Ontario Physician Employment Agreement - PDF

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					Emergency Department Coverage Demonstration Project   Projet pilote de permanence des soins dans les services des urgences
163 Queen St. East                                    163 Queen St. East
Toronto, ON M5A 1S1                                   Toronto, ON M5A 1S1
Tel.: 1-800-596-4046 ext. 3                           Tel.:   1-800-596-4046 ext. 3
Fax: 1-866-535-2694                                   Fax:    1-866-535-2694
Email: emerg@healthforceontario.ca                    Email: emerg@healthforceontario.ca
www.HealthForceOntario.ca                             www.professionssanteontario.ca


                                   Locum Credentialing Application Program
                                                                    Hospital Agreement

1. Introduction
The Locum Credentialing Application Program (LCAP) is designed to streamline the administrative process for physicians applying for
locum tenens privileges in public hospitals in Ontario. The LCAP was developed in consultation with the College of Physicians and
Surgeons of Ontario (CPSO), the Ontario Medical Association (OMA), the Professional Association of Internes and Residents of Ontario
(PAIRO), and the Ontario Region of the Society of Rural Physicians of Canada (SRPC).

2. Process
Physicians are required to complete one LCAP form annually, including accompanying documentation. The physician's completed LCAP
application will be held confidentially by the HFO MRA. At the request of a participating hospital who specifically identifies a physician,
this completed LCAP application, will be sent to the hospital(s). Hospitals process applications in accordance with the provisions of the
Public Hospitals Act, the Regulations thereunder, and the by-laws of the hospital.


3. Key Considerations
It is important for participating hospitals and physicians to note the following:
1. The participating hospital is responsible for processing the completed LCAP application in accordance with the provisions of the
      Public Hospitals Act, and the Regulations thereunder, and the by-laws of the hospital. The LCAP application does not change the
      individual hospital's authority to grant privileges to physicians under the Public Hospitals Act.

2.   Each participating hospital is responsible for its own due diligence in verifying the credentials of the applicant. HFO MRA does not
     verify or substantiate in any way the credentials of the applicant and the information provided to the hospital.

3.   The LCAP application and information provided to participating hospitals is gathered by HFO MRA on an annual basis, with the date
     provided as to when the information was obtained. Each hospital should determine whether or not they wish to update all or any
     part of the information given the date that is set out on the LCAP application.

4.   While an attempt has been made to develop an LCAP application that will fall within the standards used by most hospitals, there may
     be exceptions, and both the hospital and the physician must ensure compliance with the specific hospital's by-laws. If a hospital's
     by-laws contain additional criteria that must be satisfied in connection with a physician appointment, the individual hospital will
     have to obtain that additional information from the physician in order to ensure that they comply with their own by-laws.



4. Instructions
In order to confirm your hospital's participation in the LCAP, please sign and return the enclosed authorization form. Confirmation of your
participation will enable HFO MRA to provide you with credentialing files for participating EDCDP locum physicians.

Please return the completed application to:

                                       HealthForceOntario Marketing and Recruitment Agency
                                                 Ontario Physician Locum Programs
                                                          163 Queen St. East
                                                        Toronto, ON M5A 1S1
                                                Tel: 416-862-2200 or 1-800-596-4046
                                                          Fax: 416-874-4075
                                                Email: emerg@healthforceontario.ca

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                                                                                                                             Last updated: January 2010
                                       Locum Credentialing Application Program
                                                                             Hospital Agreement
The undersigned hospital acknowledges that it agrees to participate in the Locum Credentialing Application Program in accordance
with and subject to the specified terms as outlined below.

I understand that participation is a requirement of the Emergency Department Coverage Demonstration Project. As a hospital
participating in LCAP, I may request physicians'(s) completed LCAP application for purposes of reviewing the applications for
locum tenens appointments.

The undersigned hospital acknowledges and confirms the following:
1. The participating hospital is responsible for processing the completed LCAP application in accordance with the provisions of the
    PublicHospitals Act, and the Regulations thereunder, and the by-laws of the hospital. The LCAP application does not change the
    individual hospital's authority to grant privileges to physicians under the Public Hospitals Act.

2.   Each participating hospital is responsible for its own due diligence in verifying the credentials of the applicant. HFO MRA does not
     verify or substantiate in any way the credentials of the applicant and the information provided to the hospital.

3.   The LCAP application and information provided to participating hospitals is gathered by HFO MRA on an annual basis, with the date
     provided as to when the information was obtained. Each hospital should determine whether or not they wish to update all or any
     part of the information given the date that is set out on the LCAP application.

4.    While an attempt has been made to develop an LCAP application that will fall within the standards used by most hospitals, there may
      be exceptions, and both the hospital and the physician must ensure compliance with the specific hospital's by-laws. If a hospital's by-
      laws contain additional criteria that must be satisfied in connection with a physician appointment, the individual hospital will have to
      obtain that additional information from the physician in order to ensure that they comply with their own by-laws.




Hospital Site / Corporation


Name of CEO

Name of (select one)
   Chief of Staff                Chief of ED




                            Signature (CEO)                                                                                       Signature (Chief of Staff / Chief of ED)




                                     Date                                                                                                                Date



Notice of Collection: Personal information is collected by the HealthForceOntario Marketing and Recruitment Agency (HFO MRA) under the authority of the Development Corporations Act, Ontario
Regulation 249/07, Section 3. The personal information you provide to us during our interactions is necessary for HFO MRA to provide you with career assistance and/or assist you with your
employment search. HFO MRA may share your personal information with appropriate agencies and professional bodies, recruiters, health care employers, the Ministry of Health and Long-Term
Care, and/or community representatives for the purpose of helping you explore job opportunities and careers in Ontario. HFO MRA may also use this information to research and evaluate our
recruitment and career assistance activities. If you require further information about this please contact our information coordinator at: HealthForceOntario Marketing and Recruitment Agency, 163
Queen St. East, Toronto, Ontario M5A 1S1. Tel: 416-862-2200 or 1-800-596-4046, Fax: 416-874-4075.


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