.1.35","url":null,"abstract":"","PeriodicalId":91752,"journal":{"name":"Journal of medical regulation","volume":"51 1‐2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141004146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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