Medicine Act, 1991
Loi de 1991 sur les médecins
ONTARIO REGULATION 114/94
GENERAL
Consolidation Period: From September 29, 2014 to the e-Laws currency date.
Last amendment:192/14.
Legislative History: 241/94, 52/95, 223/95, 407/96, 77/98, 122/03, 134/10, 449/10, 346/11, 110/13, 192/14.
This Regulation is made in English only.
CONTENTS
SectionsPART II / ADVERTISING / 5-9
PART IV / CONFLICTS OF INTEREST / 15-17
PART V / RECORDS / 18-21
PART VII / QUALITY ASSURANCE
General / 26-27
Peer and Practice Assessment / 28
Continuing Professional Development and Self-Assessment / 29
Quality Assurance Information / 30
PART X / FUNDING FOR THERAPY AND COUNSELLING / 41-43
PART XI / INSPECTION OF PREMISES WHERE CERTAIN PROCEDURES ARE PERFORMED / 44-51
Part I (ss. 1-4)Revoked: O.Reg. 122/03, s.1.
PART II
ADVERTISING
5.A member shall not advertise, communicate the availability of professional services or solicit professional patronage inconsistently with this Part. O.Reg. 114/94, s.5.
6.(1)A member may communicate any factual, accurate and verifiable information that a reasonable person would consider material in the choice of a physician,
(a)in or through a medium of communication that is equally accessible to all interested members; or
(b)in a printed document that is made available only within the premises where the member practises or to a person who requests a copy, or both. O.Reg. 114/94, s.6(1).
(2)Information communicated under subsection (1) must not,
(a)be false, misleading or deceptive by the inclusion or omission of any information;
(b)contain a testimonial or any comparative or superlative statements; or
(c)contain any reference to a specific drug, appliance or equipment. O.Reg. 114/94, s.6(2).
(3)Information communicated under subsection (1) must be readily comprehensible, dignified and in good taste. O.Reg. 114/94, s.6(3).
(4)No member shall,
(a)cause or permit his or her name to appear in any communication offering a product or service to the public; or
(b)otherwise cause or permit himself or herself to be associated with the advertising or promotion of any product or service,
other than the member’s medical services in accordance with subsections (1), (2) and (3). O.Reg. 114/94, s.6(4).
7.(1)A member shall not participate directly or indirectly in a system in which another person steers or recommends people to a member for professional services. O.Reg. 114/94, s.7(1).
(2)Subsection (1) does not prevent a referral or transferral of a patient or a patient’s specimen made by a member honestly and with no conflict of interest. O.Reg. 114/94, s.7(2).
8.(1)A member shall not contact or communicate with, or attempt to contact or communicate with, any person known to need medical services to solicit or invite professional patronage. O.Reg. 114/94, s.8(1).
(2)Subsection (1) does not prevent a member from,
(a)reminding a person who has made an appointment of the appointment;
(b)communicating with his or her regular patients,
(i)to inform them about health maintenance procedures that are due to be carried out,
(ii)to inform them about health issues, preventive medicine and recent developments in medicine, or
(iii)to inform them of a possible benefit from a change in therapy. O.Reg. 114/94, s.8(2).
(3)In subsection (2),
“regular patient” means a person who,
(a)uses the professional services of the member regularly and with reasonable frequency, and
(b)has not requested the transfer of his or her records to another physician. O.Reg. 114/94, s.8(3).
(4)Clauses 6 (1) (a) and (b) do not apply to communications with regular patients under clause (2) (b). O.Reg. 114/94, s.8(4).
9.(1)Except as provided for in subsection (2), no member shall use a term, title or designation relating to a specialty or subspecialty of the profession in respect of his or her practice of the profession unless the member has been,
(a)certified by the Royal College of Physicians and Surgeons of Canada in a specialty or subspecialty of the profession to which the term, title or designation relates;
(b)certified by the College of Family Physicians of Canada in a specialty or subspecialty of the profession to which the term, title or designation relates; or
(c)formally recognized in writing by the College as specialist in the specialty or subspecialty of the profession to which the term, title or designation relates. O.Reg. 449/10, s.1.
(2)Subject to subsection (2.1), no member shall publish or knowingly permit the publication of the member’s name in anything that advertises, promotes or relates to the provision of professional services by the member, whether in a document, business card, website, or any other format, unless the following are complied with:
1.The member’s name must be immediately followed, in clear and prominent manner, and in unabbreviated form, by either,
i.the term, title or designation that the member may use with respect to the specialty or subspecialty of the profession in which the member has been certified by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada or formally recognized in writing by the College, or
ii.the title “General Practitioner”.
2.Subject to subsection (3), if one or more areas of the member’s professional practice is described, the description may include a term, title or designation relating to a specialty or subspecialty for which the member is not certified by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada or formally recognized in writing by the College, but the description must,
i.subject to subparagraph ii, follow immediately after the term, title or designation provided for in paragraph 1, and
ii.be preceded by the words “practising in”.
3.Any use of a term, title or designation in respect of the member’s practice of the profession must comply with this section. O.Reg. 449/10, s.1; O. Reg. 110/13, s. 1 (1).
(2.1)A member may, in the circumstances described in subsection (2), insert a reference to any or all of the following that apply to the member immediately following the member’s name and immediately preceding the applicable reference described in subparagraph 1 i or ii of subsection (2):
1.An academic degree.
2.A professional certification issued by the College of Family Physicians of Canada or the Royal College of Physicians and Surgeons of Canada.
3.Formal recognition in writing by the College as a specialist. O. Reg. 110/13, s. 1 (2).
(3)A member may not include a term, title or designation relating to a specialty or subspecialty for which the member is not certified by the Royal College of Physicians and Surgeons of Canada or the College of Family Physicians of Canada or formally recognized in writing by the College in any description of the member’s professional practice unless the member has the suitable knowledge, skills and judgment to engage in the kind of medical practice so described. O.Reg. 449/10, s.1.
(4)Except as allowed under subsection (5) or (6), no member shall use the title “surgeon” or the term “surgery”, a variation, or abbreviation or an equivalent of them in another language in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(5)A member who is certified by the Royal College of Physicians and Surgeons of Canada in a surgical specialty or surgical subspecialty may use a title or term referred to in subsection (4) in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(6)A member who is formally recognized in writing by the College as a surgical specialist or surgical subspecialist may use a title or term referred to in subsection (4) in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(7)Except as allowed under subsection (8) or (9), no member shall use the term “plastic”, a variation, or abbreviation or an equivalent of them in another language in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(8)A member who is certified by the Royal College of Physicians and Surgeons of Canada as a plastic surgeon may use a term referred to in subsection (7) in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(9)A member who is formally recognized in writing by the College as a plastic surgeon may use a term referred to in subsection (7) in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(10)Except as allowed under subsection (11) or (12), no member shall use the title “otolaryngologist-head and neck surgeon”, a variation, or abbreviation or an equivalent of them in another language in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(11)A member who is certified by the Royal College of Physicians and Surgeons of Canada as an otolaryngologist-head and neck surgeonmay use a title referred to in subsection (10) in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(12)A member who is formally recognized in writing by the College as an otolaryngologist-head and neck surgeon may use a title referred to in subsection (10) in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(13)Except as allowed under subsection (14), no member shall use the term “facial plastic”, a variation, or abbreviation or an equivalent of them in another language in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(14)A member who is an otolaryngologist-head and neck surgeon described in subsection (11) or (12) may use a term referred to in subsection (13) in respect of his or her practice of the profession, but when the member is using the term in the manner described in subsection (2), the member must set out the term together with his or her title as an otolaryngologist-head and neck surgeon in the manner provided for in subsection (2). O.Reg. 449/10, s.1.
(15)Except as allowed under subsection (16) or (17), no member shall use the title “ophthalmologist”, a variation, or abbreviation or an equivalent of them in another language in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(16)A member who is certified by the Royal College of Physicians and Surgeons of Canada as an ophthalmologist may use a title referred to in subsection (15) in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(17)A member who is formally recognized in writing by the College as an ophthalmologist may use a title referred to in subsection (15) in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(18)Except as allowed under subsection (19), no member shall use the term “oculoplastics” or “ophthalmic plastics”, a variation, or abbreviation or an equivalent of them in another language in respect of his or her practice of the profession. O.Reg. 449/10, s.1.
(19)A member who is an ophthalmologist described in subsection (16) or (17) may use a term referred to in subsection (18) in respect of his or her practice of the profession, but when the member is using the term in the manner described in subsection (2), the member must set out the term together with his or her title as an ophthalmologist in the manner provided for in subsection (2). O.Reg. 449/10, s.1.
Part III (ss. 10-14)Revoked: O.Reg. 122/03, s.1.
PART IV
CONFLICTS OF INTEREST
15.In this Part,
“benefit” means any benefit, gift, advantage or emolument of any kind, whether direct or indirect, and includes,
(a)the receipt of any benefit from the services of any person or reimbursement of the cost of those services,
(b)the benefit or receipt of the payment or reduction of any amount of any debt or financial obligation,
(c)the receipt of any consultation fee or other fee for services rendered, except in accordance with a written contract for each service where,
(i)a copy of the contract is available and produced to the College on demand,
(ii)each contracted service is within the normal scope of the member’s specialty, and
(iii)each service is supported by records adequate to satisfy the College that it was in fact performed,
(d)the acceptance of any loan except in accordance with a written evidence of indebtedness,
(i)executed at the time of transfer of funds,
(ii)witnessed at the time of actual execution by an individual whose name is legibly recorded on the document,
(iii)available and produced to the College on demand, and
(iv)that provides for a fixed term of loan and fixes a set interest rate, both of which are reasonable having a view to prevailing market rates at the time of the loan,
(e)the acceptance of a loan that is interest free or related in any way to a referral made by the member,
(f)the acceptance of credit unless the credit is unrelated in any way to a referral of patients to the creditor and the credit is extended pursuant to an agreement in writing,
(i)executed at the time of the transaction,
(ii)witnessed at the time of actual execution by an individual whose name is legibly recorded on the agreement,
(iii)available and produced to the College on demand, and
(iv)that provides for a fixed term of credit and fixes a set interest rate, both of which are reasonable having a view to prevailing market rates at the time of the transaction;
“medical goods or services” includes medical goods, appliances, materials, services and equipment, and drugs and laboratory services;
“member of his or her family” means any person connected with a member by blood relationship, marriage or adoption, and,
(a)persons are connected by blood relationship if one is the child or other descendant of the other or one is the brother or sister of the other,
(b)persons are connected by marriage if one is married to the other or to a person who is connected by blood relationship to the other, and
(c)persons are connected by adoption if one has been adopted, either legally or in fact, as the child of the other or as the child of a person who is connected by blood relationship (otherwise than as a brother or sister) to the other;
“supplier” means a person who,
(a)sells or otherwise supplies medical goods or services, or
(b)is registered or licensed under any Act regulating a health profession. O.Reg. 241/94, s.2.
16.It is a conflict of interest for a member where the member, or a member of his or her family, or a corporation wholly, substantially, or actually owned or controlled by the member or a member of his or her family,
(a)receives any benefit, directly or indirectly, from,
(i)a supplier to whom the member refers his or her patients or their specimens, or
(ii)a supplier who sells or otherwise supplies any medical goods or services to the patients of the member;
(b)rents premises to,
(i)a supplier to whom the member refers patients or their specimens, or
(ii)a supplier who sells or otherwise supplies any medical goods or services to the patients of the member,
except where,
(iii)the rent is normal for the area in which the premises are located, and
(iv)the amount of the rent is not related to the volume of business carried out in the premises by the tenant;
(c)rents premises from,
(i)a supplier to whom the member refers his or her patients or their specimens, or
(ii)a supplier who sells or otherwise supplies any medical goods or services to the patients of the member,
except where,
(iii)the rent is normal for the area in which the premises are located, and
(iv)the amount of the rent is not related to the referral of patients to the landlord; or
(d)sells or otherwise supplies any drug, medical appliance, medical product or biological preparation to a patient at a profit, except,
(i)a drug sold or supplied by a member to his or her patient that is necessary,
(A)for an immediate treatment of the patient,
(B)in an emergency, or
(C)where the services of a pharmacist are not reasonably readily available, or
(ii)despite subclause (i), an allergy preparation prepared by a member for his or her patient that is sold or supplied by the member for a price that does not exceed the total of,
(A)the true cost of production of the preparation, and
(B)the fee for the professional component, for the member’s review of the case, for the prescription of the material and for the general supervision of the member’s laboratory in preparing the material. O.Reg. 241/94, s.2.
17.(1)It is a conflict of interest for a member to order a diagnostic or therapeutic service to be performed by a facility in which the member or a member of his or her family has a proprietary interest unless,
(a)the fact of the proprietary interest is disclosed to the patient before a service is performed; or
(b)the facility is owned by a corporation the shares of which are publicly traded through a stock exchange and the corporation is not wholly, substantially or actually owned or controlled by the member, a member of his or her family or a combination of them. O.Reg. 241/94, s.2.
(2)A member who or whose family has a proprietary interest in a facility where diagnostic or therapeutic services are performed shall inform the College of the details of the interest. O.Reg. 241/94, s.2.
PART V
RECORDS
18.(1)A member shall make records for each patient containing the following information:
1.The name, address, and date of birth of the patient.
2.If the patient has an Ontario health number, the health number.
3.For a consultation, the name and address of the primary care physician and of any health professional who referred the patient.
4.Every written report received respecting the patient from another member or health professional.
5.The date of each professional encounter with the patient.
6.A record of the assessment of the patient, including,
i.the history obtained by the member,
ii.the particulars of each medical examination by the member, and
iii.a note of any investigations ordered by the member and the results of the investigations.
7.A record of the disposition of the patient, including,
i.an indication of each treatment prescribed or administered by the member,
ii.a record of professional advice given by the member, and
iii.particulars of any referral made by the member.
8.A record of all fees charged which were not in respect of insured services under the Health Insurance Act, which may be kept separately from the clinical record.
9.Any additional records required by regulation. O.Reg. 241/94, s.2.
(2)A member shall keep a day book, daily diary or appointment record containing the name of each patient who is encountered professionally or treated or for whom a professional service is rendered by the member. O.Reg. 241/94, s.2.
(3)The records required by regulation shall be,
(a)legibly written or typewritten or made and kept in accordance with section 20; and
(b)kept in a systematic manner. O.Reg. 241/94, s.2.
19.(1)A member shall retain the records required by regulation for at least ten years after the date of the last entry in the record, or until ten years after the day on which the patient reached or would have reached the age of eighteen years, or until the member ceases to practise medicine, whichever occurs first, subject to subsection (2). O.Reg. 241/94, s.2.
(2)For records of family medicine and primary care, a member who ceases to practise medicine shall,
(a)transfer them to a member with the same address and telephone number; or
(b)notify each patient that the records will be destroyed two years after the notification and that the patient may obtain the records or have the member transfer the records to another physician within the two years. O.Reg. 241/94, s.2.
(3)No person shall destroy records of family medicine or primary care except in accordance with subsection (1) or at least two years after compliance with clause (2) (b). O.Reg. 241/94, s.2.
20.The records required by regulation may be made and maintained in an electronic computer system only if it has the following characteristics:
1.The system provides a visual display of the recorded information.
2.The system provides a means of access to the record of each patient by the patient’s name and, if the patient has an Ontario health number, by the health number.
3.The system is capable of printing the recorded information promptly.
4.The system is capable of visually displaying and printing the recorded information for each patient in chronological order.
5.The system maintains an audit trail that,
i.records the date and time of each entry of information for each patient,