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Medical Matters: Balancing physician advocacy and professionalism
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By Dr. Scott McLeod, CPSA Registrar & CEO
As physicians and physician assistants, we are fortunate to have a certain credibility and influence simply by being part of the medical profession in Canada. This is a privilege we have earned over many years, and one we must continue to earn. One we do not take lightly.
When you combine dedicated and compassionate physicians with the privilege of heightened credibility, patient advocacy is often the result. CPSA recognizes and supports that advocacy, either for our patients or the healthcare system in general, has always been an important component of the medical profession. In short, we advocate for others because we care. However, sometimes, despite our best intentions, we may tiptoe across the line of professionalism. I want to reiterate that physicians and physician assistants have the right to advocate and voice their opinion on matters important to them, but with that comes a responsibility to communicate respectfully and professionally, since inappropriate advocacy or miscommunication can put both the individual physician and the profession at risk.
Our work as physicians, whether in a clinical setting or advocacy role, must always adhere to the CMA Code of Ethics and Professionalism, which articulates the ethical and professional commitments and responsibilities of the medical profession:
“The Code provides standards of ethical practice to guide physicians in fulfilling their obligation to provide the highest standard of care and to foster patient and public trust in physicians and the profession.”
The Code also specifies that we have a responsibility to “engage in respectful communications in all media” and “avoid any influence that could undermine [our] professional integrity.” This is particularly relevant for social media, where words that may have previously floated away after a verbal exchange are now transcribed online for all to see. With this comes the need for even more awareness and consideration when speaking up about issues impacting us or our patients. Social media advocacy can be positive, we just have to make sure that when advocating, we do so in a professional manner and take into consideration the context and environment in which we are communicating. I encourage each of you to review CPSA’s Social Media Advice to the Profession document for additional guidance about online communication.
Speaking of online advocacy, I also want to say thank you for your thoughtful, professional and respectful comments on my last Medical Matters article about pan-Canadian licensure. CPSA had a chance to meet with other physician colleges from across the country at last month’s Federation of Medical Regulatory Authorities of Canada annual meeting, during which pan-Canadian licensure was the topic of many robust discussions. I look forward to continuing this conversation with you all.
Thank you, again, for your professionalism and dedication to your patients and health care in Alberta.
Take care and I hope you have a great summer.
Scott
Thanks for your perspective. Here’s a hypothetical scenario – if a physician leader does a public presentation to other physicians and shows graphs that change the scales on the axes so that it displays information that could be potentially misleading, would you say this is inappropriate miscommunication? Do you believe you would need to talk to that physician and give them this same guidance that you give us about maintaining integrity? Do you believe that behavior tiptoes the line of professionalism? I believe that scenario shows unprofessional behavior and I think it’s potentially dangerous. I wonder how the College would respond if that scenario actually happened.
My belief is that when you see things being said on social media that you consider inappropriate, one of the reasons may be because frustrated front line physicians are publicly or privately hearing inappropriate and misleading things from physician leaders. It’s possible that they are trying to make sure the public understands what is happening behind the scenes. I believe professionalism and integrity applies to all physicians, not just the ones on social media who leadership may not agree with.
Hi Lizette, thank you for sharing your feedback. As you mention, social media is just one example of advocacy within the medical profession. Regardless of the communication channel, all physicians and physician assistants in Alberta are expected to communicate with respect and professionalism, as per CPSA’s Standards of Practice. These standards apply to all regulated members, regardless of their official title or position. If you have questions or would like guidance on a specific situation, such as the one you highlighted, please feel free to contact CPSA’s support team at support@cpsa.ca.
Thank you Scott for your continued service for our profession.
You seem to be saying advocacy is fine as long as it doesn’t hurt the profession. What if it is a change to the profession one advocating for? Many could view this stance as threatening and harmful to the profession? How does one avoid “tiptoeing over the line” in this situation?
Hi Scott, thank you for taking the time to read The Messenger and leave a comment. Advocating for a change to the profession does not mean hurting the profession, as long as it’s done in a respectful and informed way. After all, change is how we learn and grow. The line of professionalism gets crossed when advocacy becomes disrespectful, when conflicts of interest arise or when the advocacy begins to affect safe patient care. By adhering to CPSA’s Standards of Practice and Code of Ethics and Professionalism, physicians can ensure they maintain appropriate boundaries and advocate in a way that contributes to the profession in a positive way.
excellent article