Transforming and Supporting Patient Care - Health Professions ...

32Chapter 2 – Excellence in Health Profession Regulation: Raising the Bar in Ontario5. Despite progress, the current regulatory system is complex. Whileself-regulation is not incompatible with interprofessional practice,defined scopes of practice and variations in standards can challengethe delivery of integrated care in general and interprofessionalpractice in particular. 39 Other interprofessional practice issuesinclude:• Cultural issues arising from the historical hierarchy andantipathy among professions;• Lack of clarity on scopes of practice and overlapping scopesof practice;• Reluctance to share information and engage in jointinvestigations;• Inconsistent use of terminology (e.g., guidelines, standards,rules, policies), and• Inconsistent regulations and standards of practice (e.g.,Code of Ethics, conflict of interest regulations). 406. Self-regulation is fundamental to the Canadian health care system.There are promising opportunities to enhance interprofessionalcollaboration at the regulatory level – including the creation of aregulatory framework that is better positioned to evolve with and tosupport the growing reliance in the health care system oncollaboration between and among health professionals from variousprofessions at the clinical level.7. Ontario can learn much from reforms elsewhere and the time is rightto address a number of more fundamental challenges andopportunities at the regulatory level. HPRAC observes that themodels from other jurisdictions may not be entirely transferable toOntario. For example, some elements from approaches in GreatBritain and New Zealand reflect challenges specific to theirregulatory systems and may not be relevant to the Ontario context.HPRAC continues to hold the view that changes to the regulatory system toestablish interprofessional collaboration and improve transparency andaccountability should be evolutionary and build on the current strengths ofthe self-regulatory model. This perspective was also expressed by Laheyand Currie as follows:Overly broad or radical reform, such as abandonment of self-regulation,may be more than is necessary to address the problem. Indeed, it may missthe real sources of the problem altogether. In the meantime, it may causesignificant collateral damage, particularly to provider morale and the majorinitiatives that are now under way to address the broader problems of therecruitment and retention of health care providers. There is a danger thatthe relative amenability of the regulatory system to legislative change andthe sometimes illusory certainty of large legislative solutions will become39Lahey, W. and Currie, R.: 200-201.40Summary of Responses to HPRAC’s Consultation Discussion Guide.HPRAC Critical Links January 2009