Medical Imaging and Radiation
Therapy Professionals Act and
Regulations
A presentation to the NSAMRT and NSSDMS
Marjorie Hickey,QC
marjorie.hickey@mcinnescooper.com
June 24, 2010
Purpose of Today’s Meeting
• Purpose is to approve in principle the Medical
Imaging and Radiation Therapy Professionals
Act and Regulations, and to authorize the Act
and Regulations to be forwarded to external
stakeholders for comment and to Government
for introduction in the Fall sitting of the
Legislature
Topics to be Covered
•
Structure of Act, Regulations and ByLaws
•
The Purpose of the College and Composition of Board
•
Framework that incorporates :
•
Medical Imaging Technology and Radiation Therapy
•
Five Disciplines (MR Tech: Nuclear Medicine; Rad Tech; Diagnostic Ultrasound and Radiation Therapy)
•
Scopes of Practice for 5 disciplines
•
Protection of Titles
•
Protection of Practice (including grandparenting provisions and exemptions)
•
Registration and Licensing
•
Complaints and Discipline
•
Professional Corporations
•
Where do we go from here?
•
Questions?
Proposed Structure for Governance
•
•
The Act
–
Creates “College” and provides that the Board is the governing entity
–
Sets out objects of College
–
Sets out principal activities of regulatory body
Regulations
–
•
Bylaws
–
•
Provides details of registration and complaints processes
Largely deal with internal operational matters such as nomination of members
of the Board, holding of annual meetings, etc.
Policies
–
Provides guidelines to various individuals and committees exercising functions
under the Act and Regulations
New Names
•
•
Nova Scotia Association of Medical Radiation Technologists
changes to...
–
The Nova Scotia College of Medical Imaging and
Radiation Therapy Professionals
–
Assets/liabilities of NSAMRT roll into new College
–
NSSDMS remains a separate Society, with the regulatory
function for sonographers taken on by new College
Council changes to…
–
•
Board
Radiation Therapy Technologist changes to…
–
Radiation Therapist
New Names cont’d
• Radiographic Technologist changes to…
– Radiological Technologist
• Magnetic Resonance Technologist
– A new discipline
• Registered Ultrasound Professional
– Someone who engages in the practice of diagnostic
ultrasound technology (other titles relating to
ultrasound are protected)
Purpose or Objects of New College
• Current purpose of NSAMRT:
Section 6
(a)
Increase the knowledge, ability and competence of its
members;
(b)
Improve the standards of the practice of medical
radiation technology so as to ensure that the public at all
times receives the services of proficient and competent
medical radiation technologists of high ethical standards;
(c)
Do such lawful things as are incidental to or conducive to
the attainment of such objects.
Proposed New Objects
• The proposed new objects are as follows
:
Section 4 – In order to
a) serve and protect the public interest in the
practice of the profession;
b) preserve the integrity of the profession; and
c) maintain public confidence in the ability of the
profession to regulate itself,
the College shall …
Proposed New Objects cont’d
… the College shall
d) regulate the practice of medical imaging technology and radiation
therapy;
e) govern its members in accordance with this Act and the Regulations;
f) establish, develop and promote standards of practice among its
members;
g) establish, develop and promote a Code of Ethics for its members;
h) subject to Clauses (a) to (g), and in the public interest, advance and
promote the practice of the profession; and
i) do such other lawful acts and things as are incidental to the attainment
of the purposes and objects set out in this section.
Composition of the Board
• Proposed composition:
•
a) such number of members as set out in the bylaws;
b) no fewer than 33 1/3 % of public representatives
appointed by the Board who:
i) are not members of the College, and
ii) have shown an interest in serving on the
Board.
Criteria for election or appointment of members
shall be prescribed in the by-laws (not yet
determined)
Two Key Umbrella Terms
• Medical Imaging Technology
• Radiation Therapy
Five Distinct Disciplines
• Diagnostic Ultrasound Technology
• Magnetic Resonance Technology
• Nuclear Medicine Technology
• Radiation Therapy
• Radiological Technology
Scope of Practice
• Scope of practice defines the parameters of the
profession or discipline as a whole
• Proposed scope sets out specific illustrations
for each discipline and then provides general
“catch all” to relate to the practices and
procedures taught in applicable education
programs.
Scope of Practice, cont'd
•
"practice of medical imaging technology" means:
the application of professional medical imaging technology knowledge, skills and
judgment in the use of ionizing and non-ionizing radiation, magnetic fields, high frequency
sound waves and other energy forms, in the provision of diagnostic and therapeutic
modalities, in collaboration with other health care professionals, to achieve optimal health,
wellness and functional performance, and includes the practice of:
(i) diagnostic ultrasound technology,
(ii) magnetic resonance technology,
(iii) nuclear medicine technology,
(iv) radiological technology, and
(v) the practice of any other medical imaging technology discipline set out in the
regulations.
and includes research, education, consultation, management, administration, information
technology, regulation, policy or system development relevant to the foregoing.
Scope of Practice, cont'd
•
“diagnostic ultrasound technology" means those aspects of the practice of medical
imaging technology that include:
(i)
the application of high frequency sound waves to perform procedures and
produce high quality diagnostic images;
(ii)
the education, advocacy and application of ultrasound field safety and the
protection of patients, health care professionals and the public;
(iii) the assessment of patients before, during and after the application of
ultrasound;
(iv) the use of pharmaceuticals in the performance of diagnostic interventions to
enhance images;
(v)
the application of knowledge, skills and judgment in the evaluation and
interpretation of diagnostic images distinguishing artifact from pathological
process and communication of results to the reporting physician; and
(vi) such other practices and procedures within the scope of practice of diagnostic
ultrasound technology as taught in an approved education program.
Scope of Practice, cont'd
•
"magnetic resonance technology" means those aspects of the practice of
medical imaging technology that include:
(i)
the use of magnetic fields to obtain pulse sequence data sets and produce high quality
diagnostic images;
(ii)
the education, advocacy and application of magnetic field safety and the protection of
patients, health care professionals and the public;
(iii)
the assessment of patients before, during and after the application of magnetic resonance
imaging;
(iv)
the use of pharmaceuticals in the performance of diagnostic interventions to enhance
magnetic resonance images;
(v)
the application of knowledge, skills and judgment in the evaluation and interpretation of
diagnostic images; and
(vi)
such other practices and procedures within the scope of practice of magnetic resonance
technology as taught in an approved education program.
Scope of Practice, cont'd
•
"nuclear medicine technology" means those aspects of the practice of medical
imaging technology that include:
(i)
the use of radiopharmaceuticals to produce high quality images for
diagnosis and the treatment of disease;
(ii)
the education, advocacy and application of radiation safety in the
protection of patients, healthcare professionals and the public;
(iii) the assessment of patients before, during and after the application of
nuclear medicine imaging and therapy;
(iv) the use of pharmaceuticals in the performance of diagnostic interventions
to enhance images;
(v) the application of knowledge, skills and judgment in the evaluation and
interpretation of diagnostic images; and
(vi) such other practices and procedures within the scope of practice of
nuclear medicine technology as taught in an approved education program;
Scope of Practice, cont'd
•
"radiation therapy" means the application of professional radiation therapy knowledge,
skills and judgment in the use of ionizing radiation and other energy forms in the provision
of therapy, in collaboration with healthcare professionals to achieve optimal health,
wellness and functional performance, and includes:
(i)
the planning for and application of ionizing radiation to patients in accordance with a
prescription and instructions from a radiation oncologist;
(ii)
the education, advocacy and application of radiation safety in the protection of
patients, healthcare professionals and the public;
(iii)
the assessment of patients before, during and after the application of radiation
therapy treatments;
(iv)
the use of pharmaceuticals in the performance of therapy interventions to enhance
treatment;
(v)
the application of knowledge, skills and judgment in the evaluation and interpretation
of treatment; and
(vi)
such other practices and procedures within the scope of practice of radiation therapy
as taught in an approved education program;
Scope of Practice, cont'd
•
"radiological technology" means those aspects of the practice of medical
imaging technology that include:
(i)
the application of ionizing radiation to perform procedures and
produce high quality diagnostic images;
(ii) the education, advocacy and application of radiation safety in the
protection of patients, healthcare professionals and the public;
(iii) the assessment of patients before, during and after the application of
radiological technology;
(iv) the use of pharmaceuticals in the performance of diagnostic
interventions to enhance images;
(v) the application of knowledge, skills and judgment in the evaluation and
interpretation of diagnostic images; and
(vi) such other practices and procedures within the scope of practice of
radiological technology as taught in an approved education program;
Protection of Titles
•
Current title protection:
• None
•
Proposed title protection for the following:
• “Registered Medical Imaging Technologist” or “Medical Imaging Technologist”
• “Registered Medical Radiation Technologist” or “Medical Radiation Technologist”
• “Diagnostic Ultrasound Technologist”
• “Registered Ultrasound Professional”
• “Registered Diagnostic Ultrasound Professional”
• “Registered Ultrasound Technologist”
• “Registered Sonographer”
• “Sonographer”
• “Registered Technologist, Magnetic Resonance” or “Magnetic Resonance
Technologist”
• “Registered Technologist, Nuclear Medicine” or “Nuclear Medicine Technologist”
• “Registered Technologist, Therapy” or “Radiation Therapist”
• “Registered Technologist, Radiological Technology”
• “Radiological Technologist”
• “X-ray Technologist”
• Or any derivations or abbreviations thereof.
Protection of Practice
• No person shall engage in the practice of a
discipline unless such person:
– holds a license endorsing the person as eligible to
practice in that discipline;
– is a student in an approved education program in
that discipline, and is engaging in training authorized
by that program; or
– is otherwise authorized to engage in the practice of
that discipline as set out in this Act or the
Regulations.
Protection of Practice, cont’d
• Section 21(2)
“Notwithstanding any provisions of this Act or the
Regulations, the Board may set out in the by-laws a
process to authorize members licensed in one discipline
to engage in the practice of designated aspects of
another discipline”
Protection of Practice, cont’d
•
Exemptions
–
See Section 67
–
Allows for exemptions from Act for various individuals including:

the carrying out of specific tasks constituting part of the practice of
medical imaging technology or radiation therapy by persons
authorized under Section 21(2) of the Act;

the conducting of ultrasounds of the eye by persons acting under the
direction of a medical practitioner;

the measuring of follicles and endometrial thickness as part of
assisted reproduction therapy under the direction of a medical
practitioner; and

The continued practice of radiological technology by those persons
authorized at the coming into force of the Act to engage in practice
under Section 10(2) of the former Act, or as otherwise required by law.
Protection of Practice, cont’d
•
Grandparenting provisions
–
A member of the NSAMRT at the time of coming into
force of the Act
–
A person certified to practice diagnostic ultrasound
technology by ARDMS, and who has engaged in the
practice of diagnostic ultrasound technology in the
Province during the twelve month period prior to Act
coming in force.
–
Every person who, at time of coming into force of Act,
has engaged in the practice of diagnostic ultrasound
technology in the Province for a period of time during
each of the past five consecutive years.
Registration and Licensing
•
Requirements under the Fair Registration Practices Act
•
Distinction between registration and licensing
•
Categories of licences:
–
Practicing Licence, endorsed in a particular discipline
–
A practicing licence with conditions or restrictions, endorsed in
a particular discipline
–
Temporary licence, with or without conditions or restrictions,
endorsed in a particular discipline
–
Temporary licence (graduate), endorsed in a particular
discipline
Registration and Licensing, cont’d
• Licences endorsed in a particular discipline
where member meets the following criteria:
– completed an approved education program in
relevant discipline;
– completed the registration examination in relevant
discipline;
– Member otherwise meets all criteria for the issuing
of a practising licence.
Credentials Committee
• Credentials Committee reviews applications for
registration and licence and determines whether
applicant meets criteria
• Criteria spelled out in detail in Regulations
Registration Appeals
• Where registration or a particular licence has
been denied, or where terms or conditions have
been imposed, an applicant has a right of
appeal
• Appeal will consist of fresh review of entire
matter, with new decision to be rendered by
independent body, Registration Appeal
Committee
Complaints
• Complaints may relate to potential:
– Professional misconduct
– Conduct unbecoming the profession
– Incompetence
– Incapacity
Complaints and Discipline Process
• Separation of complaints/investigative process
from discipline/hearing process
• Introduction of alternate dispute resolution
methods to avoid necessity of matter
proceeding to a hearing
• Requirement for disclosure and fair processes
• Requirement for open hearing if matter is
referred to full hearing
The Investigation of Complaints
•
•
•
Broad authority given to investigator
Following investigation, matter referred to
Investigative Committee and various options
available to dispose on nondisciplinary basis
If matters reach the Investigative Committee,
various options are available to dispose on nondisciplinary basis
–
Counsel
–
Caution
–
Informal resolution
–
Mediation
Settlement Proposals
• When a matter is referred to a hearing, either
party can approach the other regarding a
settlement
• Settlement requires admission of certain facts;
admission of disciplinary matters; and agreed
upon disposition
• Both Investigative Committee and Professional
Conduct Committee must review and approve
content of settlement
Hearing Process
• Professional Conduct Committee includes
public representatives
• Full disclosure by either party to the other
• Open hearing process
• Ability to impose publication bans
• Publication of decisions
• Right of appeal
• Reinstatement applications
Professional Incorporation
• Act allows for members to practice under the
structure of a professional corporation
• At present, no Regulations proposed to set out
requirement for majority ownership by
technologists or therapists
• This can be adapted over time with additional
changes to the Regulations
What Happens from Here?
•
•
•
•
•
•
June 24, 2010 Members vote on Act and Regulations
Obtain approval to proceed
Approved Act and Regulations to be circulated to
Government and to external stakeholders for feedback
Consultation with 3 political parties between August and
October 2010
Changes made based on government feedback
If government agrees, Act introduced in fall sitting of
Legislature 2010
What happens from here?(cont’d)
• Act introduced for First and Second Reading,
then public Law Amendments process
• Can be a very political process- may need to
lobby support
• Third Reading
• If Act passes in fall sitting of Legislature 2010,
Regulations are then forwarded to Registry of
Regulations
• Anticipated proclamation date - early to mid
2011 ???
Questions?
?????
Motion
• Be it resolved that at a duly called Special
Meeting of the members of the NSAMRT held
on June 24, 2010, the proposed June 10
version of the Medical Imaging and Radiation
Therapy Professionals Act and accompanying
Regulations are approved, subject to necessary
housekeeping amendments, for forwarding to
government and external stakeholders, with the
objective of introduction in the fall sitting of the
Legislature
Motion
• Be it resolved that at a duly called Special
Meeting of the members of the NSSDMS held
on June 24, 2010, the proposed June 10
version of the Medical Imaging and Radiation
Therapy Professionals Act and accompanying
Regulations are approved, subject to necessary
housekeeping amendments, for forwarding to
government and external stakeholders, with the
objective of introduction in the fall sitting of the
Legislature