Return to Practice Guidance and Updated Telepractice Position Statement

Members, as you may be aware, the Chief Medical Officer of Health has amended Directive 2 to allow a gradual restart to all health care services. To help with the restart, the College has prepared a Return to Practice Guidance Document that members can use to adopt the necessary infection control procedures. Before finalizing this document, it was shared with the leadership of TCM professional associations and the Ministry of Health for feedback. The College has since received many helpful comments and suggestions, and we thank those who participated for their assistance.

The Quality Assurance Committee has also updated the College’s Telepractice Position Statement based on the amendment to Directive 2 and feedback received from College membership.

The College has also made available a FAQ section  related to return to practice. This includes more information on Ministry Guidance regarding personal protective equipment (PPE).

Members are reminded that the amendment to Directive 2 requires health care providers to restart their practice after a careful assessment of risks and resources. This will take time as the required planning and organization (described below) is thorough. Further, it is expected that health care providers will slowly open their practice (when all the considerations have been addressed) and expand their services once it has been determined that the measures put in place are keeping patients, staff and the health care provider safe. This is likely the requirement for a “gradual start” as opposed to a quick opening.

Directive 2 lists 3 conditions that members must consider before returning to practice. The conditions are:

  1. Members must comply with the requirements set out in COVID-19 Operational Requirements: Health Sector Restart. This is a Ministry document that covers requirements for risk assessments, hierarchy of hazard controls, screening, health human resources, critical supplies and equipment, infection control and other important issues.
  1. Members should use telemedicine or virtual care where possible to avoid having patients physically come to the clinic. Health Care Providers must consider which services should be provided remotely and which services can safely resume in-person with appropriate hazard controls and sufficient PPE.
  1. Members should be sourcing personal protective equipment (PPE) through their regular supply chain. If you are experiencing difficulty sourcing PPE, the Government has made available a directory of PPE suppliers.

With respect to condition #2, members are in the best position to determine which services should resume in person, and which should resume virtually. However, members should consider the following when making this determination

  • Your own ability to resume services at this time.
  • The need to minimize harm to patients.
  • The need to treat all patients with the same clinical needs equally unless relevant differences exist.

The need to ensure that those who continue to be burdened by the limited capacity of the health care system have their health monitored, receive appropriate care, and be re-evaluated for emergent activities should they require them.

The College will look into concerns about practitioners not following these return to practice requirements.

Members must review the following documents before they return to practice so that they are aware of what is expected of them:

Directive 2
COVID-19 Operational Requirements: Health Sector Restart
Return to Practice Guidance
Telepractice Position Statement
Return to Practice Guidance – One Page Summary

We thank all the members for your continued efforts and commitment to protecting your patients, staff and the community.