Provincial Privileging Standards Project: Dr Slater and Ms Bloch-Hansen reply

We have read the commentary from Drs Avery, Boyd, Iglesias, Johnston, Klein, Ruddiman, and Woollard [BCMJ 2014;56:326-327] with some concern. We accept that change engenders fear, but we disagree with the assertions made. The privileging dictionary project is only one of a larger suite of projects to address credentialing and privileging activities across the health system. In responding to the concerns raised we appeal to hope and to a better future for the physicians of this province. We anticipate, once implemented, the privileging dictionary project will grant physicians the opportunity to enter into conversations regarding the supports they need to maintain and exercise the skills employed in clinical practice. In undertaking this work (56 expert panels participating), we have consulted widely with practitioners from all disciplines, with boards of governance, and with administrators across the province, and we are using what we have learned to articulate the guiding principles below. While these guiding principles are not the reason this project was initiated, they are a beneficial by-product.

First, all practitioners in the province should feel supported in clinical practice. While a certain skill set is required for each medical staff position in the province, many physicians are reluctant to discuss their level of comfort performing these skills. This project creates a safe environment and context for this to occur and for discussions on how comfort may be maintained or restored.

Second, we must not confuse currency with competency. The training colleges are only now beginning to address the challenge of defining competence for the practising physician. We are interested in this issue, but it is beyond the scope of our project. Other initiatives will address competency.

Third, currency is an estimate of the level of activity below which a collegial discussion about support should be triggered. It is not a disqualifier. This discussion should be guided not only by the expectations and standards outlined in the dictionary but also by the risks inherent in the privilege being discussed and by similar activities that contribute to the skill under consideration. This is an opportunity to reflect with a respected colleague on one's professional practice and to deliberately plan an approach to skills maintenance.

Lastly, we do understand that the dictionaries being developed will need maintenance and improvement. This is an iterative process; its implementation will be closely monitored by the province, the colleges, and the health authorities. Any unintended consequences will be addressed quickly.

In the absence of a comprehensive strategy of support, rural health care has continued to face difficulties. Some may assert that our approach will lead to physicians leaving rural health. We point out that this is already happening and we believe that a planned and collaborative approach to maintaining skills may be part of the solution.

hidden


This article has been peer reviewed.

Jon Slater, MD, FRCPC, MBA,, Emma Bloch-Hansen, MBA,. Provincial Privileging Standards Project: Dr Slater and Ms Bloch-Hansen reply. BCMJ, Vol. 56, No. 7, September, 2014, Page(s) 327,356 - Premise.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply