2020 SMA Membership Guide

MEMBERSHIP GUIDE Saskatchewan Medical Association | 2020

MEMBERS ON OUR COVER Row 1, left to right:

Dr. Sara Dungavell, psychiatry, Saskatoon | Dr. Jay Kalra, pathology and laboratory medicine, Saskatoon | Dr. Mahli Brindamour, paediatrics, Saskatoon | Dr. Joel Schindel, family medicine, Comprehensive Indigenous Community Care Clinics

Row 2, left to right:

Dr. Francisco Garcia, urology, Swift Current | Nancy Hua, student, Saskatoon | Dr. Reid Sonntag, family medicine, Swift Current | Dr. Intheran Pillay, family medicine, Gravelbourg

Row 3, left to right:

Dr. Stephanie Nyberg, family medicine, Melfort | Dr. Volker Rininsland, family medicine, Moose Jaw | Dr. Crystal Litwin, family medicine, Wynyard | Dr. Allan Woo, orthopaedic surgery, Saskatoon

Row 4, left to right:

Dr. Joseph Buwembo, neurosurgery, Regina | Masooma Bhatti, student, Saskatoon | Dr. Matthew Butz, family medicine resident, Prince Albert | Dr. Janet Tootoosis, family medicine, Battleford

MISSION As the common voice of our members, we serve, represent and unite Saskatchewan physicians.

We advance the honour and integrity of the medical profession; advance the professional, personal, educational, and economic welfare of Saskatchewan physicians; and promote a high quality, patient-centred health care system.

CONTENTS 4 5

6 7 8 9 10 11 12

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Welcome Membership

CME Fund

Parental Leave Program

Retention Fund

CMPA Reimbursement Fund

Negotiations, fees and contracts Insurance Canadian Medical Association MD Financial Management Privacy Saskatchewan EMR Program Physician support programs

Physician Health Program

Member Advisory Component

Medical Benevolent Society

Retention and recruitment Rural and regional practice support Specialist support

16 17 18 19 20 21 22 23 24 26

Rural Relief Program Education and leadership Residents Insurance for residents Students Roadmap Program Member communications Structure and governance Charter of shared values CMA Code of Ethics

WELCOME Dear colleague, Thank you for choosing, to join the Saskatchewan Medical Association (SMA). The SMA provides advocacy, leadership and support in all phases of your career, as a student, a resident, a physician in active practice and in retirement. The SMA has numerous programs and services that make a positive difference in both your professional and personal life.

This guide outlines the wide range of benefits available to you and your family, and how to access them. By joining the SMA, you automatically become a member of the Canadian Medical Association (CMA) and can access all the comprehensive products, services and resources of that membership as well.

As the voice of organized medicine in Saskatchewan, the SMA represents specialists, family physicians, residents and medical students in a way that honours the values of physicians, such as collegiality and quality patient care. Our voice gets stronger with each member, helping the SMA advocate for a quality health-care system for Saskatchewan, and advance the honour and integrity of the profession.

We hope this guide serves as a useful resource. Should you have any questions about the SMA or about practising medicine in Saskatchewan, please don’t hesitate to contact us at any time.

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Saskatchewan Medical Association MEMBERSHIP GUIDE | 2020

MEMBERSHIP Continuing Medical Education Fund The Continuing Medical Education Fund reimburses physicians for expenses related to educational courses, meetings or materials, including computer hardware up to a maximum amount each year.

All eligible physicians are encouraged to take advantage of the fund. For complete program guidelines, to apply, or to check your CME balance, visit the SMA website.

Parental Leave Program The Parental Leave Program is available to licensed physicians living and working in a self-employed practice in Saskatchewan. The program provides up to 20 weeks of benefits to a physician who is taking a maternity, paternity or adopted child care leave from clinical practice. The physician will receive 50 per cent of his or her average weekly income earned over the previous six months, to a maximum of $1,300 per week. These benefits may be reduced by benefits or income received from other sources.

For more information contact the Membership & Benefits team: Joelle Kostiuk, Coordinator, Membership & Benefits Email: joelle.kostiuk@sma.sk.ca Jodie Munro, Coordinator, Membership & Benefits Email: jodie.munro@sma.sk.ca Sandi Ives, Admin. Assistant, Membership & Benefits Email: sandi.ives@sma.sk.ca Gina Robertson, Admin. Assistant, Membership & Benefits Email: gina.robertson@sma.sk.ca Cindy Anderson, Director, Membership, Benefits, & Insurance Email: cindy.anderson@sma.sk.ca

Retention Fund Along with the government of Saskatchewan, the SMA has established a physicians’ Retention Fund that provides financial rewards to physicians who practise in the province for extended periods. Physicians who practise in Saskatchewan for a defined period of time will earn annual entitlements that will be paid to them at designated intervals. In order to accumulate benefits, a physician must hold licensure with the College of Physicians and Surgeons of Saskatchewan and provide insured clinical services in Saskatchewan that meet the thresholds for eligibility or be in a medical administrative position approved by the Retention Fund board.

Dr. Joel Schindel, family physician Comprehensive Indigenous Community Care Clinics

CMPA Reimbursement Fund The SMA assists in administering the Canadian Medical Protective Association (CMPA) Reimbursement Fund, which rebates Saskatchewan physicians a portion of the fees for medical liability malpractice protection. Eligible physicians must be self-employed, meet certain thresholds of activity and not receive benefits from any third party or employer. Physicians must submit a registration form which is available on the SMA website.

Find out more at www.sma.sk.ca • •

Application forms for member benefits Personal fund balances and statements (member login required)

Dr. Mark Brown, family physician Moose Jaw Saskatchewan Medical Association

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NEGOTIATIONS, FEES AND CONTRACTS Dr. Mahli Brindamour, paediatrician, Saskatoon The SMA is the voice of physicians in Saskatchewan. From health-care reform to health issues, the association promotes quality health-care practices and health services and advocates for a quality health-care system for Saskatchewan patients and physicians.

Negotiations and contracts The SMA represents members in both negotiating contracts and administering negotiated contracts. It is the sole bargaining agent for fee-for-service physicians in negotiating with the provincial government. It also provides a number of services to groups and individual physicians working under or considering salary and contractual arrangements, including negotiation support, representation, economic and legal advice and dispute resolution.

Fees The SMA is responsible for the distribution of fee-for-service increases among the various specialty groups, known as the intersectional allocation process. The SMA and the Ministry of Health, through the conjoint Payment Schedule Review Committee, are responsible for the establishment of new fees, and modernizing and updating the fee schedule through changes in fee code rates, assessment rules, fee code descriptions and clarification of appropriate billing protocols and any other facets of the payment schedule.

Billing advice and assistance in communicating with the Ministry of Health, in regard to the payment schedule for insured services provided by a physician, is also available to all members. The SMA publishes the SMA Fee Guide for uninsured services and provides advice and assistance with billing outside agencies such as the Workers’ Compensation Board, SGI and Ministry of Justice as well as out-of-country residents.

For more information, contact: Marcel Nobert, Executive Director, Physician Services & Benefits Email: marcel.nobert@sma.sk.ca Mark Ceaser, Director, Economics Email: mark.ceaser@sma.sk.ca

Find out more at www.sma.sk.ca • •

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Saskatchewan Medical Association MEMBERSHIP GUIDE | 2020

Compensation SMA Fee Guide

INSURANCE As part of our mission to advance the economic welfare of Saskatchewan physicians, the SMA recognizes insurance as vital, not only to members, but also their families and employees. With the power of a large membership, the SMA has negotiated the essential and best features into all of our insurance plans with various insurance companies at competitive low rates. Furthermore, the SMA continues to review and subsequently enhance the plans.

As a member of the SMA, you may apply for insurance benefits with superior coverage at affordable rates. SMA insurance is designed to save you money in three ways:

Dr. Intheran Pillay, family physician Gravelbourg

1. We work with insurers who combine top coverage with the most attractive premium structure.

2. Our association rates offer significant savings over individual plans.

3. Our life and disability plans feature equity sharing with participants.

The SMA offers the following insurance products: • • • • • •

Dr. Jenny Basran, geriatrician Saskatoon

Disability Life Office overhead Extended medical and dental benefits Accidental death and dismemberment Medical office property

For more information, contact our experienced, noncommission SMA Insurance team: Donna Hanna, Insurance Administrator Email: donna.hanna@sma.sk.ca Jenna Duff, Coordinator, Insurance Email: jenna.duff@sma.sk.ca

Dr. Dalibor Slavik, family physician Saskatoon

Cindy Anderson, Director, Membership, Benefits, & Insurance Email: cindy.anderson@sma.sk.ca

A clear plan for the future means peace of mind in the present.

Find out more at www.sma.sk.ca •

insurance@sma.sk.ca

Saskatchewan Medical Association

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CMA Your SMA annual dues include membership with the Canadian Medical Association (CMA).

CMA members have been shaping Canadian health care for more than 150 years. That opportunity to advocate for change — on a national level — is just one of the many benefits memberships brings. You also gain access to an array of up-to-date clinical resources valued at more than $2,000 a year — and get exclusive discounts on clinical tools and software, business services, cell service, travel, and more. Save, learn and have your voice heard on some of the most critical health topics facing our country, all by becoming a member of the CMA.

Be heard. Have an impact. Make a difference.

Become part of a legacy of advocating for positive change in Canadian health care. Thanks in part to the awarenessraising efforts of CMA members, the CMA has been part of many historic health-care changes, including the dramatic drop in Canadians’ tobacco use, the establishment of RRSPs, and the creation of the Canadian Cancer Society. Today, members are driving equally important national dialogue on cannabis legalization, opioid prescribing, physician wellness, medical assistance in dying, gender equity and diversity in medicine and other significant health issues. Through the CMA, physicians across the country have a platform to connect and engage with each other on health and professional topics that matter to them.

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Saskatchewan Medical Association MEMBERSHIP GUIDE | 2020

As a CMA member, you can: • Create or join a collaborative community of interest: www.cma.ca/communities-interest • Shape CMA policy through member proposals: www.cma.ca/member-proposals Lend your perspective on key health topics through our Member Voice e-Panel: www.cma.ca/cma-member-voice-e-panel-0 Take part in national events like the CMA Health Summit: cmahealthsummit.ca • From Joule, CMA’s subsidiary, get access to more than $2,000 in leading evidence-based online clinical tools and apps – such as ClinicalKey, DynaMed Plus, CPS online and CPS on the RxTx Mobile app – that provide access to more than 1,000 textbooks and 600 journals, drug information, clinical practice guidelines, patient education and more .

• Participate in the Joule Innovation program that provides flexible funding, mentorship and knowledge sharing opportunities for physician innovators as well as an annual grant program that in 2019 will award $200,000 in grants for physician-led innovation.

• Get exclusive CMA member discounts on brand-name products and services for your practice, your business and your family.

For more information about the Canadian Medical Association, please visit cma.ca. For more about Joule, please visit joulecma.ca

MD FINANCIAL MANAGEMENT (MD) MD Financial Management (MD)* is the only national financial services firm 100 per cent dedicated to the financial well-being of Canada’s physicians. At MD, we have an unrivalled understanding of the unique needs of physicians and their families. We’re committed to delivering on those needs through best-in-class financial and practice solutions, investment expertise and personalized customer service that’s tailored to every career and life stage, from medical school and practice through to retirement and beyond.

MD has 50 years of physician-centric experience. MD advisors work on salary, not commission. Without incentives to sell any particular product, our advisors provide objective advice that is best suited to meet your unique financial needs. Objectivity is also part of our unique approach to fund management. It’s an approach based on disciplined oversight and selection from among the world’s best asset managers. Our priority is for you to meet your financial goals.

Contact us Why not talk to an MD advisor at one of our Saskatchewan offices to get started on your comprehensive financial plan, with advice and solutions specific to every stage of your career. You can also find out more about MD and its products and services by visiting md.ca.

MD’s Saskatchewan offices Saskatoon 100–306 Queen St., Main floor Saskatoon SK S7K 0M2 Tel.: (306) 244-0077 Toll-free: (800) 667-0077 Fax: (306) 244-8685 Email: zzprairieregion@md.ca Regina 205–3303 Hillsdale St. Regina SK S4S 6W9 Tel.: (306) 359-7200 Toll-free: (888) 880-6211 Fax: (306) 359-9900 Email: zzprairieregion@md.ca *MD Financial Management provides financial products and services, the MD Family of Funds and investment counselling services through the MD Group of Companies. For a detailed list of these companies, visit md.ca.

Saskatchewan Medical Association

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PRIVACY SMA corporate privacy In order to offer and provide the services and privileges to which members are entitled, the SMA collects personal information about its members. The association only uses this information for the purposes outlined in the SMA Corporate Privacy Policy.

The SMA is committed to protecting the privacy and security of its members’ personal information. As required by the Personal Information and Protection of Electronic Documents Act of Canada (PIPEDA), the SMA will not collect, use or disclose personal information about you without your consent. Further, we will never sell your personal information.

For further information please contact: Aftab Ahmad, Director, Saskatchewan EMR Program Phone: (306) 657-4572 Email: aftab.ahmad@sma.sk.ca

EMR/clinic-related privacy As a physician, you have a legal and professional responsibility to ensure you have taken reasonable measures to protect the confidentiality of your patients’ personal health information in your custody or under your control. This is accomplished by putting in place administrative, technical and physical safeguards. In addition, you are obligated, as a trustee, to inform patients of their rights under the Health Information Protection Act (HIPA).

The SMA offers resources on our website to help you meet these obligations.

In addition, if you have further inquiries regarding EMR/ clinic-related privacy issues, please contact: Aftab Ahmad, Director, Saskatchewan EMR Program Phone: (306) 657-4572 Email: aftab.ahmad@sma.sk.ca

Find out more at www.sma.sk.ca •

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Privacy step-by-step guide

SASKATCHEWAN EMR PROGRAM

The SMA SK EMR Program supports physician practices in the selection, implementation and adoption of electronic medical records (EMRs) and other digital health tools. In addition, the program provide services to help physician practices to reach its full potential in utilizing these digital tools efficiently through enhance use strategy.

EMRs and digital health solutions can help physicians to: • • • • • •

Enhance patient care Improve patient safety Access the most current patient information securely Enhance practice efficiencies Reduce administration Achieve seamless integration of health systems

Through a joint funding agreement between the SMA, eHealth Saskatchewan and the Saskatchewan Ministry of Health, physicians in Saskatchewan can receive ongoing support for the approved Electronic Medical Record (EMR) systems. The three partners have adopted a multi-faceted approach to quality improvement and funding to assist physicians with implementation and EMR enhance use. The Saskatchewan EMR Program has granted approval status to the following EMR vendors: • •

Telus - Med Access QHR Technologies - Accuro

For more information about the Saskatchewan EMR Program, contact: Aftab Ahmad, Director, Saskatchewan EMR Program Phone: (306) 657-4572 or (306) 321-2889 Email: aftab.ahmad@sma.sk.ca

The SMA SK EMR Program Practice Advisors consult with physicians on an individual basis to understand their needs.

Discussions include: • • • • • •

Customized plans to achieve digital health goals Ongoing advice and tips to realize more value from the EMR Enrollment in provincial integrated services Training on how to use provincial integrated services Deployment of Fluency Direct (self-edit dictations) Obtaining peer support

Find out more at www.sma.sk.ca • •

Virtual care Fluency direct

Saskatchewan Medical Association

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PHYSICIAN SUPPORT PROGRAMS The SMA supports physician health and well-being through a range of programs and services. Confidential referral, assessment, treatment and ongoing supports are available to physicians, physicians in training and their families.

Consultation and advice are also available to physicians handling difficult professional and interpersonal issues. Health promotion and educational sessions are available upon request.

Physician Health Program The Physician Health Program provides assistance to colleagues, students, residents and their families who may be struggling with a variety of issues, including: • • • •

Mental health Substance abuse/addiction Physical health Marital and family concerns

Support is available to physicians throughout the spectrum of their careers, from medical school and residency, through active practice and into retirement. Referral sources and those accessing service can be reassured that all information remains strictly confidential.

Physicians who offer support through this program come from a variety of backgrounds and expertise, the common denominator being a dedication to the provision of nonjudgmental and confidential assistance and support.

Member Advisory Component The SMA’s Member Advisory Component assists SMA members who request help in responding to investigations or inquiries such as: • •

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Patient complaints to the College of Physicians and Surgeons of Saskatchewan.

Formal interviews or disciplinary proceedings by the College of Physicians and Surgeons of Saskatchewan.

•

Billing investigations by the director of professional review or the Joint Medical Professional Review Committee.

• Proceedings initiated by the Saskatchewan Health Authority.

Its purpose is to: Provide counsel to members of the association who require assistance in responding to inquiries or investigations; assist members under investigation in preparing the best possible responses to inquiries; make appropriate recommendations when investigative procedures are deemed to be unfair or biased; and advise members under peer review when legal counsel is desirable.

Activities are designed to supplement, and not replace, those of the Canadian Medical Protective Association. All details of involvement are kept strictly confidential.

Medical Benevolent Society The Medical Benevolent Society provides financial assistance to physicians, residents, medical students, their surviving spouses and/or dependent children in need.

The Medical Benevolent Society is a registered, charitable foundation established and directed jointly by the Saskatchewan Medical Association and the College of Physicians and Surgeons of Saskatchewan.

For more information about the Physician Health Program, Member Advisory Component or Medical Benevolent Society, contact: Brenda Senger, Director, Physician Support Programs Email: brenda.senger@sma.sk.ca Jessica Richardson, Clinical Coordinator Email: jessica.richardson@sma.sk.ca Priscilla Bam, Admin. Assistant, Physician Support Programs Email: priscilla.bam@sma.sk.ca

Find out more at www.sma.sk.ca • •

Self-reflection tools (member login required) Physician Health Program contact information (member login required)

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RETENTION AND RECRUITMENT The SMA aims to help recruit physicians to Saskatchewan and retain those already working in the province. Two SMA committees manage funds which have been negotiated through the Ministry of Health to provide programming in support of these recruitment and retention efforts, the Committee on Rural and Regional Practice and the Specialist Recruitment and Retention Committee.

Rural and regional practice support The Committee on Rural and Regional Practice (CORRP) provides the following bursaries, grants and programs to support physicians practising medicine in rural and regional Saskatchewan.

Rural Relief Program – The Rural Relief Program provides relief from practice for physicians in rural communities in which there are four or fewer physicians. Relief may be requested for periods of four to 14 days. Learn more on page 16.

Rural and Regional Extended Leave Program – The Rural and Regional Extended Leave Program provides funds to physicians in rural or regional practice for reimbursement of costs and forgone practice income in order to participate in an educational activity. The program supports physicians who are upgrading their skills and knowledge in areas of their choice, within the parameters of the program. The duration of training may range from one to six weeks.

Rural Travel Fund – This program facilitates cooperation and support between physicians practising in rural Saskatchewan.

It is intended to encourage improved communication between rural physicians and to help maintain the quality of care being provided to rural residents. Physicians may claim reimbursement when travelling to provide the following services in neighbouring communities: anaesthesia, surgical assistance, consultations, practice coverage and satellite clinics.

Rural and Regional Emergency Care CME Program – This program reimburses physicians in rural and regional practice for the cost of registration and a portion of the travel and accommodation expenses associated with certifying and re-certifying their skills in emergency care and risk management, within the parameters of the program. CORRP family medicine resident bursary recipients are eligible for PALS, ATLS and ALARM during residency.

Rural and Regional Clinical Skills Program – The Rural and Regional Clinical Skills Program is intended to provide the opportunity for medical students and family medicine residents to work alongside a rural or regional family physician who provides both in-patient and emergency coverage for a weekend on

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call period. In this way the student will enhance their clinical skills and be introduced to rural medicine in a positive way.

Rural and Regional Physician Enhancement Training Program – This program provides funding for two practising rural or regional physicians and for two second-year family medicine residents to complete a third year of training to enhance their skills in areas such as obstetrics, anaesthesia, general surgery, internal medicine, geriatrics or psychiatry. Practising rural or regional physicians receive income replacement funding. Third-year family medicine residents may receive a stipend equal to that of a resident at pay level PGY3 on the College of Medicine grid. Recipients must provide a returnof-service in a rural or regional community.

Family Medicine Resident Bursary Program – Successful medical resident candidates can receive bursary support to a maximum of two years of funding. Upon obtaining licensure, bursary recipients are required to provide a return-of-service commitment in rural, northern or regional Saskatchewan.

Special Needs Loan Program – This program provides assistance to students and residents training to practise medicine in rural, northern or regional Saskatchewan and is intended to be a last resort financial option, having exhausted other funding options.

Roadmap Program for Students and Residents – The Roadmap Program for Students and Residents acts as a guide to medical learners throughout their medical training journeys. It offers opportunities for learners to have positive experiences in rural and regional Saskatchewan through rewarding contests and events. It also provides resources and information to help learners through the challenges of medical school while giving them an opportunity to influence how health care is delivered in the province. Learn more on page 21.

Find out more at www.sma.sk.ca • Roadmap Program events and contests • Program application forms Specialist support • Bursary and grant eligibility requirements

Specialist support The Specialist Recruitment and Retention Committee was established in 2000 to design programs that facilitate the recruitment and retention of specialists to the province.

The committee offers the following programs, although several of the programs are being reviewed.

Specialist Recruitment Incentive – A grant is available to eligible specialists who establish a practice for a minimum of 36 months in a Saskatchewan community. A limited number of grants will be available per annum. Preference will be given to applicants who are Saskatchewan-trained, Canadiantrained or are a landed immigrant holding full licensure with the College of Physicians and Surgeons of Saskatchewan.

All applications are subject to approval by the Specialist Recruitment and Retention Committee.

Specialist Extended Leave Program – The Specialist Extended Leave Program is provided through an agreement between the Saskatchewan Medical Association and the government of Saskatchewan. The program’s purpose is to provide

funds to specialist physicians for reimbursement of costs and foregone practice income in order to participate in personalized educational instruction. The program also supports physicians to upgrade skills and knowledge in areas of their choice for periods of one to six weeks.

Specialist Enhancement Training Program - The Specialist Enhancement Training Program provides funding to allow specialists practising in Saskatchewan, either Canadian certified or foreign-certified, the opportunity to obtain additional training. Training may be sought as a professional sabbatical to obtain post sub-specialty training or to meet the requirements of the Royal College of Physicians and Surgeons to sit the Canadian certification exam.

Six annual grants are available for a maximum of two years and are provided according to the length of training.

Candidates are encouraged to pursue studies at the University of Saskatchewan or another accredited North American teaching program.

For more information about rural, regional and specialist recruitment and retention programs, contact sma@sma.sk.ca.

Dr. Joanne Sivertson, obstetrician/gynaecologist, Prince Albert

Find out more at www.sma.sk.ca • •

Specialist program application forms Program guidelines

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RURAL RELIEF PROGRAM Physicians practising in rural Saskatchewan are an integral part of a patient-focused health-care system. The SMA offers relief support to help rural physicians maintain a healthy work/life balance.

Rural Relief Program Many rural physicians provide medical coverage with heavy call responsibilities to the communities they serve.

The Rural Relief Program is intended to provide relief from this demanding regime for periods of four to 14 days for practices in rural communities in which there are fewer than five physicians.

Through the Rural Relief Program, the SMA contracts physicians who are available to travel throughout rural Saskatchewan and replace the local physician on a temporary basis.

A physician may request the services of an SMA locum to attend a continuing medical education program, have a vacation or to ensure medical coverage to the community while attending to personal/family matters.

Host physicians pay a subsidized rate for each day of locum coverage, as well as an on-call retainer, and arrange accommodations for the visiting physician.

If you meet the program criteria and you require a locum, please submit your request up to six months in advance.

Requests can be made online or by contacting the coordinator for the rural relief program. The SMA will contact you (approximately one month in advance) to let you know if a locum physician is available to fill your request.

For more information about the Rural Relief Program, contact: Rochelle Plemel, Coordinator, Physician Relief (Locum) Program Email: rochelle.plemel@sma.sk.ca

Photo credit: Kristine Kim, internal medicine

Find out more at www.sma.sk.ca •

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Request a Rural Relief locum online

EDUCATION AND LEADERSHIP Physician Leadership Institute (PLI) Medical students, residents and practising physicians are supported with life-long learning opportunities from Joule’s Physician Leadership Institute. At Joule, we recognize physicians are leaders in health care. Learn today to lead tomorrow.

When you enrol in a PLI course, you can be confident that: • •

•

•

Course content and examples will be practical and relevant to health care and medical practice in Canada.

Instructors are subject-matter and education experts with an intimate knowledge of Canada’s healthcare environment.

Learning approaches incorporate multiple perspectives, include real-life, real-time activities and promote rich problem-solving among peers.

Classmates are health-care professionals with interests and needs similar to your own.

For more information about in-house PLI courses, contact: Delilah Dueck, Coordinator, Community Engagement Email: delilah.dueck@sma.sk.ca

Canadian Certified Physician Executive (CCPE) Physicians are encouraged to consider accreditation through the Canadian Certified Physician Executive (CCPE) credential program, developed by the CMA and the Canadian Society of Physician Executives. The CCPE is the first nationally recognized, standards-based peer assessment for physicians in leadership roles. Based on the CMA’s Physician Leadership Competency Framework, the credential affirms that individual physicians who seek leadership or executive-type roles have demonstrated the knowledge and skills needed for successful performance.

Practice Enhancement Program The Practice Enhancement Program (PEP), jointly funded by Saskatchewan Health, the SMA and the College of Physicians and Surgeons of Saskatchewan, offers Saskatchewan’s physicians a positive means of assessing their medical practices. The assessment process is one of medical peer review that looks at a physician’s office facilities, procedures and medical records to determine the quality of care being provided by that physician. As assessments are completed and specific needs for enhancement are observed, PEP recommends educational and remedial resources to improve skills in specific areas.

Dr. Annette Epp, obstetrician/gynaecologist, Saskatoon

Find out more at www.sma.sk.ca •

Sign up for PLIs online

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RESIDENTS Once you have started your medical training, the SMA has a range of benefits available to you and your family. By joining the SMA, you automatically become a member of the Canadian Medical Association (CMA) and can access all the comprehensive products, services and resources of that membership as well.

Bursaries and grants Family Medicine Resident Bursary Program - Successful medical resident candidates can receive bursary support to a maximum of two years of funding. Upon obtaining licensure, bursary recipients are required to provide a return-in-service commitment in rural, northern or regional Saskatchewan. The deadline for application is October 31.

Special Needs Loan Program - This program provides assistance to students and residents training to practise medicine in rural, regional or northern Saskatchewan and is intended to be a last resort financial option, having exhausted other funding options.

Governance and leadership The SMA meets with the Resident Doctors of Saskatchewan (RDoS) and its executive regularly in an effort to maintain an ongoing communication link regarding resident issues.

Through elections by RDoS, post-graduate residents are represented on various SMA committees including the Representative Assembly (the SMA’s parliament), the Legislation and Policy Committee, the Committee on Rural and Regional Practice, the Physician Health Program, and the Specialist Recruitment and Retention Committee, and have observer status on the Board of Directors.

Resident leadership CMA membership provides residents access to a range of programs to develop their leadership and advocacy skills.

They also get opportunities to provide their perspective on important health issues and help the CMA better represent the profession. Learn more at: www.cma.ca/student-and-resident-leadership

Rural and Regional Physician Enhancement Training Program - The Rural and Regional Physician Enhancement Training Program provides funding for two second-year family medicine residents to complete a third year of training to enhance their skills in obstetrics, anaesthesia, general surgery, emergency medicine, geriatrics or psychiatry.

MD Financial Management MD Financial Management offers investment expertise and a wide range of financial products and services to resident members and their families. They can specifically address resident needs through their financial planning service and debt-management expertise.

Physician Support Programs The SMA supports the health and well-being of physiciansin-training through a range of programs and services.

Confidential referral, assessment, treatment and ongoing supports are available to residents and their families. Please see page 12 for more information.

Dr. Neil Kalra, radiology

Find out more at www.sma.sk.ca

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• •

Bursary and grant eligibility requirements Learn more about SMA physician support programs.

INSURANCE FOR RESIDENTS As part of our mission to advance the economic welfare of Saskatchewan physicians, the SMA recognizes insurance as vital, not only to members, but also their families and employees. In partnership with the University of Saskatchewan, residents have not only full membership with the SMA but also are eligible for SMA life and disability insurance coverage as part of their benefit package paid for by the University of Saskatchewan (U of S) through the Resident Doctors of Saskatchewan (RDoS) contract.

Residents complete three applications to access these benefits:

1. Life insurance: • • • •

•

Two units life insurance: $100,000 with waiver of premium rider No medical underwriting Name any beneficiary Premiums paid by University of Saskatchewan through RDoS agreement (except for optional future insurance option rider) Additional life insurance up to $5,000,000 available for you and your spouse

2. Disability insurance: • • •

Maximum based on PGY Medically guaranteed to $2,500/month Premiums paid by University of Saskatchewan through RDoS agreement.

Coverage can continue and be increased throughout residency and following residency whether or not you remain in Saskatchewan. Contact insurance@sma.sk.ca for more details.

Level

Coverage available

PGY1

$4,900

PGY2

$5,400

PGY3

$5,800

PGY4

$6,300

PGY5

$6,700

PGY6

$7,200

Premiums paid by U of S through RDoS contract.

Application forms must be completed. Coverage is not automatic.

For more information, contact: Jenna Duff, Coordinator, Insurance Email: jenna.duff@sma.sk.ca

Your insurance will evolve with you as you transition from resident to practising physician, whether or not you stay in Saskatchewan.

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STUDENTS Once you have started your medical training, the SMA has a number of benefits available to you and your family. By joining the SMA, you automatically become a member of the Canadian Medical Association (CMA) and can access all the comprehensive products, services and resources of that membership as well.

Insurance As part of our mission to advance the economic welfare of Saskatchewan physicians, the SMA recognizes insurance as vital, not only to members, but also their families and employees. With the power of a large membership, the SMA has negotiated the essential and best features into all of our insurance plans with various insurance companies at competitive low rates. Students are eligible to take advantage of:

1. Life insurance • • • • •

Two units of life insurance: $100,000 No medical underwriting (guaranteed coverage) Name any beneficiary Additional life insurance up to $5,000,000 available for you and your spouse Continues through residency and into practice whether or not you stay in Saskatchewan

2. Disability insurance • • •

•

Year 1 and year 2 students: $1,500/month disability insurance with no medical underwriting Year 3 and year 4 students: $2,500/month disability insurance with no medical underwriting Additional disability insurance up to $4,000/ month available to year 4 students with medical underwriting Converts to enhanced coverage upon entrance into residency. Premiums assumed by University of Saskatchewan if residency is in Saskatchewan

Your insurance will evolve with you as you transition from student to resident to practising physician, whether or not you stay in Saskatchewan. For more information, contact Jenna Duff, Coordinator, Insurance at jenna.duff@sma.sk.ca.

Student leadership The SMA works with the Student Medical Society of Saskatchewan (SMSS). Through the SMSS, medical students are represented on various SMA committees, including the Representative Assembly, the Committee on Rural and Regional Practice, the Specialist Recruitment and Retention Committee, the Physician Health Program and the Board of Directors.

Physician Support Programs The SMA supports the health and well-being of physiciansin-training through a range of programs and services.

Confidential referral, assessment, treatment and ongoing supports are available to students and their families.

Please see page 12 for more information.

Rural and Regional Clinical Skills Program

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The Rural and Regional Clinical Skills Program provides the opportunity for medical students and family medicine residents to work alongside a rural or regional family physician who provides both in-patient and emergency coverage for a weekend on-call period.

MD Financial Management

The Roadmap Program

MD Financial Management has a team of MD advisors and early career specialists dedicated to supporting medical students and residents, whether it’s budgeting, cash flow management, finding the right credit solution or other strategies.

The Roadmap Program is an initiative of the SMA’s Committee on Rural and Regional Practice and the Specialist Recruitment and Retention Committee

CMA student programs The CMA 150th Anniversary Bursaries and Awards Program The CMA 150th Anniversary Bursaries and Awards program celebrates the values of the profession while providing financial support for medical students. Learn more: www.cma.ca/cma-150th-anniversary-bursaries-andawards-program

For students and residents The Roadmap Program for students and residents acts as a guide to medical learners throughout their medical training journeys. It offers opportunities for learners to have positive experiences in rural and regional Saskatchewan and gives them an opportunity to influence how health care is delivered in the province.

What to expect •

CMA CaRMS Interview Prep Program As med school comes close to completion and residency is looming, are you ready for your CaRMS interviews? CMA offers a free program to practise your interview skills and get tips and tricks from residents. Learn more: www.cma.ca/carms-interview-prep-program

Student Leadership CMA membership provides you access to a range of programs to develop your leadership and advocacy skills.

You also get opportunities to provide your perspective on important health issues and help the CMA better represent the profession. Learn more: www.cma.ca/student-and-resident-leadership

• •

•

Four tours per year to rural/regional centres where participants will get a taste of life and practice in that community and have the opportunity to build connections with local physicians.

Fun contests with great prizes including trips to the SRPC Rural and Remote Conference.

Appreciation events that allow students/residents to socialize with their colleagues, build collegiality and network with practising physicians.

Access to student/resident specific information and resources such as: • Bursaries and grants • Insurance • Education and leadership opportunities • Physician support programs

For more information, contact: Delilah Dueck, Coordinator, Community Engagement Email: delilah.dueck@sma.sk.ca

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MEMBER COMMUNICATIONS Electronic communication

Publications

Website and member site

SMA Digest

The SMA website, www.sma.sk.ca, contains the most up-todate information about the association and is your hub for physician stories, news, upcoming events and information about SMA programs and services.

SMA Digest celebrates the stories of Saskatchewan physicians, provides news, features, job opportunities and other items of interest to members. It is the official membership magazine of the SMA and is published and distributed semiannually to practising physicians, students and residents in Saskatchewan.

As an SMA member, you also have access to the private member section of the website. Registering to use the site is easy and once registered, you can check your dues, CME balance, insurance summary and update your personal information. The member site also allows you to find member-specific resources, and contact information for SMA staff, the Board of Directors and your Representative Assembly delegates.

Social media Have something to say? Join the conversation on matters relevant to you as a Saskatchewan physician: • • •

Twitter: @sma_docs Facebook: www.facebook.com/SMADocs Instagram: @sma_docs

SMA eNews The SMA eNews is sent via email to members regularly, allowing the SMA to keep in touch with you about what your colleagues are up to, upcoming events, updates to programs and services, and other timely information affecting the health-care landscape in Saskatchewan.

Daily news report The daily news report provides links to news stories that may be of interest to physicians, locally, provincially and globally.

Please email sma@sma.sk.ca to subscribe.

Practice alerts | Member notices Practice alerts and member notices relay time sensitive information that is relevant to our members. Practice alerts contain more urgent information, typically impacting patient care. Member notices contain less urgent information, often pertaining to your membership, benefits or the SMA.

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President’s Letters President’s Letters are sent to the membership to provide timely updates on specific topics. These are emailed to members, and they can also be found online along with our other publications.

For more information about member communications, contact: Ivan Muzychka DIrector, Communications & Community Engagement Email: ivan.muzychka@sma.sk.ca Maria Ryhorski, Communications Advisor Email: maria.ryhorski@sma.sk.ca Girard Hengen, Communications Advisor Email: girard.hengen@sma.sk.ca

Find out more at www.sma.sk.ca • • •

Latest news President’s Letters SMA Digest archive

STRUCTURE AND GOVERNANCE Saskatchewan Medical Association members provide direction and guidance to the organization through the Representative Assembly and a number of different committees.

Representative Assembly The Representative Assembly is the governing body of the Saskatchewan Medical Association. It consists of representatives from regional medical associations, specialty sections and medical students and residents. It is given the authority to act for the entire membership as it considers fit and proper and in the interest of members.

The Representative Assembly sets the direction of the SMA. It elects the SMA Board of Directors and approves the annual budget, including membership dues and policies regarding reimbursement of expenses to individuals providing services to the association. It is also responsible for appointing the association’s auditors.

Board of Directors and committees The Board of Directors is responsible to the Representative Assembly and exercises all powers of the association and the Representative Assembly between meetings. Responsibilities of the Board include establishing policies relating to the collection of membership dues and nomination and election of district delegates, expending funds as provided in the annual budget and engaging personnel to carry on the administration of SMA business. SMA committees vary in scope and deal with the details that accompany the policies established by the Board of Directors.

2019-20 Board of Directors Executive President - Dr. Allan Woo, Saskatoon Vice-President - Dr. Barb Konstantynowicz, Regina Honorary Treasurer - Dr. Eben Strydom, Melfort Past-President - Dr. Siva Karunakaran, Regina

Board of Directors Dr. Pam Arnold Dr. Geethan Chandran Dr. Annette Epp (on leave) Dr. John Gjevre Dr. Andre Grobler Dr. Carla Holinaty Dr. Crystal Litwin Dr. Naeem Parvez Dr. Guruswamy Sridhar (CMA Representative) Vacant (RDoS Representative) Ms. Daisy Ko (SMSS Representative) Dr. Janet Shannon, Chair of the Board of Directors

Staff The SMA staff manages the day-to-day activities of the association, and works toward the strategic priorities set out by the Board of Directors.

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Charter of Shared Values: A vision for intra-professionalism for physicians What is it?

The CMA Charter of Shared Values aims to identify shared values and commitments to each other and to the profession to which physicians and learners can commit to promote trust and respect within the profession and for each other, and identify opportunities for engagement and leadership to promote civility and confront incivility within the profession.

Why does it matter?

The Charter is intended to further strengthen professional responsibilities in support of a unified and aligned profession. We achieve the highest degree of both individual and collective success when we work together, commit together and believe together; when we share a clearly articulated set of common values, virtues and principles; and when we subscribe to the same explicit and implicit understandings.

Commitments to Each Other: Our most important shared values RESPECT As a physician, I will strive to be respectful; I will recognize that everyone has inherent worth, is worthy of dignity, and has the right to be valued and respected, and to be treated ethically; I will respect others and their personal and professional dignity; and I will aim to promote and model respect through collaborative training and practice.

INTEGRITY As a physician, I will strive to act with integrity; I will act in an honest and truthful manner, with consistency of intentions and actions; and I will act with moral concern to promote and model effective leadership and to achieve a good outcome for patients.

RECIPROCITY As a physician, I will strive to cultivate reciprocal relationships; I will be kind with my physician colleagues, and expect them to respond similarly; I will share and exchange my knowledge and experience with them; and I will be generous with them in spirit and in time.

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CIVILITY As a physician, I will strive to be civil; I will respect myself and others, regardless of their role, even those with whom Saskatchewan Medical Association I may not agree; I will enter into communication with my physician colleagues with an attitude of active and open MEMBERSHIP listening, GUIDE | 2020whether it be in person, in writing, or virtually; and I will accept personal accountability.

Commitments to the Profession Commitments to the Profession 1. Commitment to promoting a culture of respect and collegiality 1.aCommitment tobuild promoting a on culture of respect andwhere collegiality As physician, I will strive to a culture based mutual respect and collegiality physicians treat each other as people in a shared endeavor, and promote civility.

I will strive to: As a physician, I will strive to build a culture based on mutual respect and collegiality where physicians treat each other as people in a shared promote civility. will strive to:dialogue and relationships •endeavor, Cultivateand respectful, open, andI transparent Cultivate respectful, and transparent and relationships •• Take responsibility foropen, promoting civility anddialogue confronting incivility within the profession Take responsibility for promoting civility and confronting incivility within the profession •• Recognize the relative value among family medicine and specialties and across the educational spectrum, and of the profession’s shared • contributions Recognize thewithin relativehealth value systems among family medicine and specialties and across the educational spectrum, and of the profession’s shared contributions health systems • Model healthywithin and supportive training and practice environments • Model healthy and supportive training and practice environments

2. Commitment to promoting a culture of self-care and support 2.aCommitment tobuild promoting a culture of self-care andaresupport As physician, I will strive to a culture of self-care and support where physicians empowered to ask for help and are supported to

As a physician, I willphysical, strive tomental, build a culture of self-care andI will support where care for their own and social well-being. strive to: physicians are empowered to ask for help and are supported to care for their own physical, mental, and social well-being.

I will strive to: • Value physician health and wellness and promote a professional culture that recognizes, supports, and responds effectively to your needs • and Value physicianin-need health and wellness and promote a professional culture that recognizes, supports, and responds effectively to your needs colleagues and colleagues in-need • Cultivate an environment of physical and psychological safety, conducive to challenging the status quo, as well as encouraging help• seeking Cultivatebehaviours, an environment of fear physical and psychological without of negative reprisal safety, conducive to challenging the status quo, as well as encouraging helpseeking behaviours, fear of system-level negative reprisal • Recognize that both without individual and barriers contribute to health and wellness-related issues and advocate for cultural and • systemic Recognizechange that both individual and system-level barriers contribute to health and wellness-related issues and advocate for cultural and to remove barriers systemic change to remove barriers

3. Commitment to promoting a culture of leadership and mentorship 3.aCommitment tofoster promoting a culture of leadership As physician, I will strive to a culture of leadership and mentorship across theand careermentorship life cycle. I will strive to:

a physician, strive to foster a culture of leadershipinand mentorship careerof lifetraining, cycle. I practice, will striveand to: health system delivery •AsEncourage andI will enable opportunities and participation leadership rolesacross acrossthe all levels •• Promote Encourage and enable opportunities and participation in leadership roles across all levels of training, practice, and health system delivery and enable formal and informal mentorship opportunities and leadership training across all levels of training and practice Promote enable of formal and informal mentorship and leadership training across all levels of training andofpractice •• Value theand exchange knowledge and experience andopportunities encourage reflective relationships (bi-directional) across all levels training • and Value the exchange of knowledge and experience and encourage reflective relationships (bi-directional) across all levels of training practice and practice

4. Commitment to promoting a culture of inquiry and reflection 4.aCommitment tofoster promoting a culture of inquiry and reflection As physician, I will strive to a culture of inquiry and reflection that values and enables reflective practice, individually and collectively. a physician, IAs will strive to: I will strive to foster a culture of inquiry and reflection that values and enables reflective practice, individually and collectively.

I• Value will strive to: and enable collective inquiry and self-reflection to effect meaningful change •• Foster Value and enable collective inquiry and self-reflection to effect meaningful change curiosity and exploration to identify strengths and capabilities of teams and health systems to generate new possibilities for action •• Cultivate Foster curiosity and exploration to identify strengths and capabilities of teams and health to generate new possibilities for action strong connections and relationships between, and meaningful interactions with,systems colleagues • Cultivate strong connections and relationships between, and meaningful interactions with, colleagues

5. Commitment to promoting a culture of quality 5. Commitment to promoting a culture of quality As a physician, I will strive to foster a culture of quality and quality improvement. I will strive to:

As a physician, I will strive to foster a culture of quality and quality improvement. I will strive to: • Foster intra- and inter-professional collaborations and promote collaborative models of care Foster intraand inter-professional collaborations and promote collaborative care and system level, and commit to developing •• Provide high quality patient care and have a view to continuous improvementmodels at the of practice • and Provide high quality patient care and have a view to continuous improvement at the practice and system level, and commit to developing applying the skills and techniques of quality improvement and applying the skills and techniques of quality improvement • Understand that quality improvement is a critical and life-long part of education and practice; participate in maintaining professional • standards Understand quality improvement inthat myself and my colleaguesis a critical and life-long part of education and practice; participate in maintaining professional standards in myself and my • Engage patients, families, andcolleagues caregivers in the process of improvement • Engage patients, families, and caregivers in the process of improvement

6. Commitment to valuing a culture of diversity 6. Commitment to valuing a culture of diversity As a physician, I will strive to foster a community of practitioners that reflects the diversity of the communities they serve. I will strive to:

As a physician, I will strive to foster a community of practitioners that reflects the diversity of the communities they serve. I will strive to: • Promote diversity within the profession to be receptive and responsive to the evolving (physical, emotional, cultural, socioeconomic) needs • of Promote diversity within the profession to be receptive and responsive to the evolving (physical, emotional, cultural, socioeconomic) needs our patient populations of our patient populations • Foster a training and practice environment where diverse and unique perspectives, across generations, cultures and abilities, are heard and • appreciated Foster a training and practice environment where diverse and unique perspectives, across generations, cultures and abilities, are heard and appreciated • Foster diversity in leadership across the full spectrum of leadership roles within the profession and health systems •• Value Fosterthe diversity in leadership the full spectrum leadership roles within profession and importance of theseacross perspectives within theofmedical profession, eventhe when they may nothealth be mysystems own patients, families, and • caregivers Value the importance of these perspectives within the medical profession, even when they may not be my own patients, families, and in the process of improvement caregivers in the process of improvement Saskatchewan Medical Association MEMBERSHIP GUIDE | 2020

cma.ca/medicalprofessionalism cma.ca/medicalprofessionalism

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CMA CODE OF ETHICS AND PROFESSIONALISM

The CMA Code of Ethics and Professionalism articulates the ethical and professional commitments and responsibilities of the medical profession. The Code provides standards of ethical practice to guide physicians in fulfilling their obligation to provide the highest standard of care and to foster patient and public trust in physicians and the profession. The Code is founded on and affirms the core values and commitments of the profession and outlines responsibilities related to contemporary medical practice.

In this Code, ethical practice is understood as a process of active inquiry, reflect ion, and decision-making concerning what a physician’s actions should be and the reasons for these actions. The Code informs ethical decision-making, especially in situations where existing guidelines are insufficient or where values and principles are in tension. The Code is not exhaustive; it is intended to provide standards of ethical practice that can be interpreted and applied in particular situations. The Code and other CMA policies constitute guidelines that provide a common ethical framework for physicians in Canada.

In this Code, medical ethics concerns the virtues, values, and principles that should guide the medical profession, while professionalism is the embodiment or enactment of responsibilities arising from those norms through standards, competencies, and behaviours.

Together, the virtues and commitments outlined in the Code are fundamental to the ethical practice of medicine.

Physicians should aspire to uphold the virtues and commitments in the Code, and they are expected to enact the professional responsibilities outlined in it.

Physicians should be aware of the legal and regulatory requirements that govern medical practice in their jurisdictions.

 © 2018 Canadian Medical Association. You may, for your non-commercial use, reproduce, in whole or in part and in any form or manner, unlimited copies of CMA Policy Statements provided that credit is given to Canadian Medical Association.

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A. VIRTUES EXEMPLIFIED BY THE ETHICAL PHYSICIAN Trust is the cornerstone of the patient–physician relationship and of medical professionalism.

Trust is therefore central to providing the highest standard of care and to the ethical practice of medicine. Physicians enhance trustworthiness in the profession by striving to uphold the following interdependent virtues: COMPASSION. A compassionate physician recognizes suffering and vulnerability, seeks to understand the unique circumstances of each patient and to alleviate the patient’s suffering, and accompanies the suffering and vulnerable patient.

HONESTY. An honest physician is forthright, respects the truth, and does their best to seek, preserve, and communicate that truth sensitively and respectfully.

HUMILITY. A humble physician acknowledges and is cautious not to overstep the limits of their knowledge and skills or the limits of medicine, seeks advice and support from colleagues in challenging circumstances, and recognizes the patient’s knowledge of their own circumstances.

INTEGRITY. A physician who acts with integrity demonstrates consistency in their intentions and actions and acts in a truthful manner in accordance with professional expectations, even in the face of adversity.

PRUDENCE. A prudent physician uses clinical and moral reasoning and judgement, considers all relevant knowledge and circumstances, and makes decisions carefully, in good conscience, and with due regard for principles of exemplary medical care.

B. FUNDAMENTAL COMMITMENTS OF THE MEDICAL PROFESSION Commitment to the well-being of the patient Consider first the well-being of the patient; always act to benefit the patient and promote the good of the patient.

Provide appropriate care and management across the care continuum.

Take all reasonable steps to prevent or minimize harm to the patient; disclose to the patient if there is a risk of harm or if harm has occurred.

Recognize the balance of potential benefits and harms associated with any medical act; act to bring about a positive balance of benefits over harms.

Commitment to respect for persons Always treat the patient with dignity and respect the equal and intrinsic worth of all persons.

Always respect the autonomy of the patient.

Never exploit the patient for personal advantage.

Never participate in or support practices that violate basic human rights.

Commitment to justice Promote the well-being of communities and populations by striving to improve health outcomes and access to care, reduce health inequities and disparities in care, and promote social accountability.

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Commitment to professional integrity and competence Practise medicine competently, safely, and with integrity; avoid any influence that could undermine your professional integrity.

Develop and advance your professional knowledge, skills, and competencies through lifelong learning.

Commitment to professional excellence Contribute to the development and innovation in medicine through clinical practice, research, teaching, mentorship, leadership, quality improvement, administration, or advocacy on behalf of the profession or the public.

Participate in establishing and maintaining professional standards and engage in processes that support the institutions involved in the regulation of the profession.

Cultivate collaborative and respectful relationships with physicians and learners in all areas of medicine and with other colleagues and partners in health care.

Commitment to self-care and peer support Value personal health and wellness and strive to model self-care; take steps to optimize meaningful co-existence of professional and personal life.

Value and promote a training and practice culture that supports and responds effectively to colleagues in need and empowers them to seek help to improve their physical, mental, and social well-being.

Recognize and act on the understanding that physician health and wellness needs to be addressed at individual and systemic levels, in a model of shared responsibility.

Commitment to inquiry and reflection Value and foster individual and collective inquiry and reflection to further medical science and to facilitate ethical decision-making.

Foster curiosity and exploration to further your personal and professional development and insight; be open to new knowledge, technologies, ways of practising, and learning from others.

C. PROFESSIONAL RESPONSIBILITIES PHYSICIANS AND PATIENTS Patient–physician relationship The patient–physician relationship is at the heart of the practice of medicine. It is a relationship of trust that recognizes the inherent vulnerability of the patient even as the patient is an active participant in their own care. The physician owes a duty of loyalty to protect and further the patient’s best interests and goals of care by using the physician’s expertise, knowledge, and prudent clinical judgment.

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In the context of the patient–physician relationship: 1. Accept the patient without discrimination (such as on the basis of age, disability, gender

identity or expression, genetic characteristics, language, marital and family status, medical condition, national or ethnic origin, political affiliation, race, religion, sex, sexual orientation, or socioeconomic status). This does not abrogate the right of the physician to refuse to accept a patient for legitimate reasons.

2. Having accepted professional responsibility for the patient, continue to provide services until these services are no longer required or wanted, or until another suitable physician has assumed responsibility for the patient, or until after the patient has been given reasonable notice that you intend to terminate the relationship.

3. Act according to your conscience and respect differences of conscience among your colleagues; however, meet your duty of non-abandonment to the patient by always acknowledging and responding to the patient’s medical concerns and requests whatever your moral commitments may be.

4. Inform the patient when your moral commitments may influence your recommendation concerning provision of, or practice of any medical procedure or intervention as it pertains to the patient’s needs or requests.

5. Communicate information accurately and honestly with the patient in a manner that the patient understands and can apply, and confirm the patient’s understanding.

6. Recommend evidence-informed treatment options; recognize that inappropriate use or overuse of treatments or resources can lead to ineffective, and at times harmful, patient care and seek to avoid or mitigate this.

7. Limit treatment of yourself, your immediate family, or anyone with whom you have a similarly close relationship to minor or emergency interventions and only when another physician is not readily available; there should be no fee for such treatment.

8. Provide whatever appropriate assistance you can to any person who needs emergency medical care.

9. Ensure that any research to which you contribute is evaluated both scientifically and ethically and is approved by a research ethics board that adheres to current standards of practice. When involved in research, obtain the informed consent of the research participant and advise prospective participants that they have the right to decline to participate or withdraw from the study at any time, without negatively affecting their ongoing care.

10. Never participate in or condone the practice of torture or any form of cruel, inhuman, or degrading procedure.

Decision-making Medical decision-making is ideally a deliberative process that engages the patient in shared decision-making and is informed by the patient’s experience and values and the physician’s clinical judgment. This deliberation involves discussion with the patient and, with consent, others central to the patient’s care (families, caregivers, other health professionals) to support patient-centred care.

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In the process of shared decision-making: 11. Empower the patient to make informed decisions regarding their health by

communicating with and helping the patient (or, where appropriate, their substitute decision-maker) navigate reasonable therapeutic options to determine the best course of action consistent with their goals of care; communicate with and help the patient assess material risks and benefits before consenting to any treatment or intervention.

12. Respect the decisions of the competent patient to accept or reject any recommended assessment, treatment, or plan of care.

13. Recognize the need to balance the developing competency of minors and the role of families and caregivers in medical decision-making for minors, while respecting a mature minor’s right to consent to treatment and manage their personal health information.

14. Accommodate a patient with cognitive impairments to participate, as much as possible, in decisions that affect them; in such cases, acknowledge and support the positive roles of families and caregivers in medical decision-making and collaborate with them, where authorized by the patient’s substitute decision-maker, in discerning and making decisions about the patient's goals of care and best interests.

15. Respect the values and intentions of a patient deemed incompetent as they were expressed previously through advance care planning discussions when competent, or via a substitute decision-maker.

16. When the specific intentions of an incompetent patient are unknown and in the absence of a formal mechanism for making treatment decisions, act consistently with the patient's discernable values and goals of care or, if these are unknown, act in the patient's best interests.

17. Respect the patient's reasonable request for a second opinion from a recognized medical expert.

PHYSICIANS AND THE PRACTICE OF MEDICINE Patient privacy and the duty of confidentiality 18. Fulfill your duty of confidentiality to the patient by keeping identifiable patient information

confidential; collecting, using, and disclosing only as much health information as necessary to benefit the patient; and sharing information only to benefit the patient and within the patient’s circle of care. Exceptions include situations where the informed consent of the patient has been obtained for disclosure or as provided for by law.

19. Provide the patient or a third party with a copy of their medical record upon the patient’s request, unless there is a compelling reason to believe that information contained in the record will result in substantial harm to the patient or others.

20. Recognize and manage privacy requirements within training and practice environments and quality improvement initiatives, in the context of secondary uses of data for health system management, and when using new technologies in clinical settings.

21. Avoid health care discussions, including in personal, public, or virtual conversations, that could reasonably be seen as revealing confidential or identifying information or as being disrespectful to patients, their families, or caregivers.

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Managing and minimizing conflicts of interest 22. Recognize that conflicts of interest may arise as a result of competing roles (such as

financial, clinical, research, organizational, administrative, or leadership).

23. Enter into associations, contracts, and agreements that maintain your professional

integrity, consistent with evidence-informed decision-making, and safeguard the interests of the patient or public.

24. Avoid, minimize, or manage and always disclose conflicts of interest that arise, or are perceived to arise, as a result of any professional relationships or transactions in practice, education, and research; avoid using your role as a physician to promote services (except your own) or products to the patient or public for commercial gain outside of your treatment role.

25. Take reasonable steps to ensure that the patient understands the nature and extent of your responsibility to a third party when acting on behalf of a third party.

26. Discuss professional fees for non-insured services with the patient and consider their ability to pay in determining fees.

27. When conducting research, inform potential research participants about anything that may give rise to a conflict of interest, especially the source of funding and any compensation or benefits.

PHYSICIANS AND SELF 28. Be aware of and promote health and wellness services, and other resources, available to

you and colleagues in need.

29. Seek help from colleagues and appropriate medical care from qualified professionals for

personal and professional problems that might adversely affect your health and your services to patients.

30. Cultivate training and practice environments that provide physical and psychological safety and encourage help-seeking behaviours.

PHYSICIANS AND COLLEAGUES 31. Treat your colleagues with dignity and as persons worthy of respect. Colleagues include

all learners, health care partners, and members of the health care team.

32. Engage in respectful communications in all media.

33. Take responsibility for promoting civility, and confronting incivility, within and beyond the

profession. Avoid impugning the reputation of colleagues for personal motives; however, report to the appropriate authority any unprofessional conduct by colleagues.

34. Assume responsibility for your personal actions and behaviours and espouse behaviours that contribute to a positive training and practice culture.

35. Promote and enable formal and informal mentorship and leadership opportunities across all levels of training, practice, and health system delivery.

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36. Support interdisciplinary team-based practices; foster team collaboration and a shared

accountability for patient care.

PHYSICIANS AND SOCIETY 37. Commit to ensuring the quality of medical services offered to patients and society through

the establishment and maintenance of professional standards.

38. Recognize that social determinants of health, the environment, and other fundamental considerations that extend beyond medical practice and health systems are important factors that affect the health of the patient and of populations.

39. Support the profession’s responsibility to act in matters relating to public and population health, health education, environmental determinants of health, legislation affecting public and population health, and judicial testimony.

40. Support the profession’s responsibility to promote equitable access to health care resources and to promote resource stewardship.

41. Provide opinions consistent with the current and widely accepted views of the profession when interpreting scientific knowledge to the public; clearly indicate when you present an opinion that is contrary to the accepted views of the profession.

42. Contribute, where appropriate, to the development of a more cohesive and integrated health system through inter-professional collaboration and, when possible, collaborative models of care.

43. Commit to collaborative and respectful relationships with Indigenous patients and communities through efforts to understand and implement the recommendations relevant to health care made in the report of the Truth and Reconciliation Commission of Canada.

44. Contribute, individually and in collaboration with others, to improving health care services and delivery to address systemic issues that affect the health of the patient and of populations, with particular attention to disadvantaged, vulnerable, or underserved communities.

Approved by the CMA Board of Directors Dec 2018

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Saskatchewan Medical Association

201 – 2174 Airport Drive, Saskatoon, SK S7L 6M6 P: (306) 244-2196 or 1-800-667-3781 (toll-free in SK) E: sma@sma.sk.ca F: (306) 653-1631 www.sma.sk.ca

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www.sma.sk.ca www.sma.sk.ca

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