Organization
[February 13, 2024 3:38 PM]
Ontario Medical Association (OMA)
 
Response in PDF format:
OMA Response_20240213.pdf
Physician (including retired)
[February 12, 2024 7:54 PM]
Is it your intention to mandate "gender affirming care" as the only option going forward, based on the following: "Using patients’ preferred names, titles, and pronouns"?

If so, what medical evidence do you base this on? Current studies do not show "gender affirming care" to be a safe or effective pathway for most people.

Sneaking medical guidelines into "professionalism" requirements is not helpful. If you believe "gender affirming care" is the only reasonable option for anyone who voices a hint of gender dysphoria, perhaps you should publish a separate guideline explaining your justification.

The most current medical evidence (for those of us who still care about such antiquated concepts) suggests:

"There are no long-term studies demonstrating benefits nor studies evaluating risks associated with the medical and surgical interventions provided to these adolescents. There is no long-term evidence that mental health concerns are decreased or alleviated after “gender affirming therapy.” Many individuals who have been treated with “GAT” later regret those interventions and seek to align their gender identity with their sex. Because of the risks of social, medical, and surgical interventions, many European countries are now cautioning against these interventions while encouraging mental health therapy."

https://acpeds.org/position-statements/mental-health-in-adolescents-with-incongruence-of-gender-identity-and-biological-sex

Are you suggesting that anyone who encourages a patient to consider accepting their biological and genetic reality should be deemed unprofessional? And sterilizing meds with complex surgeries and high complication/regret rates like vaginoplasty and mastectomy are the only "professional" option to offer?

If so, please say so directly, so I can direct the CMPA to your guideline when I am sued as one of my patients comes to later regret their "gender affirming care", and lack of ability to breast feed or even have children at all from it.

Keep medical guidelines in medical documents. If your position is strong you should have no problem doing so. Keep politics out of medicine. If you care so much about politics, run for office.

If you are going to tell doctors how they should handle medical issues, I expect it should be evidence based, and it should not be shoehorned into nebulous "professionalism" requirements.
Physician (including retired)
[February 11, 2024 6:33 PM]
The definitions in your EDI glossary and the intersectional lens need much self-reflection and revision to provide Ontario patients with safe equitable care.

How can your definitions contradict themselves so deeply infringing on a care free from bias?

"Stereotypes: conventional, intuitive, and oversimplified conceptions, opinions, or images of a group of people."--- "Racism is often grounded in a presumed superiority of the white race over groups historically or currently defined as non-white."

These are opposite and one of them should not exist in your glossary

"Prejudice: negative opinions, feelings or beliefs held by someone about another individual or group, often based on negative stereotypes about race, age, sex, etc."
"Privilege: unearned power, benefits, advantages, access, and/or opportunities that exist for members of dominant groups in society. People from dominant groups (e.g., white, heterosexual, male, able-bodied)"

These are opposite and one of them should not exist in your glossary.

EDI definitions have much to learn from Martin Luther King. MLK was of the opinion that all people are created equal and should have equal opportunities. He was a visionary who believed that we do not need to push down to raise up.

Canadians, patients, physicians all deserve equal care and consideration.
Many of us are immigrants, myself included, many struggle with economic uncertainty.
As physicians we must show understanding to each of our patients based on their personal experiences, free from judgment and bias.


I hope that the CPSO envisions the future of MLK in its definitions and future guidelines.
Physician (including retired)
[February 12, 2024 8:03 PM]
Agreed entirely. As a non-white (which I only mention because the people running these consultations may care to consider my race in terms of the value of my opinion), I have never seen such racism in my entire life in Canada as I now do from the "DEI woke left" that is infecting every industry with their poisonous and hateful beliefs.

The contradictions you point out are obvious. Racism does not fix racism. There is no such thing as "noble racism." There is only racism.

Assuming that only one race can be racist or pushing the notion that one race should be treated differently from another IS INHERENTLY RACIST and it frankly disgusts me.

I grew up with MLK's "I have a dream" burned in my memory. It still remains there. It is the guiding principle I operate on and have my whole life.

To be told by the CPSO that no only is that unacceptable, but I must throw the principles I hold most dear out, and INTENTIONALLY DISCRIMINATE in order to maintain "professionalism" boils my blood.

Hypocrisy and contradictions are expected from a group that favors victimhood as their most cherished ideal. Life is unfair. Everyone is dealt a different hand. Encouraging more racism and discrimination in the name of "DEI" is not going to fix anything. It just fosters more victimhood and animosity.

As doctors, it is not our jobs to discriminate for or against our patients, but to provide good, high quality care to all patients. We should be taking into account any possible challenges or stressors they may face regardless of their race or gender.

I hope that, one day, the people pushing this awful ideology can figure out the destructive nature of what they are doing and change for the better.

"I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character."

How about we start there? If you want this to be the future, then start living that way today.
Organization
[February 09, 2024 11:08 AM]
Professional Association of Residents of Ontario (PARO)
 
Response in PDF format:
PARO Response_20240209_Redacted.pdf
Organization
[February 08, 2024 4:51 PM]
College of Physicians and Surgeons of Alberta (CPSA)
On behalf of CPSA, thank you for the opportunity to review the draft and provide feedback.

CPSO may wish to consider the following:
  • Clearly state in the Principles that they are enforceable under the Professional Behaviour policy
  • Being receptive to colleague feedback is mentioned twice – it may be worth including considering feedback from patients/family members
Please let me know if you have any other questions or require additional information.
Other health care professional (including retired)
[February 07, 2024 3:54 PM]
Note: Some content has been edited in accordance with our posting guidelines.
Hello,

Again, as a retired nurse living in [redacted] with last position before early retirement in a clinical research role - mostly oncology drugs - in the pharmaceutical industry until the company was acquired by an out of province company, I read the comments and the draft.

I suggest this draft policy is set aside while focus might better be spent on recruiting medical students and adding some of this to their program and while working to try to retain doctors in this province as the rate of burn out, the millions of patients without doctors, other high level priorities might best be considered before spending time with this perhaps important but less urgent policy draft. 

Phases including public debate, social media, humility and more are excessive while health care is in a prolonged crisis.

While general practice office referral to specialists is challenging and wait lists long, while emergency units wait lists for patients and other priorities might be addressed this policy is of relevance in a long term cancer centre setting for patient-doctor-team setting among other practice settings but not all patient-doctor experiences.

The CMPA response of January 25 might be of interest. I do not agree with some of the CNO response earlier today.
Organization
[February 07, 2024 10:41 AM]
College of Nurses of Ontario (CNO)
 
Good Morning,
Thank you for the opportunity to review and provide feedback on the following four policies: Consent to Treatment, Physician Treatment of Self, Family Members, or Others Close to Them, Principles of Medical Professionalism and Professional Behaviour.
Overall, we found these documents articulate important expectations to the profession. We found the policies to be relevant and concise. Also, we found the companion resources to be particularly helpful when looking for more information to support the expectations.
We have attached a document that highlights a few considerations that may support your update of these resources.
Please feel free to reach out to me directly should you have any questions or require any clarification.
 
Response in PDF format:
CNO_Response_20240207.pdf
Physician (including retired)
[January 25, 2024 5:22 PM]
Note: Some content has been edited in accordance with our posting guidelines.
A very complex and yet difficult topic. I think there needs once again to have not only the principles outlined but also references and explanations. Unfortunately, with the media, every caution must be taught to our junior colleagues. Posts and blogs must always have a guiding line, how would feel if this e-mail or blog was read by the public?    Today we live in a very challenging world, and I would like to know where the basis is for some of the troubling activities that fall under the banner of Medical Professionalism. [redacted]
Organization
[January 25, 2024 2:10 PM]
Canadian Medical Protective Association (CMPA)
Response in PDF format: 
PMP & PB_CMPA Response_20240125_Redacted.pdf
Physician (including retired)
[January 23, 2024 3:41 PM]
While I appreciate the sentiment. I agree with many that have posted already. Creating an official statement about what you think it means to be a good person and demanding that we be kind, compassionate and humble? This 'over-lawyering' of a lofty goal may lead to unintended consequences, misunderstandings, and disputes.

It is generally advisable to be careful when attempting to mandate these 'soft skills' , ensuring that the intent is not lost in unnecessary wordiness, buzzwords, politics, and complexity.

In my opinion, overly detailed or intricate statements like this completely obscure the primary purpose and goals of what I think you are trying to achieve, making it harder for the parties involved to navigate and comply with the terms.
Physician (including retired)
[January 22, 2024 7:19 PM]
Frankly it’s insulting to mandate physicians do all of these things that are not actually about medicine and medical care and then provide lip service about physicians should also take care of themselves “when possible”. Every thing is this policy that is not actually about medical care should have a when or if possible added to it.

There is not enough time in the day as is to actually provide medical care to those who need it. Our system is in a crisis. Physician burnout is at an all time high. Physicians are leaving medicine. It seems that physicians taking care of themselves so they can stay in medicine, continue practicing, and caring for patients should not be a “when possible” thing but the most important part of them being “professional”.

From the policy
“Physicians honour their own humanity by:
• Acknowledging their physical and social needs, vulnerabilities, and limitations
• Taking time away from work, when possible”
Physician (including retired)
[January 22, 2024 7:02 PM]
Most of the policy has nothing to do with actual medical care. Physicians are healthcare providers. In an interaction with a patient they are providing medical care. Many things affect a person’s health. To expect a physician, by virtue of a policy on expected physician behaviour, to address all of these vast social issues is impossible, impractical and NOT what the CPSO is for.

“• Bringing an intersectional lens to their daily processes and practices
• Committing to allyship and striving to address discrimination and oppression in health care”

These are responsibilities of administrators, policymakers, and organizations as a whole. Mandating what physicians do beyond the provision of medical care is far too prescriptive and fails to provide guidance to physicians on what actually professional requirements are related to medical practice.

These items are not part of the (usual) ‘job’ description when physicians are being hired. If these are expectations for daily practice and in every patient encounter, it would be impossible for physicians to actually provide medical care. I can’t even fathom how much time it would require to have these discussions with just one patient. This is not a 5 minute conservation.
Member of the public
[January 18, 2024 10:56 AM]
Note: Some content has been edited in accordance with our posting guidelines.
CPSO only cares about appearances. I just went through [redacted] CPSO investigations regarding a physician [redacted]. CPSO did not properly investigate because their basic premise is "doctors are honest ".

Ontaruo needs doctors so CPSO turns a blind eye and does "kangaroo court" investigations.

I guess we must wait for [redacted] to kill someone?
Physician (including retired)
[January 18, 2024 8:37 AM]
The CPSO clearly wants to be relevant and sensitive to the needs of pts and the public. However, I think it is entering the political sphere with the depth and scope of this policy.
Professionalism, in my humble opinion, is a complex entity and not easy to define and can have a broad scope and a narrower one.
This policy is trying to do too much with regards to expectations of physician behaviour.
It would be best to narrow this policy down to the main expectations of physicians, and not try to be very preachy.
Physician (including retired)
[January 18, 2024 1:11 PM]
Note: Some content has been edited in accordance with our posting guidelines.
 
WE need a big effort to Reduce CPSO Dictation to Physicians on Many aspect of medicine while practicing much subliminally.Its only this year we have a Person of Colour appointed on the staff [redacted].We have committess including Complaint committees completely staffed by Causains [redacted].We Need to have equal representations on such committees when People of Colour are confronted to understand their mind.Professionalism cannot be dictated ,check the Presidents of USA..humans will be such but although medicine has progressed the Z generation has a completely different attitude
to Professionalism as they have never had severe restriction since early school days.
I would encourage CPSO to Charge a minimal fee for each complaint and endorse Physician being able to sue such patients for any misdemeanors.
We have reduce this Profession to a Subservience of extreme with Absolutely No Recourse
Prefer not to say
[January 17, 2024 3:09 PM]
The drafting of this policy is very one sided, clearly formulated by social studies-driven ideologues, with terminology reflective of the social contagion of the present zeitgeist.

A negative effect of this policy is that it alienates a large proportion of patients who do not hold the sociopolitical views approved by CPSO. By forcing physicians to maintain such views, or silence antithetical ones, bonds with patients who hold these antithetical views will be weakened or broken. These views are not incorrect, but merely unorthodox in the current sociopolitical climate.

In short, this policy will harm patients.
Physician (including retired)
[January 17, 2024 2:21 PM]
Professionalism in medicine is about providing better health services with equity and respect, with empathy and understanding. It is not our job to look at intersectionality, and it will lead to divisiveness further. All the comments below say the same, so I hope you will consider them seriously.
Physician (including retired)
[January 17, 2024 2:08 AM]
You will never stop will you? You are an ideologically driven organization corrupted by your political agenda.

"Bringing an intersectional lens to their daily processes and practices"
"Committing to allyship and striving to address discrimination and oppression in health
care"

This has absolutely nothing to do with being a doctor. It is political left wing indoctrination. You cannot and should not be mandating our personal politics. I do not believe in an "intersectional lens," "allyship," or your likely woke perspective on "discrimination and oppression in health care."

My job is to provide good care to all people regardless of their race, gender, or any other factors. I REFUSE to discriminate for or against anyone, which is what is required by "intersectional anti-oppression allyship."

If your intention was to say doctors should not discriminate against patients and should provide good care to all patients, say that. If you are saying we must agree with your racist, sexist, woke agenda, stuff it. I will find another job or region to work in.

I am a 5 star rated family doctor (as per RateMD's). I do not need you to tell me what my political ideology should be. And I refuse to accept it.
Physician (including retired)
[January 16, 2024 7:59 PM]
The CPSO seeks to greatly increase its regulatory power with this new draft. We should oppose all of these changes, as they do not serve the interests of the public or the profession. The CPSO will be granted so many additional levers of power with these regulations that it will be nearly impossibly for a physician to have any independent thought without risking their license. This is the most blatant power grab I have seen in a long, long time. I fully expect these to pass and physician autonomy to evaporate, as most people will not have the sense to see what is being taken here.
Physician (including retired)
[January 16, 2024 3:14 PM]
Idealistic principals, but dangerous to include some of these in something that looks like a regulation. In particular embracing the 'anti-oppression' language is VERY concerning and I'm sad to see the CPSO hasnt recognized the political agenda behind those trying to push that language into every day lfe. While there can be bias and racism in medical care, that should be addressed. However we are MDs, I dont see us oppressing anyone and i'm in practice 4 decades. We are experts in health care, NOT political advocates pushing the D E I/antipoppression movement that is slowly destroying our world, where effort and acheivement do not count, but levelling the field for those who are "opperessed" ( and i'm stil wondering just WHO gets decide who the oppressed are?) seems the primary objective.

OUR lives are complex enough, this should be more simplistic, less flowery words and concepts that no one is going to understand nor advance.

It is enough to say we should treat patients with humility, respect, empathy and check our personal biases at the door. The SIMPLER more direct language will be much more effective, if that is your actual intent.
Physician (including retired)
[January 09, 2024 8:05 PM]
Good to see the college parsing the minutia of physician behaviours. Clearly well-versed and informed in the social sciences which are unfortunately built on evidence constructed on a hill of beans. The social sciences are clearly influenced by bias, meant to confirm an ideology more than create a path to truth. It is too bad that there is no iota of evidence to support your moral recreation of the physician while you animate a transition from from Humanism to intersectionalism. A movement from equality to the morally bankrupt concept of equity.

Yet continue to play the violin while patients and their doctors struggle to succeed in a failing system. Best not to confront the cause of the failure lest it lead to unsettling and unfortunate conclusion. Keep the blinders firmly in situ.
Physician (including retired)
[January 07, 2024 12:21 PM]
We always act within our limitations and scope of practice, but it’s WILD that pharmacists can practice integrative medicine, dictate and charge patients for travel consults without the ability to prescribe those meds and demand we as physicians prescribe meds and order investigations. When I ask for a appt or charge pt for non OHIP services, the patient gets upset with me when I charge them for the appt to prescribe these meds. I have to stay in my lane, but CPSO allows other AHP to drive all over the place without putting protective statements for its members. So cool!
Physician (including retired)
[January 05, 2024 8:50 PM]
Regarding:

Learning about and employing trauma-informed approaches to care
• Reflecting on their own implicit and unconscious biases
• Fostering welcoming and inclusive spaces for everyone
• Using patients’ preferred names, titles, and pronouns
• Recognizing the unique experiences, opportunities, and barriers created by each person’s
intersecting social identities (i.e., race, ethnicity, gender, sexual orientation, class, and/or
religion).
o Where possible, striving to address the discrimination faced by patients from
marginalized and underrepresented populations

The above phrases are a word-salad of nonsense. The Can Meds website updates have similar paragraphs which are also word-salad nonsense. The CPSO MUST get rid of these paragraphs. The words are meaningless. What is "trauma-informed care"? It is a meaningless made-up term. Get rid of it. If biases are unconscious, by definition they are not available to the conscious mind. Get rid of it. "Fostering welcoming and inclusive spaces"? Meaningless. Using patients preferred names etc? Compelled speech. You should have learned your lesson with Jordan Peterson. Get rid of it. "Recognizing the unique experiences, opportunities, and barriers created by each person’s intersecting social identities (i.e., race, ethnicity, gender, sexual orientation, class, and/or religion)." This is nothing but hackneyed left-wing nonsense. Intersectionality is a made up nonsensical term. get rid of it. "Where possible, striving to address the discrimination faced by patients from marginalized and underrepresented populations". I bet that you cannot define what the terms "underrepresented" and "marginalized" even means. Get rid of it. It is all garbage. 
Physician (including retired)
[December 17, 2023 3:56 PM]
Allyship and intersectionality are not relevant to the practice of medicine. They suggest aligning with a political movement, which has brought divisiveness, discrimination and lends itself to misinterpretation.
I am offended to be asked the socio-demographic questions. There was a time this was not allowed.
Physician (including retired)
[December 16, 2023 11:27 PM]
I have serious reservations about this document. While many of the principles described are fundamental to the practice of medicine others are problematic.

It is not clear what the CPSO expects with regard to " Promoting health equity and working to address the social determinants of health impacting patients" . It is not clear how the CPSO expects individual practitioners to address these social determinants and taken to the extreme it could create the expectation that a physician should make financial contributions to organizations or political parties that CPSO perceives as addressing these issues. I think these are not within the scope of medical practice.

The following segment also raises issues
  • Embracing social accountability
    • Recognizing and, where possible, addressing community and population health needs
    • Promoting equitable access to health care and social supports
  • Practising in a manner that promotes and protects public health
  • Recognizing the power and role of respectful, evidence-based physician advocacy
  • Fulfilling reporting obligations
  • Practising effective resource stewardship
I am not sure how the CPSO expects an individual practitioner to address community and population health needs. This is the role of various levels of government and regulators. It seems impossible for a physician to address population health needs and is an unreasonable requirement.

Likewise what is effective resource stewardship? It sounds wonderful but my hospital might have very different concept of what resource stewardship is compared to a different hospital and in fact what the institution considers effective stewardship may be completely opposite of what my patient requires. Is the intent of this policy to ask us to limit access to necessary resources or to advocate on behalf of our patients for access to resources that are being limited. This is not an abstract concept but is one we were faced with during covid when we had to make potential decisions about scarce resources and this would add an unnecessary layer and is dangerous for the CPSO to state without defining what it means.

Finally I have grave concerns about most of this section:
Please see my comments in caps, since I cannot change colors or fonts in this document

Recognizing and Honouring Humanity
By honouring their own humanity and the humanity of others, physicians create the foundations for trusting, respectful, and empathetic relationships. For physicians, honouring humanity means recognizing the inherent value and dignity of all people, including themselves, and keeping the varied experiences of patients at the centre of health care delivery. It also means acknowledging that physicians and other care providers themselves need care and compassion in order to provide effective and sustainable care. In the practice of medicine, recognizing and honouring humanity means caring for people, not simply treating diseases.
Physicians honour their own humanity by:
  • Acknowledging their physical and social needs, vulnerabilities, and limitations
  • Demonstrating self-compassion in the face of personal pain and moral injury
  • Taking time away from work, when possible
  • Recognizing personal impairment or decline
  • Asking for help from colleagues and making use of available wellness resources, when necessary
Physicians honour the humanity of their patients by:
  • Respecting the autonomy of their patients
  • Learning about and employing trauma-informed approaches to care ( I HAVE NO IDEA WHAT IS MEANT BY THIS, PARTICULARLY AS IT APPLIES TO MY SPECIALTY)
  • Reflecting on their own implicit and unconscious biases
  • Fostering welcoming and inclusive spaces for everyone
  • Using patients’ preferred names, titles, and pronouns
  • Recognizing the unique experiences, opportunities, and barriers created by each person’s intersecting social identities (i.e., race, ethnicity, gender, sexual orientation, class, and/or religion).
I THINK CPSO SHOULD EXPLAIN HOW A PHYSICIAN IS EXPECTED TO RECOGNIZE THESE. IT IS REASONABLE TO STATE THAT THESE FACTORS MAY AFFECT HOW A PATIENT VIEWS THE INTERACTION BUT NOT REASONABLE TO EXPECT THE DOCTOR TO UNDERSTAND WHAT IMPACT THIS MAY HAVE ON THE INDIVIDUAL IN FRONT OF THEM
  • Where possible, striving to address the discrimination faced by patients from marginalized and underrepresented populations
Physicians honour the humanity of their colleagues by:
  • Recognizing the individual needs and lived experiences of colleagues and other care providers
  • Modelling kindness, ethical care, and compassion for colleagues, staff, and other care providers
  • Fostering an emotionally and physically safe workplace that is conducive to the delivery of quality health care
Physicians honour the humanity of the public by:
  • Bringing an intersectional lens to their daily processes and practices
THIS SOUNDS NONSENSICAL, IT IS MEANINGLESS AND UNCLEAR WHAT THE CPSO EXEPCTS A PHYSICIAN TO DO THAT THEY AREN'T ALREADY DOING
  • Committing to allyship and striving to address discrimination and oppression in health care
WHILE I AGREE WE SHOULD ALWAYS STRIVE TO ADDRESS DISCRIMINATION IT IS UNCLEAR WHAT IS MEANT BY "OPPRESSION" IN THE CONTEXT OF MEDICAL PRACTICE IN ONTARIO. I HAVE BEEN IN PRACTICE FOR OVER 40 YEARS AND HAVE NOT WITNESSSED OPRESSION IN ANY HOSPITAL I HAVE WORKED IN OR IN NON HOSPITAL PREMISES. I HAVE SEEN EXAMPLES OF DISCRIMINATION BUT THAT WAS MANY YEARS AGO BUT NEVER OPPRESSION. I FEEL THIS IS A LOADED WORD AND HAS NO PLACE IN A CPSO POLICY.

I appreciate the opportunity to provide feedback and would be happy to discuss in greater detail.
Physician (including retired)
[December 14, 2023 1:35 PM]
Allyship and intersectionality are political ideas that currently enjoy precedence in academic left-wing thought. They have no place in a College document about professionalism. It would be equally improper and overtly political to demand that physicians bring a "Marxist," "Natalist" "Capitalist," "Islamic," or "Republican" lens to their practice.

By their own measure, it is frankly unprofessional for the College to publish such an overtly political document insofar as it obviously impairs trust between the profession and the large swath of the population not currently enthralled by academic left-wing political thought.
Physician (including retired)
[December 14, 2023 12:37 PM]
This type of wording is currently being used to justify outward racism and hatred toward specific groups felt to be “privileged”. I think it should be avoided! It’s divisive currently and medicine should be anything but that!
Physician (including retired)
[December 14, 2023 10:28 AM]
I would strike the entire statement:

"Physicians honour the humanity of the public by:
  • Bringing an intersectional lens to their daily processes and practices
  • Committing to allyship and striving to address discrimination and oppression in health care"

I find theses statements unnecessary ,overtly political and polarizing.

Physicians honour the humanity of the public by treating each individual with respect and kindness without discrimination.

The rest of it is just forcing code words for a misguided social political movement into a document that should be apolitical and reflective of common values among ALL physician
Physician (including retired)
[December 14, 2023 9:23 AM]
I would strike the entire statement:

"Physicians honour the humanity of the public by:
  • Bringing an intersectional lens to their daily processes and practices
  • Committing to allyship and striving to address discrimination and oppression in health care"
It is unnecessary and overtly political, not to mention polarizing. Physicians honour the humanity of the public by treating each individual with respect and kindness without discrimination. Period. The rest of it is just forcing code words for a misguided social political movement into a document that should be apolitical and reflective of common values among ALL physicians.
Physician (including retired)
[December 14, 2023 8:46 AM]
The section on Humility really seems out of place to me. While humility --being humble-- might be a good virtue in general, I do not believe that it represents a necessary professional behavior and I would remove this section and relabel it. Lifelong learning, for example, is not a feature of humility to me. Neither is providing safe and competent care. Neither is social accountability. Neither is resource stewardship. Neither is patient advocacy.

Interestingly, the section on humility also includes clear contradictions. For example, advocating for individual patients (which usually means advocating for them getting timely and quality care) is often diametrically opposed to resource stewardship (which in Canada means rationing access to care).

Overall, I find this document far too over-reaching and climbing dangerously into the area of prescribing narrowly how humans that have the title of "physician" must behave. The CPSO should focus on eradicating bad doctors that provide bad care and that harm patients and peers. The CPSO should not be in the business of telling people what to think and should not have aspirational social engineering goals.