We have heard from many members with questions or concerns about these audits

Many members are apprehensive about any dealings with the CPSM, and the prospect of having your practice reviewed is uncomfortable. It’s important to remember that the CPSM is mandated by law to supervise the practice of its members to help ensure safe care for Manitobans.

Here are some details about the Program:

• Being selected for a review by the Program is not complaint-based or otherwise related to concerns about your practice. It is your age alone that triggers the audit.

• There is no need to contact CMPA if you are selected for an age-triggered audit.

• The review is intended to be educational. The CPSM says that they welcome questions about the process at any time

• The process begins with a standard questionnaire about you and your practice. The questionnaire may include questions about your practice you have never considered, and it may take some time to work through it.

• Most of the time, you will be asked to supply a number of randomly selected patient charts.

• These charts will be reviewed by another member in the same discipline as you. The audit should take about four months after you return your questionnaire.

• The auditor’s written report will be sent to you for your review and comment. You can discuss the audit report with a CPSM consultant if you wish.

• The audit report may contain recommendations respecting your practice. The audit report is sent to a Committee (the CSC) with your name and identifying details removed. The CSC reviews the report and makes its decision on whether the audit was satisfactory, whether additional improvements are suggested or required, and at what interval a repeat audit will be scheduled.

In most cases, the CSC will make one of four recommendations:

Reasonable Care – you will be commended for your standard of care and advised that a repeat audit will take place in five years;

Self-Refelective Quality Improvement Activity – you will be given suggested changes and asked to reflect upon how these changes could be beneficial to your practice. You will be asked to complete a document for the CPSM with your thoughts and can expect to be contacted by letter in about one year to inquire about your progress in implementing these changes. A repeat audit will take place in five years;

Negotiated Improvement Plan – you will be requested to meet with a medical consultant or the Director of Quality to discuss and identify specific improvement opportunities. You would have a repeat chart audit in less than five years and would be responsible for the cost of the further audit, which we understand in most cases would be in the range of $1000-$1,500.

Prescribed Learning Plan — you will be requested to meet with the Director of Quality to discuss and identify specific improvement opportunities, and create a plan to make the necessary changes. You would have a repeat chart audit in less than five years, and would be responsible for the cost of the further audit, again in the range of $1000-$1,500.

If the audit report contains serious concerns which could affect patient safety, or contain evidence of fraud or other misconduct, your audit can be forwarded to the Registrar. The CPSM tells us that this is a rare occurrence in the Program.

CPSM assures us that this review is about improving members’ practices and ensuring that members are supported as they continue to practice.

We have learned from members that many of the suggested improvements relate to charting. Improved charting is more important than simply satisfying the CPSM. It is critical to being able to justify billings to Manitoba Health (and to Manitoba Finance in the unhappy event of a billing audit). CMPA also reminds members that thorough charting is also helpful if they are required to defend against a complaint or a claim. Most importantly, it is vital to effective patient care.

When you are contacted by the Program, it will require an investment of your time and effort. However, that is part of the privilege of practicing in a self-regulating profession. It goes without saying that the prospect of an audit should never be the reason to retire from practice.

Doctors Manitoba is here to answer any questions you may have, and assist you at any step along the way. You can reach out to aswan@​doctorsmanitoba.​ca or 204−985−5860.