Physicians’ advocacy role must be protected

The Royal College of Physicians and Surgeons of Canada’s CanMEDS framework lists “health advocate” as one of seven core roles that physicians require to “effectively meet the health care needs of the people they serve.” That role is defined, in part, as physicians working “with those they serve to determine and understand needs, speak on behalf of others when required, and support the mobilization of resources to effect change.” Physicians have long understood the responsibility that comes with their role as health advocates, and there are myriad examples of how that advocacy has helped individual patients and society as a whole. Read: CMA and CNA host emergency summit on state of Canada's ailing health systems The Canadian Medical Association (CMA) strongly supports advocacy for and by physicians, and calls for policies and other measures to safeguard physicians from fear of reprisal and retaliation when speaking out for their patients and communities. The COVID-19 pandemic has dramatically amplified the importance of these protections, given physicians' role as advocates at a time of unprecedented public health risks. As president of the Canadian Medical Association (CMA), I have spent countless hours in recent months speaking to government officials and to media, advocating for resources and health system change to benefit physicians, other health workers and, ultimately, our patients. It has been empowering to advocate on behalf of my peers for changes that would improve access to care and reduce wait times for patients while enhancing the professional experience for physicians and other health workers. As a pediatrician, I have taken great pride in my role as a children’s health advocate, calling on provinces and territories to bolster efforts to vaccinate children against COVID-19 and to protect youth in schools and other settings. It is a responsibility that many of us are proud of, but that also comes with immense challenges. During the pandemic, we have witnessed how physicians and other health workers have become targets for a minority of citizens who oppose vaccination, or any efforts to mitigate the pandemic; for internet trolls and bots; even for decision-makers who wish to stifle informed opinions and feedback that differs from their own narratives. Last year, the CMA advocated to the federal government for legislation to prohibit the harassment and intimidation of healthcare workers and patients. Thankfully, this legislation was passed in December, offering a degree of protection to health care workers from online and in-person abuse. We have also seen physicians face professional reprisals for speaking against public health policy, despite the fact that their advocacy efforts have focused solely on keeping their patients and communities safe. The politicization of healthcare is nothing new, but if we are going to truly advocate on behalf of our patients and colleagues, we must encourage dialogue and debate while ensuring that medical professionals’ efforts are respected and not met with retaliation or reprisal. Dr. Katharine Smart is president of the Canadian Medical Association and a pediatrician in Whitehorse, YK.

Physicians’ advocacy role must be protected

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