Documentation in clinical notes and reports to third parties should be factual, objective, and use a suitable tone of medical professionalism.
(March 2020)
Advice on effective communications with patients and managing their expectations to help prevent conflicts in medical practice.
(March 2020)
Practising physicians, particularly those at the beginning of their career, should ensure they have enduring access to medical records after leaving a practice for medical-legal purposes.
(March 2020)
A look at how the legalization of recreational marijuana may affect physicians’ practices, including whether it will eliminate patients’ requests for medical marijuana.
(January 2020)
Practical suggestions for disclosure of discrepancies stemming from pathological analysis or diagnostic imaging.
(December 2019)
A review of CMPA member enquiries following the legalization of cannabis for recreational use reveals that the new regulatory regime has generally not had a significant medical-legal impact for our members.
(December 2019)
An overview of a physician's duty to maintain confidentiality and protect the privacy of patients' personal health information in instances of disclosure requests from third parties, including the police or other authorities.
(November 2019)
Certain provinces have legislation to prevent apologies for adverse events from being used in court proceedings.
(November 2019)
End-of-life treatment decisions can be difficult for both physicians and patients, but many issues can be avoided by following the key concepts outlined.
(November 2019)
An overview of the principles of retention, sharing and transferring of medical records.
(October 2019)
An overview of information privacy considerations when using electronic medical records in practice.
(September 2019)
Guidance for specialists on their ethical and professional responsibilities in accepting to care for new patients.
(September 2019)
Physicians should understand the role of coroners and medical examiners in Canada,
and how and when to provide information to them.
(June 2019)
Explanation of physicians’ mandatory and discretionary obligations to report patients who have a medical condition that may make it dangerous for them to drive.
(June 2019)
When patients make requests for specific care providers, treatments, or services, physicians should assess whether they can reasonably accommodate such requests.
(June 2019)
Physicians who respond affirmatively to a request for a medical-legal report should prepare the report with care and in keeping with their College’s policies and guidelines.
(June 2019)
A review of CMPA medical-legal cases involving spinal surgery performed by a neurosurgeon or orthopaedic surgeon with risk management strategies for all phases of surgical care.
(June 2019)
Text messaging offers the potential for improved communication among physicians and healthcare teams, and using it appropriately can mitigate some of the inherent risks of this channel.
(June 2019)
Polices introduced by the medical regulatory authorities (Colleges) reflect concerns expressed by some in the medical community about the use of marijuana for medical purposes and the challenging role given to physicians and other healthcare providers.
(May 2019)
A discussion of physicians’ obligations when certifying a patient’s death.
(April 2019)
Physicians can successfully manage online ratings using a reasonable and measured approach.
(April 2019)
Guidance for physicians on assessing whether a chaperone is right for their practice.
(March 2019)
Physicians treating pregnant patients should be knowledgeable about the developments in prenatal testing and the current standards of practice, and be able to communicate testing information so patients can make informed decisions on the future of their pregnancy.
(March 2019)
Physicians should consider encouraging patients to engage in advance care planning and appointing a substitute decision-maker early, before the patient no longer has the capacity to consent to end-of-life care.
(March 2019)
CMPA gives advice to physicians travelling across international borders and having border agents search mobile electronic devices, such as smartphones, that may contain confidential patient information.
(January 2019)
Strategies for managing the stress associated with transitioning to a new EMR system for managing patient records.
(December 2018)
Addressing privacy breaches has become more complex as the rules around notifying and reporting have recently changed or are about to change across the country.
(October 2018)
The CMPA analyzes members’ calls and medical-legal questions about opioid treatment of patients suffering chronic non-cancer pain.
(September 2018)
Physician leaders who foster a culture of accountability in their teams and institutions help promote learning from undesirable behaviours that include human error, and at-risk and reckless behaviour.
(September 2018)
Any medical procedure where instruments are inserted into the mouth may result in dental injury, and physicians should inform patients of this risk and appropriately disclose the injury if it occurs.
(August 2018)
Professional and ethical obligations to keep in mind when considering offering medical services through online virtual clinics.
(July 2018)
Physicians can be better prepared to transfer patient health information when they understand who has custody of and access to medical records.
(May 2018)
A review of medical-legal cases involving complications of cholecystectomy.
(May 2018)
Individuals have a general right to access their personal information in independent medical examination files, but there are exceptions to what must be produced
(May 2018)
Tips for physicians to help prevent drug diversion and related unlawful prescription activity, and avoid potential medical-legal difficulties.
(March 2018)
Physicians may release a patient’s medical records to lawyers only with patient authorization or where required by law.
(February 2018)
Physicians working with medical scribes should be aware of their obligations as an employer, delegator, and supervisor.
(January 2018)
EHR and EMR technologies change the way medical care is delivered, creating both opportunities and challenges for healthcare providers.
(December 2017)
Physicians, other healthcare professionals, and health system leaders are encouraged to actively seek out patients’ perspectives to improve healthcare planning and delivery.
(December 2017)
Adequate record keeping may help during a billing audit.
(November 2017)
Physicians should try to accommodate patients’ requests to limit access to their personal health information.
(October 2017)
Greater clarity in patient care can be achieved through healthcare directives, and when physicians understand their purpose and the rules governing them.
(October 2017)
Considerations to help prevent and mitigate the damage arising from ransomware attacks to computer systems.
(July 2017)
Disruptive behaviour in the healthcare workplace can take a toll on co-workers and patients, but conflict may be reduced by using a disarming approach.
(June 2017)
Online social networks in healthcare provide a means for worldwide collaboration among physicians, but participants should maintain the standards of professionalism expected of the profession.
(April 2017)
Physicians should speak with patients about their alternative medicine treatments and, as much as possible, provide guidance on potential negative interactions.
(February 2017)
Physicians can take steps to mitigate the medical-legal risks of patients taking photos and making video and audio recordings during healthcare encounters.
(February 2017)
Physicians who are familiar with regulatory requirements governing organ and tissue donations can more effectively meet their obligations and mitigate the potential for complaints.
(January 2017)
Physicians regularly encounter patients or family members who behave aggressively and make demands that may be unrealistic and potentially harmful. In their medical practice, physicians need strategies and tools to manage conflict and such challenging behaviours.
(January 2017)
An overview of obligations and issues for doctors when providing or discussing vaccinations with patients or legal guardians.
(January 2017)
Physicians can take reasonable steps to maintain the best interests of the patient in the midst of family disputes concerning the care of children or of elder patients.
(December 2016)
How physicians can take steps to minimize medical-legal risk when using mobile health applications (mHealth) in their practice.
(December 2016)
The management of elder abuse cases is an increasingly important aspect of physicians’ practices, though determining the appropriateness of actions to address suspected abuse can be challenging.
(December 2016)
By practising in a collegial manner, physicians may enhance the health outcomes of their patients and themselves.
(September 2016)
The practice of marking transcribed reports or entries “dictated but not read” gives rise to medical-legal risks and can create uncertainty for those relying on that information in providing patient care.
(June 2016)
A discussion of consent issues that may arise when caring for adults with diminished mental capacity (competency).
(May 2016)
Physicians can work collaboratively with physician assistants, but should be aware of the potential risks inherent in this working relationship and how these can be managed.
(April 2016)
Patient handovers can be a time of high risk. Patient safety experts recommend various strategies to improve the performance of this task.
(March 2016)
A review of the most recent 5 years of CMPA medical-legal cases involving cosmetic procedures identified a number of consent deficiency issues.
(March 2016)
Protecting the privacy of patient information when using digital communication channels, including email, portals, and social media platforms.
(January 2016)
While workplace conflict is inevitable, there are steps physicians can take to de-escalate and resolve disputes before they impact patient care.
(December 2015)
Physicians in non-surgical disciplines who perform invasive procedures may be exposed to medical-legal risks, though these can be effectively mitigated.
(December 2015)
The CMPA recommends that member physicians and others working in healthcare adjust the default privacy options of Microsoft 10 to obtain greater control over their personal and patient information and address potential privacy concerns.
(September 2015)
Hip or knee arthroplasty can greatly improve quality of life, yet it may also have significant risks.
(September 2015)
A discussion of the principles of access, the challenges with access, and managing the risks.
(August 2015)
Physicians providing emergency care as good Samaritans often have questions about their legal and ethical obligations and the liability protection available to them.
(July 2015)
Changes to the Criminal Code have raised the age of consent for sexual activity. Physicians should be guided by legislation in each province and territory on their duty to report such activity to the appropriate authorities if there are reasonable grounds to believe the child is being abused.
(June 2015)
Considerations for ending the doctor-patient relationship.
(June 2015)
After day surgeries, consider if patients are ready for discharge, require accompaniment on leaving the facility, and have sufficient discharge and follow-up instructions.
(June 2015)
This publication provides guidance and good practices about physician communications with patients concerning the disclosure of harm stemming from healthcare delivery, and aligns with the Canadian Patient Safety Institute’s (CPSI) Canadian Disclosure Guidelines (2011).
(May 2015)
Increasingly medical education is focusing on physician competencies that address safe patient care and that enable more accurate assessment of performance.
(May 2015)
An analysis of recent CMPA cases highlighting the medico-legal risks associated with surgical ureteric injury.
(March 2015)
Physicians owe patients a duty to keep their personal health information confidential, yet there are times when this conflicts with other statutory duties or with concerns for public safety.
(March 2015)
Tips to assist physicians in communicating effectively with patients and their families when a patient’s prognosis is terminal.
(March 2015)
A review of hospital-based patient safety incidents and common reasons leading to them.
(March 2015)
Physicians’ office staff can contribute to safe care for patients and reduce medico-legal risk. This article reviews several issues identified in the CMPA medico-legal files and provides suggestions on reducing risk.
(March 2015)
Physicians can take steps to avoid conflicts of interest that can arise when dealing with commercial interests.
(January 2015)
Providing patients with online access to their electronic medical records may offer improvements in patient health. Physicians should keep in mind their obligations to protect patient information and document appropriately.
(December 2014)
Adequate discharge strategies to help reduce the risk of unplanned hospital readmissions, unfavourable patient outcomes, and medico-legal problems for physicians.
(December 2014)
Specific risk management strategies for physicians who are providing care to patients experiencing mental health issues.
(November 2014)
When patients suffer harm from healthcare delivery, physicians will want to disclose the incident to the patient, and if the media become interested, then prepare appropriately.
(October 2014)
Highlights of medico-legal issues associated with anaesthesia and analgesia administered by anesthesiologists for surgery and during labour and delivery.
(September 2014)
Physicians can successfully manage online ratings using a reasonable and measured approach.
(September 2014)
Case studies related to boundary crossings and violations.
(September 2014)
A case study illustrating the legal concepts of informed consent and of battery (or “a violation of the integrity of the person” under Québec’s civil law).
(July 2014)
Physicians participating in clinical research studies should be aware of their relevant legal, ethical, and professional obligations.
(July 2014)
Physicians have an obligation to protect patient information and can take steps to help prevent privacy breaches associated with sending and receiving faxes.
(July 2014)
This article focuses on the main areas of medico-legal risk for psychiatrists.
(June 2014)
A review of problems, pitfalls, and emerging liability issues with the use of electronic patient records
(June 2014)
Effective communication and awareness of legal requirements are key to obtaining consent for treatment of children.
(May 2014)
This article explores the role of physicians in promoting the exchange of information and active decision-making by patients. It also examines the relationship between decision-making and consent.
(April 2014)
The circumstances under which physicians can treat themselves, family and friends are limited.
(March 2014)
A practical resource for physicians, describing the implementation and use of electronic medical records (EMRs) and electronic health records (EHRs), including benefits, technological issues, and medico-legal risks.
(March 2014)
Physicians can take steps to address bullying and other abusive behaviours they may be subjected to by patients and their families, colleagues and other healthcare workers, and third parties.
(March 2014)
This article discusses what physicians can do to deliver culturally competent and culturally safe medical care.
(March 2014)
How to better manage the risk of patient harm, adverse birth outcome, and potential medico-legal problems associated with the administration of oxytocin during labour.
(March 2014)
Physicians acting as clinical supervisors play a valuable role in the remediation of physician colleagues and, as members of the CMPA, are eligible for the Association’s assistance if medico-legal difficulties arise.
(December 2013)
Physicians should carefully reassess patients who return with symptoms that are not resolving as expected or are worsening.
(September 2013)
The increased availability of genetic testing raises a number of medico-legal questions that physicians should consider.
(September 2013)
Highlights from CMPA discussion paper “The role of physician leaders in addressing physician disruptive behaviour in healthcare institutions.”
(September 2013)
Physicians supervising medical trainees must keep in mind their responsibilities to patients when delegating tasks to trainees.
(June 2013)
A review of CMPA medico-legal cases involving feeding tube placement identifies clinical situations of higher risk that can affect patients and physicians.
(June 2013)
Privacy legislation, regulatory policies and professional obligation require that CMPA members take reasonable measures to protect the privacy of their patients' personal health information. With the advent of electronic records, members should be cognizant that encryption can help secure personal health information and may be required by law.
(April 2013)
An analysis of the CMPA’s pediatric medicolegal cases identified a
number of common factors that resulted in poor clinical outcomes.
(December 2012)
Recognizing and eliminating biases and prejudice contributes to safer medical care.
(December 2012)
Assisting prospective parents seeking to adopt a child from abroad can pose challenges for physicians, particularly when they are asked to assess a child’s condition without a physical examination or to prescribe medication for a child with whom they do not have a doctor-patient relationship.
(December 2012)
A review of medico-legal problems associated with hernia repairs in the preoperative, intra-operative, and post-operative stages.
(December 2012)
A physician must provide certain information to patients to obtain informed consent, even for simpler procedures and treatments.
(December 2012)
The practice of medicine is undergoing unprecedented change.
(October 2012)
Physicians assume key responsibilities in healthcare including the provision of much needed medical care, research into new treatments, teaching the future generation of doctors, and managing healthcare facilities, centres, or clinics.
(October 2012)
As healthcare delivery relies increasingly on integrated or collaborative care, a growing number of physicians are working in teams composed of physicians and other healthcare professionals.
(October 2012)
To respond appropriately to a request to release patient information, physicians must understand the legal rules surrounding the ownership and handling of the information.
(October 2012)
Trust, loyalty, and honesty are the foundations of a good doctor-patient relationship and of professionalism in the practice of medicine.
(October 2012)
Medico-legal issues for ophthalmologists related to the pre-operative, intra-operative, and post-operative periods of cataract surgery.
(September 2012)
A review of medico-legal cases concerning diagnosis and management of skin cancer.
(September 2012)
Strategies to reduce medico-legal risk when prescribing medications or using medical devices outside of their licensed indications.
(September 2012)
As the healthcare environment continues to change, physicians remain committed to quality patient care, while keeping in mind accompanying risk management considerations.
(September 2012)
Engaged and empowered patients take an active role in managing their healthcare, and physicians must be aware of the medico-legal implications.
(August 2012)
A review of the medico-legal issues with bariatric surgery in the pre-operative, intra-operative, and post-operative periods
(June 2012)
A complaint to a medical regulatory authority (College) initiates a process that warrants a physician's attention and timely response.
(June 2012)
Risk management suggestions related to verbal and written communication in the trauma setting and when resources are limited.
(June 2012)
Risk management suggestions from an analysis of medico-legal cases related to the diagnosis of trauma patients.
(April 2012)
A review of medico-legal problems related to malfunctions, improper use, and deficiencies in training and supervision when using medical or surgical equipment.
(March 2012)
As the Canadian population ages, physicians may need to adjust their practices to better meet the needs and expectations of older adults and avoid potential medico-legal risks.
(March 2012)
If physicians have reason to believe a child is in need of protection, they are responsible for informing the appropriate authority in a timely manner. Planning what to say to the family is important.
(March 2012)
Physicians should be prepared to respond to patient enquiries about complementary and alternative medicine and natural health products.
(March 2012)
Litigation related to the placement of central lines is most often related to consent, delegation, standard of care, and documentation.
(December 2011)
Privacy legislation and policies set the foundation for safeguards to maintain confidentiality of patient information.
(December 2011)
There are a number of steps that can be taken to reduce the likelihood of patient dissatisfaction with Independent Medical Evaluation.
(July 2011)
Physicians undertaking clinical research are expected to obtain valid consent.
(July 2011)
A review of medico-legal problems related to prescribing and monitoring medications for older patients.
(June 2011)
A discussion on how members can help meet the clinical, emotional and informational needs of patients after large scale adverse events.
(June 2011)
An exploration of privacy and consent issues when using clinical images or recordings of patients to teach medicine.
(March 2011)
Responsibilities of physicians when planning to close or leave a practice due to retirement, illness, or other reasons.
(March 2011)
CMPA provides free telephone record pads for physicians to use when documenting telephone advice.
(January 2011)
A review of the legal duties and ethical considerations for physicians to report their reasonable concerns about the professional competency, conduct or behaviour of another physician to health care institutions/hospitals, public health officials or regulatory authorities (Colleges).
(December 2010)
Responding to patient requests for exemptions to wearing a seatbelt while driving.
(December 2010)
A review of some of the medico-legal risks related to the use of medical directives in emergency departments, and patients who LWBS by a physician or sign out AMA.
(September 2010)
In the case of E. (Mrs.) vs. Eve (1986), the Supreme Court of Canada established limitations related to therapeutic sterilization of mentally incapable (incompetent) patients.
(April 2010)
Intoxicated patients pose special risks in the emergency department because of their behaviour, and the difficulty of adequate assessment and treatment.
(December 2009)
It is well recognized that health care providers continuously strive to ensure the best possible clinical outcomes for their patients. They do so cognizant that no one individual or system can ever fully eliminate the risk and occurrence of adverse events
(July 2009)
Delays in the diagnosis of ectopic pregnancies may lead to poor patient outcomes and medico-legal difficulties for physicians.
(June 2009)
A review of legal actions involving physicianprescribed opioids.
(March 2009)
Risk management considerations for supervising physicians, and supervised residents and other trainees.
(September 2008)
Considerations in responding to patients' requests for support in acquiring firearms.
(July 2008)
Passport applications no longer need to be signed by specified professionals, and when signing certain personal information must be included.
(June 2008)
Appropriate use of aminoglycosides requires awareness of the potential side effects and their symptoms.
(June 2008)
A study examining the medico-legal risks of airway management by anaethesiologists from 1993 — 2003.
(May 2008)
The physician's role in providing a child's medical information to a parent.
(May 2008)
Physicians may be asked to attest to the capacity of a patient if the patient's will is contested or at the time the will is being prepared.
(April 2008)
Physicians can rely on hospital staff to carry out their own functions but are also expected to exercise appropriate caution.
(March 2008)
Clinical care is increasingly provided by collaborative teams with the promise of better outcomes for patients. This document identifies potential medico-legal risks in collaborative care and proposes solutions to lessen those risks for patients and providers.
(January 2008)
DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. The use of CMPA learning resources is subject to the foregoing as well as the CMPA's Terms of Use.
