The Registrar magazine - Issue 7 - Winter 2023

Issue 7 Winter 2023

20 Years Young:

CNAR marks milestone birthday

Steady leadership in uncertain times:

Ali Arlani, CEO & Registrar of CMRAO, marks the condominium management authority’s 5th anniversary

It’s Black History Month:

The Registrar profiles registrant and medical trailblazer, Dr. Kannin Osei-Tutu

Algomed’s East Coast 360:

Paying patients still on the hook after a Quebec private healthcare clinic abruptly leaves Nova Scotia

Issue 7 Winter 2023 Journalists and Writers Damian Ali M. Daniel Roukema Graphic Designer Allison Wedler

GOOGLE ALERTS ARE NOT ENOUGH Regulators need professional issues & media monitoring services

Production Manager Allison Wedler Editor in Chief M. Daniel Roukema Photo credits Adobe Canva CLEAR CNAR Luciann Photography MDR Strategy Group Ltd. The Registrar magazine is produced and published by MDR Strategy Group Ltd. 800-1701 Hollis Street Halifax, Nova Scotia Canada B3J 2T9

LISTEN TO WHAT YOU SEE Daily coverage reports by 9AM Alerts and analyses Monthly analytics Quarterly summaries Annual reports

CONTACT US TODAY WWW.MDRSTRATEGY.CA

1-800-874-3820 editor@theregistar.ca www.theregistrar.ca www.mdrstrategy.ca © 2023. All rights reserved

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IN THIS ISSUE

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12

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Frustration with vehicle sales dealers: regulators shift into high gear to slow unauthorized businesses

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Happy birthday! CNAR marks 20th anniversary with year-long initiatives, conference in Vancouver

10 CNAR 2022 in pictures 12 Five years of condo management

regulation: CEO and Registrar Ali Arlani reflects on the CMRAO’s start-up and future

4 21 Meet medical trailblazer and EDI leader, Dr. Kannin Osei-Tutu

28 CLEAR’s upcoming international congress: Global health and labour market challenges top of mind in Ireland

32 Consumer Alert: Algomed, a Quebec

private health care organization arrives on Nova Scotia’s shores and leaves patients stranded

35 Perspective: Protecting the mental

health of interviewees in regulatory investigations

18 Fraud Prevention Month 2023: Regulators join forces to protect the public

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Frustration with vehicle sales dealers: Regulators shift into high gear to slow unauthorized businesses

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urchasing a vehicle can be a complicated process, and many of these complexities are fueled by bad faith actors.

Consumers may not be given adequate details on their new purchase at an unregistered dealership. Thus, it

can result in underhanded sales tactics being used for a quick profit, all to the consumer’s detriment. Shari Prymak, Senior Consultant at Car Help Canada, says that the benefit of purchasing from a registered dealer helps to secure consumer rights.

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“If you have an issue with your car at any stage, even after the fact, you can head back to the dealership and resolve it,” Prymak said. “These are things that delegated authorities in provinces are responsible for and helping you with.”

Canadian regulators overseeing the auto sales market are challenging illegal operators on multiple fronts.

The Ontario Motor Vehicle Industry Council, or OMVIC, is one of Canada’s vehicle sales regulators whose mandate is to maintain a fair and informed marketplace, as well as administer and enforce the Motor Vehicle Dealers Act (MVDA), along with certain pieces of the Consumer Protection Act on behalf of the provincial government.

An OMVIC registration process includes a rigorous background check, passing a certification course, and, after becoming licensed, remaining and abiding by professional standards. Every Ontarian vehicle dealership must be registered with OMVIC to operate legally, to which OMVIC Registrar and CEO Maureen Harquail says that consumers will have certain protections on their purchase.

“One of the big protections comes in the form of the Motor Vehicle Dealers Compensation Fund, which helps consumers if something goes wrong [with their purchase],” Harquial said.

The Compensation Fund “provides theregistrar.ca

In 2021, OMVIC conducted almost 2,400 inspections, and laid 539 charges against 88 alleged curbsiders financial assistance to consumers who make a valid claim for a vehicle transaction against an OMVIC-registered dealer,” as stated on the OMVIC website.

Along with the Compensation Fund, featured webinars on OMVIC’s digital platforms and a consumer support team ready to answer any and all motor vehicle-related questions, Harquail says that the organization has a partnership with Georgian College, where the automotive business school of Canada is located.

“We work very closely with Georgian College to develop unique programs, such as the certification course for dealers and salespeople in Ontario,” Harquial said. “This really helps us expand our reach and build upon the consumer confidence that we require.”

To better inform more vulnerable consumers, such as young adults or new immigrants, on how to properly navigate the motor vehicle

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sales market, Harquial says it is essential to build awareness on “curbsiders” – illegal, unlicensed dealers or salespeople who pose as private sellers.

Curbsiders misrepresent themselves and the vehicles they sell, many of which are previous write-offs or are odometer-tampered, Harquial says.

To challenge their establishment in the market, Harquial says that three core factors are integral to OMVIC’s regulatory presence: • annual consumer awareness campaign via broadcast television and social media, which educates the public about OMVIC’s regulatory mandate; • OMVIC’s website which has industryleading information and relevant news; • enforcement of the MVDA, including regular inspection of dealerships, investigations pertaining to industry misconduct and non-compliance.

“In 2021, OMVIC conducted almost 2,400 inspections, and laid 539 charges against 88 alleged curbsid-

ers,” Harquail said. “With our consumer support team and dealer support team working in tandem, it allows us to both increase education for our dealers who have questions, while also ensuring consumers in Ontario are better served.”

Elsewhere in Canada, auto sales regulators are involved in similar efforts.

The Alberta Motor Vehicle Industry Council, or AMVIC, takes the fight to “backyard mechanics,” who operate illegally within the province. Senior Communications Officer Laura Meador says these illegal operators violate municipal zoning laws by conducting business out of residential properties, which creates an unfair marketplace for businesses that are licensed.

By raising heightened awareness on these unfair business practices, and supporting an honest exchange of in-

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formation between consumers and stakeholders, Meador says that AMVIC continues to actively protect vehicle choppers via: • mandatory licensing for motor vehicle businesses and salespeople as required by the Consumer Protection Act of Alberta; • helping automotive businesses understand the legislative requirements by conducting inspections that serve to educate businesses; • providing a consumer services team trained in alternate dispute resolution that handle consumer questions, as well as complaints that are submitted via AMVIC Online.

Patrick Poyner, Director of Investigations, Licensing and Legal Services of the Vehicle Sales Authority of B.C., says that the regulator stays up-todate with illegal dealership operations via an industry standards team.

This team conducts hundreds of inspections annually, allowing the regulator to locate potential operators acting in bad faith, and relay that information to the public.

During investigations, Poyner says that they advise illegal dealerships to cease their operations via an undertaking. This legal agreement is ordered by the Registrar, and states that they will or will not conduct a specified action. Undertakings can be viewed publicly on the VSA’s website.

That code of conduct starts the moment the purchaser walks through the door, and continues until the vehicle drives off the lot Website resources, such as a licensee database, are also available to consumers who are not sure about a potential illegal dealership’s operations. A code of conduct, in the Motor Dealer Act (MDA), is posted in every licensee’s dealership and legally establishes everything a dealer is supposed to follow in their operations.

“That code of conduct starts the moment the purchaser walks through the door, and continues until the vehicle drives off the lot,” Poyner said.

“Should disputes occur, we are hopeful they can be resolved between the consumer and licensee and, if they can’t, we as the regulator are taking whatever steps are necessary.”

Prymak says a regulator’s website remains the primary resource for consumers who want their questions answered thoroughly.

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Happy birthday!

CNAR marks 20th anniversary with year-long initiatives, conference in Vancouver

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NAR’s (Canadian Network of Agencies for Regulation) is very pleased to officially kick off its milestone 20th Anniversary! This exciting year will feature a number of new initiatives, including CNAR TV video interviews with long-time Affiliates and Partners, podcasts, giveaways, a celebration of important milestones, exploring future trends, new events (including CNAR’s first virtual international symposium), and more. We welcome all to join us on the CNAR journey, reflecting on the last 20 years and exploring what is in store going forward.

CNAR was established in 2003 as the federation of national organizations whose provincial and territorial members are identified in legislation as responsible for protection of the public through self-regulation of professions and occupations. Since 2007, CNAR has held an annual conference to address emerging regulatory issues and exchange information between licensing boards, accrediting agencies, examining bodies, and government officials at all levels.

Over the course of 2023, CNAR will celebrate the community that has brought the association to where it is today. CNAR will highlight its complete journey, from the time it was established as the “Canadian Network of National Associations of Regulators,” to where it is today, serving

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CNAR has grown tremendously over the last 20 years, with the help of our Affiliates and Partners thousands of Canadian regulators in every province and territory of Canada. From profiles of long-time individual and organizational supporters, to light-hearted trivia contests, this year promises to be one that fully embraces – and extends CNAR’s gratitude to – the community.

“CNAR has grown tremendously over the last 20 years, with the help of our Affiliates and Partners,” said Alyson Gaffney, Executive Director, CNAR. “It is with their support, their expertise, their engagement, and their continued loyalty and dedication to CNAR that we have been able to build this association towards our goal of continuously connecting Canadian regulators and promoting regulatory excellence in Canada. We look forward to celebrating the CNAR community itself throughout this milestone year.”

national conference) and interviews will be posted on www.cnar-rcor.ca in the coming weeks. The pinnacle of the 20th Anniversary celebration will be CNAR’s second hybrid conference event from October 16th to the 18th, 2023 at the Hyatt Regency Vancouver.

Our call for conference speakers is now open, welcoming proposals from both within and outside the CNAR community. Please visit www.cnarrcor.ca for details. Upcoming Events (to www.cnar-rcor.ca for details on all the below): • Feb. 15th: Making Governance Matter workshop featuring renowned regulatory advisor, Harry Cayton

• March 1st: Boardroom Culture workshop, hosted by Governance Solutions New Resource: Master Class Brief: Diversity, Equity, and Inclusion (based on 2022 Master Class) Call for Speakers for CNAR’s 16th Annual Conference: Deadline March 24th Call for Research Proposals: Regulation in the Public Interest; Deadline May 1st

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CNAR 2022: Charlottetown, PEI October 2022

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Photography by Berni Wood, www.reelmedia.ca and MDR Strategy Group Ltd. theregistrar.ca

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Cover Story

Cover Story

Ali Arlani Five years of condominium management regulation: CEO and Registrar Ali Arlani reflects on the CMRAO’s start-up and future

CEO and Registrar Ali Arlani

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Amassing the resume

Housing alone has presented unique challenges around the country. While the purchase of homes in some cities has recently cooled, rental costs in many other cities have soared.

Arlani moved to Ontario for employment with the provincial government. At the Ministry of Municipal Affairs and Housing, where he spent 18 years writing building codes, he was a senior technical policy advisor and later a director of the Housing Development and Buildings Branch.

When it comes to consumer protection and housing, Ontario is uniquely positioned in Canada. In addition to robust legislation that protects renters, half a dozen regulatory authorities oversee and regulate housing in the public interest.

One regulatory body, the Condominium Management Regulatory Authority of Ontario (CMRAO), was established by the former Liberal provincial government in 2017 to license and regulate condominium managers and management provider businesses. Led by Ali Arlani, Registrar and CEO, the CMRAO is celebrating its fifth year of operations and its positive impact on the province’s condominium management sector.

Cover Story

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sk any Canadian to name the most pressing issues affecting their lives today, and you’ll likely hear about the cost of living and housing. Following the tremendous shift in the Canadian and global economies since the start of the COVID-19 pandemic in 2020, inflation has had a pronounced impact on many people.

Born in Iran, Arlani’s story reflects the path of many Canadian immigrants.

He pursued higher education and earned degrees in economics and civil engineering. He then received a Ph.D. in Building Engineering from Concordia University in Montreal.

“In 2004, I was asked to head an adjudicative agency called Ontario Municipal Board as its CEO,” Arlani said.

Ali Arlani and Sandy Vizely

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Cover Story

“I spent about eight years doing a lot of reform and consolidation for adjudicative agencies, which was followed by my appointment to the Assistant Deputy Attorney General position in 2012.”

Building awareness as a regulator The CMRAO was established in tandem with the Condominium Authority of Ontario, the authority created in part, to provide mandatory training to condominium directors and to provide a dispute resolution mechanism through the Condominium Authority Tribunal. With 12,000 condo corporations in Ontario, there was a dire need to streamline operations to ensure condominium management providers meet education and experience standards, and comply with a code of ethics. But, creating a new regulatory authority was challenging.

The CMRAO’s specific mandate is to set standards and enforce the required licensing of condominium managers and management service providers.

Inside the CMRAO main office

Arlani’s extensive developmental and governmental experience, including appointments as CEO of the Environment and Land Tribunals Ontario and Executive Lead for the Social Justice Tribunals Ontario, led him to the top job at the CMRAO.

“Essentially, you didn’t have a regulated profession called ‘condominium management,’” Arlani said. “Now, since you are trying to build from zero, we had to, within the first couple of years, create an environment that both enhances the credibility within the industry and identifies the key stakeholder groups.”

The journey was a resounding success, as Arlani helped to set the foundation for the regulatory body by

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establishing standard licensing procedures and competency profiles, supporting the development of a new post-secondary condominium management training program facilitated by Humber College in 2021, and setting regulatory exams for growing professionals in the industry.

Cover Story

It’s important that there is growth in this profession, I see in the next five years that we can increase our number of licensees so that condominium communities can inevitably thrive.

By establishing a digital service delivery model as CMRAO’S flagship feature, Arlani says that it established the organization to support condominium managers more efficiently. With innovative, risk-based approaches to licensing and compliance, Arlani adds that speaking to colleagues in the regulatory sector nationwide has allowed the CMRAO to prosper. He says he is proud of the authority’s website capabilities, which he feels embodies the critical tenets that make a regulator modern and relevant.

Reflecting on the CMRAO’s fifth anniversary, Arlani acknowledges the work to date has set the foundation

Forward-thinking digital leadership Unique to the CMRAO’s operations is its prioritization of digital-first operations. Arlani notes how crucial this has become, especially in light of COVID-19 and the subsequent lockdowns that prevented the public from receiving in-person service.

Sandy Vizely, Deputy Registrar, CMRAO

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Cover Story

Vizely and Arlani

for continued growth and innovation.

“From my point of view, we’ve now gotten to a level of maturity where we can make best use of the tools provided to us, which allows our focus to be as flexible as possible to continually make improvements to the system,” he said.

It takes a village to raise a new regulator, and the senior management team has supported Arlani’s direction in invaluable ways. Deputy Registrar Sandy Vizely says that the Registrar and CEO is clear and steadfast with his mission but embraces and feeds off ideas from staff.

“He really empowers management and staff to do their jobs, and, in an organization as small as ours, I think

that is critical,” Vizely said.

Where high turnover in licensing and regulation, especially among new organizations, is commonplace, the CMRAO seems to have bucked that trend. “The team we currently have is largely the same as when I came in 2018, and that working relationship is something I truly respect,” Arlani said.

“Sandy in particular, was in charge of building the lead infrastructure and systems, and having someone like him on my team was instrumental in my success as Registrar and CEO.” Arlani says he wants to continue emphasizing his working relationship with the government.

“We have managed that relationship very well over the past five years,” he said. “That has helped us tremen-

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The next five years Reaching the first anniversary of any organization’s foundation in ordinary times is no small feat. Reaching a fifth-year anniversary amid a global pandemic, all the while establishing an identity and modern regulatory frameworks, can be seen as truly monumental.

Arlani takes all of it in stride and foresees the continued profession-

alization of the sector on the horizon. An ideal goal, however, would be to showcase condominium management as the preferred field for all, including those graduating from academic institutions or new immigrants to Canada, irrespective of their background.

Cover Story

dously, in the context of needing approvals or when you provide notices to them. No one gets caught off-guard, and a productive working relationship like this is what keeps us ahead of the curve.”

“It’s important that there is growth in this profession,” Arlani said. “I see in the next five years that we can increase our number of licensees so that condominium communities can inevitably thrive.”

Arlani and Vizeli with Tsehaie Makonnen, CMRAO Communications

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Fraud Prevention Month 2023: Regulators join forces to protect the public

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very year in March, the Competition Bureau, the Royal Canadian Mounted Police, and the Canadian Anti-Fraud Centre co-chair Fraud Prevention Month, a nationwide campaign to inform the public of fraud aimed at consumers and businesses.

The co-chairs are joined by a group of more than 60 businesses, consumer advocacy groups, government departments, law enforcement agencies, and regulatory bodies that make up the Fraud Prevention Forum and collaborate in a massive marketing and activities campaign to inform and protect the public.

This year’s theme, “Tricks of the trade: what’s in a fraudster’s toolbox?” aims to inform the consumers and businesses about sophisticated trends in fraud that victimize the public. With the rise of technology transforming criminal activity, this year’s campaign is important in delivering the right information and strategies to those who remain at risk.

According to the Competition Bureau’s website, the Fraud Prevention Forum model has been implemented in 29 countries including the United States, Australia, and England, all of whom host their own Fraud Prevention Month activities.

Canadian regulators are well represented members of the Fraud Prevention Forum, and the following are involved in this year’s campaign:

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• Alberta Motor Vehicle Industry Council • Alberta Securities Commission • Autorité des marchés financiers • College of Immigration and Citizenship Consultants • Financial and Consumer Services Commission • Manitoba Financial Services Agency • Ontario Motor Vehicle Industry Council • Ontario Securities Commission • Organisme d’autoréglementation du courtage immobilier du

Québec (OACIQ) • Technical Standards and Safety Authority Members of the public are urged to follow the aforementioned and share their social media messages.

To become a member of the Fraud Prevention Forum, contact the Competition Bureau for more information.

MDR Strategy Group and The Registrar will promote regulators’ campaigns daily on LinkedIn, Twitter, Facebook, and Instagram.

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Black History Month: Celebrating innovation and excellence

Black History Month

Dr. Kannin Osei-Tutu Meet medical trailblazer and EDI leader, Dr. Kannin Osei-Tutu

Dr. Kannin Osei-Tutu

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Black History Month

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t age 10, Kannin Osei-Tutu suffered an eye injury that could have turned him blind.

With no ophthalmologists in Terrace, B.C., and a concerned family weighing their options, he was flown to Vancouver to meet Dr. Harris, a physician that led the young boy to one day influence the social and cultural landscape of medicine in Canada.

“I was so scared, being a 10-year-old kid,” Osei-Tutu said. “He made me feel reassured and comforted, and that made me want to do that for somebody else in the future. That was the moment that I decided that I wanted to go into medicine.”

Today, Dr. Kannin Osei-Tutu, MD, MSc., CCFP is an accomplished physician, academic, and leader in Equity,

This is a needed structural intervention in the system that currently doesn’t exist.

Diversity, and Inclusion (EDI) and anti-Black racism initiatives. He is also at the forefront of developing programs that improve licensure and learning processes. His efforts are recognized nationwide, and he is determined to continue disrupting the status quo for greater equity by inspiring others to engage in systemic transformation.

Family and cultural influence Born in Winnipeg, Manitoba, Dr. Osei-Tutu was the child of Ghanaian parents who emigrated to Canada, with his father and mother arriving in 1959 and 1960 respectively. Both were staunch activists in the west African country but left during political unrest. After his father, a trailblazing retired urologist, completed his surgical sub-specialization in Winnipeg, the family settled in the small town of Terrace, B.C., where the younger Osei-Tutu spent his formative years.

“My parents, particularly my mom, value compassion and they remain committed to caring for others as a way of life,” Dr. Osei-Tutu said. “Even to this day, she calls herself “the real doctor” in the family and always tries to keep me informed about Ghanaian medicinal practices and concepts of wellness.”

Dr. Osei-Tutu is an accomplished scholar who received his Master of

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Redefining standards Nowadays, in a world where EDI in licensing and regulation is front-andcentre, Dr. Osei-Tutu has been leading inclusionary efforts for some time. He currently serves as National CANRAC (Canadian Residency Accreditation Consortium) Chair of the Anti-Black

Black History Month

Science from Dalhousie University in 1997 and later completed three years of plastic and reconstructive surgery and a family medicine residency at the University of Toronto. He received certification from the College of Family Physicians of Canada in 2010, became licensed with the College of Physicians and Surgeons of Alberta in 2011, and currently practices in Calgary.

Sadly, it is not uncommon for Black, Indigenous, and racialized trainees to experience racism in the learning environment and they typically suffer in silence and do not feel they have a safe space to be heard.

Racism Accreditation Working Group (AWG-ABR), which advocates for new standards with explicit language and policy promoting anti-Black racism in various areas of accreditation.

His work as Chair coincides with the establishment of the Black Physicians’ Association of Alberta in 2021. As the Founder and President, Dr. Osei-Tutu provides mentorship and guidance to prepare the next generation of Black doctors.

“I’m encouraged that things are shifting and starting to move,” 23

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Black History Month

institutions in Canada have a reporting mechanism explicit to racial harm and trauma. Endorsed by multiple medical organizations, the program has secured substantial funding and will launch later this year.

Dr. Kannin Osei-Tutu receives the 2022 Donald I. Rice award.

Dr. Osei-Tutu said. “As a profession, medicine has lagged somewhat behind other sectors of society, such as business and law, when it comes to coordinated, wide-scale, and systemic efforts to address EDI and anti-racism. But, it’s also the profession that could make the greatest impact if we commit to the pursuit of safe, equitable and inclusive clinical environments for care providers and patients.

Fundamentally, it’s the profession that is about caring for people.”

Dr. Osei-Tutu designed the National Ombuds of Canada in 2022, the first and only national reporting mechanism for racialized trainees who experience or witness racism in postgraduate medical learning settings. Dr. Osei-Tutu identified the need to address a critical gap – only one of 17 medical 24

“This is a needed structural intervention in the system that currently doesn’t exist.” Dr. Osei-Tutu said.

“Sadly, it is not uncommon for Black, Indigenous, and racialized trainees to experience racism in the learning environment and they typically suffer in silence and do not feel they have a safe space to be heard. By implementing a safe pathway for trainees who have been harmed or discriminated against, and by leveraging the accreditation process to establish a zero tolerance standard for racism, I hope to see this model expanded and positioned to disrupt other forms of discrimination in the learning environment.”

A big trend in medical care right now involves artificial intelligence.

Dr. Osei-Tutu sees the potential of A.I. being used to promote better health equity outcomes in patient care, but he cautions that the development of algorithms requires scrutiny.

“Our own biases are embedded into these algorithms,” he said. “Some A.I. applications have been found to perpetuate biases and cause harm

Dr. Kannin Osei-Tutu in his practice.

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Historic appointment and recognition Earlier this month, the University of Calgary appointed Dr. Osei-Tutu to the role of inaugural Senior Associate Dean – Health Equity and Systems Transformation at the Cumming School of Medicine, effective February 1, 2023. This follows him receiving the prestigious Donald I. Rice Award in 2022 from the College of Family Physicians of Canada, which recognizes an outstanding

Black History Month

to marginalized patients. If certain behaviors occur in a clinical environment, because of one’s partialities, A.I. tools could serve as a check and balance on a practitioner’s unconscious biases. Research is ongoing, but emerging evidence suggests A.I. could be a powerful tool for justice if we build algorithms that can correct against a practitioner’s biases.”

CFPC family physician who has contributed to teaching, vision, and leadership in family medicine.

As Senior Associate Dean, Dr. Osei-Tutu will work in Health Equity and Systems Transformation, which encompasses a broad spectrum of issues in and outside the school. He is hopeful that this will enable him to support a shift in the institution’s culture to one of authentic inclusion where all students, trainees, and faculty feel they belong.

“With this senior leadership role, I’ll be at the decision-making table and will be able to influence policy and procedures from which many from marginalized backgrounds have previously been excluded,” he said.

“Externally, I’ll be responsible for operationalizing our school’s social ac-

Dr. Kannin Osei-Tutu and his family

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Black History Month

countability so that we are genuinely interfacing with local communities, medical regulatory and third-party organizations in the province, and advocating on behalf of the Cumming School on a national level. My goal is to collaborate broadly with others and support the school in becoming a beacon for medical education in Canada, and make us be the place that people want to come practice and feel they belong.”

The road ahead “A sick person should never have to travel,” Dr. Osei-Tutu recalls his father saying to him. To take care of the community at large, his father pioneered a travelling urology service, which saw him going to different locations in B.C., from Smithers to Prince Ru-

I think I would be able to tell that 10-year-old boy that all of this, and all of the stuff you have gone through, was going to be worth it at the end of the day.

pert and beyond, to take care of Indigenous patients.

This type of authentic innovation drives Dr. Osei-Tutu’s work, so he can continue to impact patient lives positively. He says that keeping things in focus by continually pushing the boundaries of what is possible keeps him resilient for the road ahead.

Reflecting on his childhood in Terrace, Dr. Osei-Tutu says, “I think I would be able to tell that 10-year-old boy that all of this, and all of the stuff you have gone through, was going to be worth it at the end of the day.”

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CLEAR’s upcoming international congress:

Global health and labour market challenges top of mind in Ireland

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his year, on May 4 and 5, the Council on Licensure, Enforcement, and Regulation (CLEAR) will host its seventh International Congress on professional and occupational regulation.

To be held in Dublin, Ireland, regulators from around the world will examine and discuss the trends and issues of licensing and regulation from a global perspective. CLEAR Program Coordinator Virginia Shapland says that both days will focus primarily on engagement and collaboration.

“We see this [event] as a launchpad for regulators in the years to come,” Shapland said. “It gives them an opportunity to hear about what other regulatory stakeholders are engaged in, and provides roundtable opportunities to discuss how the sector is impacted by those same issues.”

Shapland says that the organization is pleased with how planning for the international event is progressing.

Delegates from around the world have registered, including several from Canada, the US, and Australia.

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Dublin, Ireland

CORU, the Irish health and social care regulatory authority, looks forward to welcoming its global colleagues to Dublin.

Margaret Hynds O’Flanagan, CORU’s Head of Recognition and Deputy Registrar and Chairperson of CLEAR’s International Relations Committee, acknowledges the importance of this meeting given the global pressures on healthcare. Portability of credentials, and the use of technology to reduce the burden of professionals becoming licensed in the sector, will be a big topic of discussion.

“The [International Relations] Committee will look at issues around mobility this year, with one of them being

changes and trends,” she said. “Alongside the technology and the ethics on this [international recruitment], finding ways to support the professional in adjusting to their environment.”

Topical planning will be done by a number of CLEAR committees, who will conduct environmental scans to assess the most significant issues affecting each regulator’s jurisdiction.

Hosting different regulators from various parts of the world allows regulatory colleagues to get a better sense of how to directly address consumer needs, she says.

Preceding the seventh International Congress on May 3 is CLEAR’s Regulatory Research Day, which will allow 29

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attendees to network and explore how academic information and research shape policy on an international scale. A keynote delivered by Cary Coglianese, founder of the highly-acclaimed Penn Program on Regulation, will also be on the docket.

“We’re starting to see that you don’t have to start off of ground zero,” Shapland said. “You can build off of what researchers, and even non-regulators, have done. This collaborative aspect allows everyone to grow, and get out of their silos.”

Acknowledging the International Congress as part of the ongoing return to in-person learning, Shapland says that CLEAR has seen a sharp increase in direct engagement. It allows regulators to better focus on priority objectives, such as Diversity, Equity, and Inclusion (DEI) access, which is necessary to make positive change more broadly.

Ireland, Hynds O’Flanagan says, is an example of how broader change can be made, for professionals who serve the public. Ireland’s equality legislation, she says, advanced rapidly in the final decades of the 20th century, and

Margaret Hynds O’Flanagan (she/her), Head of Recognition and Deputy Registrar, CORU

has significant ambitions and commitment to DEI. Hynds O’Flanagan says that current action reinforces fairness and transparency.

“We now have a Human Rights and Equality Commission, and part of their legislation states that any public sector authority has a duty to protect and actively promote DEI,” she said.

“It’s government mandated work, and we have to do it to ensure people’s rights are protected.”

More information can be found on CLEAR’s website, with full program details being publicly available in February 2023.

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Consumer Alert:

Algomed, a Quebec private health care organization arrives on Nova Scotia’s shores and leaves patients stranded

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ast summer, Algomed, a nurseled private health care agency chain based in Quebec, expanded its primary care services to the Halifax Regional Municipality. The purpose, according to Algomed co-founder Dr. Adam Hofmann, was to provide more health care services to Nova Scotians who have limited access to the province’s strained public healthcare system.

However, in January 2023, a mere few months after opening, the clinic’s east coast operations were shuttered.

Its social media pages were removed and surprised patients have been unable to contact the organization. Patients who signed up to Algomed’s subscription-based pricing model have been left with no recourse for refunds, and their credit cards continue to be charged.

“My wife and I were really hopeful about Algomed,” said a patient who spoke with The Registrar on the condition of anonymity. “The nurse practitioner who saw us was exception-

After trying to reach Algomed for the past month, I’ve reached out to my credit card company to stop payment. This never should’ve happened, and people deserve much better

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“The NSCN regulates nurses as individual health care practitioners and we do not regulate or license private health care corporations,” she said.

“We believe public nurse-run clinics could play a vital role in providing the public with greater access to healthcare. There are examples in Nova Scotia where these have been making a positive difference when added as an option to our health care system.”

Sue Smith, Registrar and CEO, the Nova Scotia College of Nurses

al, and we felt safe with this private solution to Nova Scotia’s health care challenges. But Algomed won’t cancel my required monthly subscription even though their service is no longer accessible to me. They’re stealing my money, which is deeply disturbing, inappropriate, and repugnant, and unnecessarily increases risks to an already vulnerable population.”

The Registrar reached out to Algomed, but several requests for an interview have gone unanswered.

The Nova Scotia College of Nursing regulates nurses and nurse practitioners in the province. Sue Smith, its CEO and Registrar, provided information on the College’s stance of public and private health care servicing.

At a time when more than 100,000 Nova Scotians are waiting for a family doctor, it’s a lucrative proposition to set up a clinic where nurse practitioners, who have extended scopes of practice from Registered Nurses, can see patients who are willing to pay.

In contrast to the College, Janet Hazelton, the president of the Nova Scotia Nurses’ Union, says that she was surprised that a private health care clinic like Algomed set up shop in Nova Scotia at all.

“The market isn’t really great in Atlantic Canada,” Hazelton believes.

“People don’t have as much disposable cash as others in central Canada where these facilities [like Algomed] could work.”

Raylene Langor, a Halifax lawyer, says the principal issues are about contracts and consumer protection.

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Raylene Langor

She asserts that it is vital to read the wording of the service contract between the clinic and each patient. A breach of contract could allow the client to recover money that they are properly owed. In Nova Scotia, Section 26(5) of the Consumer Protection Act implies a statutory service warranty, or promise made by one party to another. In exchange for a fee, or any other guarantee, a service agreed by both parties must be carried out.

encouraged to reach out to legal counsel if necessary.

“After trying to reach Algomed for the past month, I’ve reached out to my credit card company to stop payment.

This never should’ve happened, and people deserve much better,” said the patient who spoke to The Registrar.

Any patient of Algomed, or of any service, where a consumer feels that their contractual obligations are being breached should attempt to stop payment. Consumers are also 34 theregistrar.ca

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Perspective: Protecting the mental health of interviewees in regulatory investigations

By Dean Benard

W

hen investigators conduct interviews, it is easy to forget that they are in a position of power, and the imbalance of power can lead to detrimental outcomes that will affect the usefulness of the information gathered as well

as leave the person interviewed in a bad place psychologically. We have all seen the tough interview styles in the movies and TV, but as most would agree, what we see in the movies is very often the exact opposite of reality, or at least what should be reality.

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As a regulatory investigator you have a responsibility to gather information that can be relied upon to make important decisions. Instilling discomfort and engaging in tactics that manipulate can lead to incorrect, missing, exaggerated, and false information being provided by interviewees. It is critical to manage the mental health of interviewees in an investigation. An unpleasant or frightening interview can lead to re-victimization or distress that will negatively impact the interviewee’s mental health, and potentially undermine the validity of the information they provide. The following steps should be taken to ensure a psychologically safe experience for those being interviewed: • Give the interviewee a clear understanding of process, what their role is in that process, and how the interview will unfold. Also, allow them to ask questions they might have to help them feel better prepared and give them a little control. This helps balance the power differential.

• Create a safe environment by assessing their comfort around the location of the interview (if it is in-person). During the interview, try to foster a safe and supportive environment by building rapport and avoiding aggressive language or tones. Where possible, give them a chance to tell their story. Don’t

bombard them with question and after question. Giving them this chance allows them to provide a narrative and you can ask clarifying questions after.

• Avoid aggressive questioning techniques and speak in a nonjudgmental way. It is good to show empathy in an interview.

• Offer breaks if you observe a need for one. Let them know in advance that they can ask for a break and that is just fine.

• In many cases a support person should be offered, either a person they can consult with before the interview, or to have present during the interview. Of course, this should not be another witness or party to the investigation and appropriate confidentiality provisions will need to be put in place.

• Try to be respectful of the interviewee’s limit for discussing a topic or continuing with the process.

It might be necessary to have additional meetings rather than trying to get it all done at once.

• Stay open minded, check your own bias, and remember that not all people have the same life experiences as you. Their ability to recall information, or the order information is provided are not necessarily indicators of deceit.

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Of course, this is just the tip of the iceberg when it comes to managing interviewees in a manner that protects their mental health. What might seem easy to you can be a mountain to climb for someone else. All the above is part of taking a trauma informed approach to interviewing, but it isn’t the whole story. Here I point out the need for an empathetic, respectful, and dignified approach, but there is much more to it than that. However, for now, taking the above steps, can help protect the mental health of in-

terviewees and ensure that the information you gather is reliable and valid. By taking this approach you are also promoting a culture of respect and empathy within your organization, which is essential for building trust and obtaining reliable outcomes.

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