Changing perceptions and improving physician practice
Estimated read time: 6 minutes.
Working together to enhance patient care
As Alberta’s medical regulator, we’re responsible for supporting the ongoing competency of regulated members and under the Health Professions Act, CPSA-regulated members are required to work with CPSA to assess their competence. Under two separate umbrellas of quality assurance and quality improvement, CPSA has several programs in place to support and enhance physician competence.
On the quality improvement side, all regulated members must participate in CPSA’s Physician Practice Improvement Program (PPIP), which includes quality improvement and professional development activities completed throughout a five-year cycle. Under quality assurance, approximately 180 CPSA-regulated members are selected annually to participate in CPSA Continuing Competence programs. One such program is the Individual Practice Review (IPR), a customized, educational process looking at an individual physician’s practice to highlight what they’re doing well and identify where they can make changes to improve.
For many physicians and physician assistants, this can be intimidating. While CPSA and regulated members have a shared commitment to provide safe, high-quality care, going through a competence assessment has the potential to feel like there’s someone looking over your shoulder seeking out every misstep. However, the goal of CPSA’s Continuing Competence programs is to help regulated members enhance the quality of their practice so they’re equipped to provide the best care possible to their patients.
A few years ago, Dr. Aquaeno Ekanem, an Edmonton-based family physician, was one of these physicians. He began the roughly 18-month IPR process in 2021 and finished in 2022.
We met with Dr. Ekanem to talk about his experience working with CPSA throughout his IPR and how it helped shift his perception of CPSA as a regulator.
Dr. Aquaeno Ekanem received his medical degree in Nigeria in 1999. He practised in Nigeria and the U.K. before coming to Alberta in March 2011. His dynamic, Edmonton-based family practice is wide-ranging and includes an emergency room practice as well as home care for the elderly.
What’s been your experience interacting with CPSA?
I’ve interacted with CPSA many times throughout my career in Alberta, including through CPSA’s complaints process, and my interactions with CPSA have overall been positive. I’ve also had some difficult experiences with patients and colleagues in the past that have led me to reaching out to CPSA, and I’ve generally felt supported whenever I’ve reached out.
What do you believe to be the common perception of CPSA amongst regulated members?
Any time I’ve interacted with CPSA it’s been in a positive light overall, but let’s be clear, no physician wants to interact with CPSA, because they’re the regulator. It’s not just in Alberta, everywhere you go regulators are like the tax man—nobody likes them, but we have to work with them, pay our dues and practise up to standard. Whenever a physician hears they have a message from CPSA it causes anxiety, whether we like it or not, but over the years CPSA has done a lot of work in the community to put some human faces to CPSA and that has helped.
Can you tell us your initial thoughts about being selected to participate in an IPR?
When dealing with the regulator, there is not a lot of flexibility to say no, because there might be consequences if you do. I knew I had to cooperate, and I did that to the fullest extent I could. It’s like driving a car—you keep to the conditions of a driver’s licence so you can keep your licence. Was it a pleasant experience to be picked for the IPR unexpectedly? No, but I knew I had no choice but to go through the process. However, I had a positive learning experience.
Was there a point in time where you began to lean into the process as opposed to seeing it as only something you were required to do?
I look at it this way: being a physician is the ultimate service, and people may not actually like your service. They have the right to complain about your service and give you feedback to help you improve. I found out I had some blind spots that I needed to improve and, to be candid, I’ve been better for it overall. As tough and unpleasant as I initially thought the process would be, I’m better for it. It helped me and the feedback from the assessors was very encouraging. Towards the end, I actually looked forward to it and enjoyed the process because I could see the improvements in my processes.
How has the IPR and engaging with CPSA helped you in your practice?
I’ve been able to take a lot and apply it to my practice. It’s a cultural change and it’s a change in behaviour. It takes time and I had no choice but to change, but when I did it, it actually helped me.
The process was very demanding and it kept me on my toes, but I found things to fix for my own good and for the health of my patients. As unpleasant as the process might have felt at the beginning, it’s part of our education and it did help and make me better, particularly as it relates to my own processes for things like preventative screening.
What would you tell a colleague who is apprehensive about participating in an IPR?
I would tell them that this is someone looking over their shoulder at what they’re doing, which nobody likes. If you’re a good cook, you don’t want anybody watching over your shoulder as you run through your recipe, but participating in the process might reveal that you missed some vital spices or ingredients that can make the finished product that much more delicious. I would tell them to prepare for the process by making sure that they are available, cooperative and prepared to learn things about themselves and their practice. It can be very revealing and challenging, but you should embrace it and, at the end of the day, it will make you a better physician.
Want to learn more about CPSA’s Individual Practice Review and other Continuing Competence programs? Visit our website!
