Provincial Privileges for Physicians
~ A Message from Dr. Tanya Munroe Senior Medical Director, Access and Flow and Jesse Joice Director, Medical Education and Administration, Medical Affairs
This memo is to clarify the impact to physician privileges resulting from the May 23rd, 2023 implementation of Nova Scotia Health’s new medical By-Laws.
Effective May 23, 2023, any physician who holds privileges in one of Nova Scotia Health’s four zones can order lab and diagnostic image tests in all other zones.
Effective May 23, 2023, any physician who holds privileges in one of Nova Scotia Health’s four zones which enables them to write orders for patients in hospital (facility-based privileges) can write orders for any hospital-based patient in all other zones.
For further clarity, a physician who holds privileges in one of Nova Scotia Health’s four zones is only required to apply for privileges in another zone if they will be physically providing care in a Nova Scotia Health facility in that zone. All other health services can be provided remotely under the privileges of their primary appointment.
Language from Medical By-Laws for reference (Section 7, Clause 2):
(2) An appointment to the medical staff in any zone constitutes sufficient authority to do any of the following in any zone, subject to any additional requirements as may be stipulated by the Province or in the policies or rules:
(a) access diagnostic services;
(b) provide written orders;
(c) provide medical advice virtually to patients, NSHA staff or other medical staff members.
For any questions regarding the interpretation of these By-Laws please e-mail: jesse.joice@nshealth.ca
Diagnostic Testing for Pertussis
With an increase in pertussis cases across Canada, and more recently declared outbreaks in PEI, NB and NFLD, Public Health would like to remind physicians of the testing guidelines for this notifiable disease.
Diagnostic testing for pertussis consists of a nasopharyngeal (NP) swab for polymerase chain reaction (PCR), preferably before initiating antibiotic therapy. The NP swab must be collected using a COPAN Viral swab and dropped off or delivered to your local lab, where possible, or sent to the IWK for processing.
Due to the non-specific nature of the early illness, pertussis often goes under-diagnosed. Healthcare providers should consider pertussis in patients presenting with clinically compatible signs or symptoms, including the initial stage characterized by rhinorrhea, sneezing, low-grade fever, and a mild cough. After 1 to 2 weeks of a gradually worsening cough, the paroxysmal stage begins, characterized by bursts of rapid coughing, ending with an inspiratory whoop and sometimes post-tussive vomiting. The clinical presentation varies with age, in young infants, clinical symptoms can be atypical, the whoop and post-tussive vomiting may be absent, and the presentation may be solely episodes of apnea. In adolescents and adults pertussis can be an unrecognized cause of prolonged cough.
Given the recent media attention across Canada in the increase of pertussis cases, healthcare providers may receive an increase in questions or visits to clinics and emergency departments. Please keep pertussis on your differential when seeing patients with cough.
Mpox cases in Canada and World Health Organization Public Health Emergency of International Concern
~ A Message from the Emerging and Re-emerging Infections Network
The Office of the Chief Medical Officer of Health for Nova Scotia has provided a memo regarding mpox cases in Canada and the recent World Health Organization Public Health Emergency of International Concern, sent on behalf of Dr. Jennifer Cram. The purpose of this memo is to provide health care practitioners with information on Mpox, case management, and immunization in light of the evolving situation.
The OCMOH Memo can be found on the ERIN HUB.
Key points from the Memo.
General Information on Mpox and Clinical Case Management
- Mpox is a notifiable disease per It’s the Law; report suspected or confirmed cases immediately to Public Health.
- Mpox is a viral illness that does not spread easily but requires close skin-to-skin contact with lesions, scabs, body fluids, and direct contact with personal items used by someone with mpox. Mpox can also be spread by respiratory droplets during prolonged face-to-face contact and from an infected pregnant person to the fetus.
- Symptoms may start with a flu-like prodrome, and then progress to a rash or lesions in a single location or all over the body.
- While cases in Canada have largely occurred in men who report sexual contact with other men, anyone who is exposed can get mpox.
- The highest risk for acquiring mpox is currently out-of-province travel or contact with someone who has traveled to an area reporting infections.
- Given high rates of co-infections, it is recommended clinicians broadly test for STBBIs if suspecting mpox.
- Individuals who are immunocompromised, pregnant, and children under 12 are at increased risk of severe disease if infected with mpox.
- People can reduce the risk of an mpox infection by receiving vaccine, having fewer sexual partners, using barrier protection, avoiding close contact with anyone feeling unwell, practicing good hand hygiene and respiratory etiquette, and disinfecting high-touch surfaces and objects.
Pre and Post Exposure Immunization
To reduce the likelihood of infection, Nova Scotia publicly funds a two-dose series of Imvamune vaccine to groups identified at high risk, with doses separated by at least 28 days.
Imvamune is available as a pre-exposure immunization to anyone who meets the current criteria:
Pre-exposure immunization for individuals 18 years and older at increased risk of mpox:
- Men who have sex with men (MSM) who meet one or more of the following criteria:
- Have more than one sexual partner
- Are in a relationship where at least one of the partners has other sexual partners
- Have had a confirmed bacterial sexually transmitted infection acquired in the last year
- Have engaged in sexual contact in sex-on-premises venues.
- Sexual partners of individuals who meet the criteria above.
- Sex workers regardless of gender, sex assigned at birth, or sexual orientation.
- Staff or volunteers in sex-on-premises venues where workers may have contact with fomites potentially contaminated with mpox.
- Those who engage in sex tourism regardless of gender, sex assigned at birth, or sexual orientation.
Imvamune is also recommended as a post-exposure immunization for high-risk contacts of mpox cases. Nova Scotia Public Health assesses the need for post-exposure immunization on a case- by-case basis.
Accessing Imvamune
Since May 2023, Imvamune has been accessible as a publicly funded vaccine to physician offices and some pharmacies, like other vaccines for Nova Scotians at high-risk of vaccine-preventable diseases. Please submit a Vaccine Requisition by confidential email or fax as per usual process.
For questions regarding the high-risk vaccine process, including delivery and pick-up questions, please contact publichealthvaccineorders@nshealth.ca.
Canadian Certified Physician Executive Registration Open - Calling all Physician Leaders
The Canadian Certified Physician Executive (CCPE) credential recognizes and advances physician leadership and excellence through a national, peer-generated, standards-based assessment process. The credential is based on the tenets of the LEADS in a Caring Environment Capabilities Framework.
The most important component of either route — Academic or Practice Eligibility — is the quality of the applicant's senior or executive leadership roles. The Peer Assessment Panel is looking for impact across the healthcare system at multiple levels.
If you are interested, please visit the CCPE credential website or email Deirdre for more information.
The deadline to apply is October 31, 2024.
Madeline Power joins Canadina Medical Hall of Fame with Medical Student Award
Congratulations to Madeline Power for receiving the Canadian Medical Hall of Fame Medical Student Award for her work integrating innovative technologies and sustainable practices into health care.
View the full write up on the Medical Hall of Fame site and watch her video here.
Free Pallium LEAPTM Core Online sessions
The Palliative Care Network is offering free Pallium LEAPTM Core Online sessions to health care providers at Nova Scotia Health who are interested in developing competencies in adopting a palliative care approach in their daily clinical practice. This 2 credit-per-hour Group Learning program has been certified by the College of Family Physicians of Canada for up to 24.0 Mainpro+ credits.
Registrants must make a commitment to complete the pre-course work which includes 16 self-directed online modules completed at your own pace prior to the online dates (approximately 8 hours of work).
The webinar portion is delivered over two, three-hour blocks that you must attend over the designated dates.
This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada and approved by the University of Ottawa’s Office of Continuing Professional Development. You may claim a maximum of 12 hours.
Session dates (Atlantic Time):
- September 25th and 26th (Wednesday, Thursday) 5-8 pm
- October 7th and 8th (Monday, Tuesday) 5-8 pm
- November 18th and 19th (Monday, Tuesday) 5-8 pm
- November 30th (Saturday): Two same day sessions
- 1st Session: 8.30 – 11.30a.m.
Break: 11.30 a.m. -12noon
- 2nd Session: 12.00 – 3.00 p.m.
- December 9th and 10th (Monday, Tuesday) 5-8 pm
Seats are limited and will be filled on a first-come-first-served basis.
To confirm seat availability and register for any of the sessions, please email: palliativecare@nshealth.ca
Autism Nova Scotia and AIDE Canada Research Project on Healthcare Billing Codes for Individuals with Intellectual and Developmental Disabilities
Autism Nova Scotia and AIDE Canada have collaborated on a research project on healthcare billing codes that general practitioners can use to bill for annual physical exams, to allow extra time during visits that is often needed when seeing individuals with intellectual and developmental disabilities (IDD's).
The below poster highlight the findings from their research project and the significance of using specific billing codes to improve healthcare access for individuals with intellectual and developmental disabilities (IDD's). With hopes of raising awareness among healthcare professionals, the poster aims to increase the adoption of these billing codes and increase the importance of annual physical exams. Along with contributing towards more equitable healthcare. Learn more here.
Local Health Care Champions bring First Annual Run for the Cure to the South Shore
The Canadian Cancer Society’s quest to find a breast cancer cure is getting a boost this fall, thanks to support for South Shore residents and Dr. Joan Proctor, a local surgeon and women’s health advocate, who has led efforts to bring an independent Walk/Run for the Cure to the region.
The event takes place Sunday, October 6 at Centennial Trail in Bridgewater. To date more than 20 teams have registered with an impressive and rising tally of more than $13,000.
Among those participating are team “We Rise Up” -- organized by Nova Scotia Health team member, Stephanie Mailman-Crouse, who is the Quality Lead for Medical Device Reprocessing Services with Nova Scotia Health’s Perioperative (Surgical) Services Network.
Mailman-Crouse, who is also a beloved mother, wife, daughter, friend and colleague, is undergoing treatment following her own breast cancer diagnosis in December. She is looking forward to the event.
“I will be participating in the walk/run and speaking as a cancer thriver,” she said. “Every dollar raised will fund breast cancer research and support programs and services for people like me who are impacted by this disease.”
Participants who register before September 3 and raise $150 or more will receive an event t-shirt.
Interested? You can register here.
Congratulations to the organizers and best of luck to all the teams, with a special round of applause to our Nova Scotia Health heroes playing such important roles in this event.
Read the full newsletter here.