After-hours care coverage—a response to registrant inquiries
Following an article in the last College Connector, titled “Providing after-hours coverage is not optional; it’s a necessary component of patient care,” the College received several inquiries from registrants.
Some expressed concern that colleagues weren’t following the College practice standard, Care Coverage Outside Regular Office Hours and wondered how the College might better enforce the standard. Both family physicians and specialists felt frustrated that they were often directed to a voicemail with no option for direct contact with one another.
Others felt the expectations set out in the practice standard were too onerous—particularly for those in rural settings. Inquiries about remuneration for after-hours care and fee for service billing were directed to the Medical Services Commission and Doctors of BC.
Registrants are reminded that the expectations set out in the standard are not new; in fact, the requirement to provide after-hours care coverage for patients has been a foundational component of the standard since it was first published in 1995.
Providing care outside of regular office hours should not be onerous as patients rarely need to call in follow-up to a recent visit. In fact, the College receives very few complaints from patients who have tried and failed to reach their physician or surgeon after hours. More frequently, issues arise when pathologists, radiologists, pharmacists, and other colleagues cannot make contact to obtain important information about a patient when it is needed. In all cases, clear communication is key. Patients, their families, other health professionals in the circle of care, laboratories, imaging facilities, hospitals and others must be informed of coverage arrangements—that is how to “ensure ongoing medical care.”
A recent example of the importance of after-hours care coverage was recently shared with the College. In this case, a patient had gone in for surgery and shortly afterwards experienced an adverse outcome resulting in the need for another emergent surgery. However, when this patient was re-admitted to the hospital the second time, the admitting physicians could not get in touch with the specialist who performed the first surgery to obtain important information—and nothing had been documented in the patient’s record. This resulted in a significant delay, put the patient in a high-risk situation, and caused a lot of trauma for both the patient and their family.
Cases like this underscore the importance of having a plan in place for after-hours coverage and the need to establish effective communication channels between colleagues to ensure continuity of care for BC patients.
Questions related to Care Coverage Outside of Regular Office Hours or any other practice standard can be directed to email@example.com.