Organization
[May 10, 2023 3:15 PM]
Ontario Medical Association (OMA)
Response in PDF format.
Organization
[May 05, 2023 9:20 PM]
FAIR Association of Victims for Accident Insurance Reform
Thank you for the opportunity to provide input to this preliminary consultation. FAIR is a grassroots not-for-profit organization of MVA (Motor Vehicle Accident) victims who have been injured in motor vehicle collisions and who have struggled with the current auto insurance system in Ontario.
 
The CPSO policy appears to be clear and easily understandable from a public perspective and the intent to minimize and address disruptive behavior is evident. It also appears to protect just some of Ontario’s patients.
 
What is missing is the mention of the word ‘clients’ or ‘subjects of examinations’ under Responsibilities to Patients, sections 4 and 5.
 
It is noteworthy that in the THIRD PARTY MEDICAL REPORTS POLICY the patients being examined are designated as ‘subjects’ and examinations are referred to as a professional encounter or service.
 
We see that the physicians who perform these Third-Party examinations have all the perks from the CPSO as do treating physicians such as access to CMPA if a complaint arises but car crash survivors in the claims process, a vulnerable group of traumatically injured patients, appear to be closed out of this behavior policy in regards to the Regulator’s expectations of their members’ behavior in Third Party medical settings.
 
We have seen many complaints about insurer IME/IEs or Third-Party reports and testimony in the past and many contain elements of abuse as described in the Policy at consideration here. Rude, profane, disrespectful, insulting, demeaning, threatening, bullying, or abusive language, tone, innuendos, and behavior, outbursts of anger, mocking, shaming, disparaging or censuring patients, colleagues, and others involved in the provision of health care and too often the repeated failure to listen to patients and to promptly respond to requests for information.
 
As a Regulator who is charged with protecting the public interest CPSO shouldn’t create a safe space for a small segment of their members who abuse Ontario patients just because they are in a situation where no ‘duty of care’ is owed to these patients. The absence of a ‘duty of care’ should not be seen as an absence of accountability or free pass to behave badly or abuse others.
 
Under section 4, the wording should include ‘subjects of examinations’ or ‘clients’ in the sentence “acting respectfully toward patients, subjects of examinations, their families, friends or visitors, and prospective patients…”.
 
Under section 5, the wording should include ‘subjects of examinations’ or ‘clients’ in the sentence “Advocacy for patients and clients both individually and collectively…”.
 
Thank you for your consideration of our concerns.
Prefer not to say
[May 05, 2023 3:21 PM]
Additional comment. Please note that the many of the behaviours listed in the Guidebook (e.g., early markers and information collected) are entirely non-specific. They could be seen or expected for a broad array of reasons, and do not actually evaluate the presence or severity of any disruptive behaviour. Indeed, these behaviours would be common in individuals being monitored or managed for disruptive behaviours. They would also be common in other individuals for a broad array of reasons. These sections should be removed or significantly revised. Ideally, more comprehensive evaluation of such observations would be performed by suitable professionals. The overall CPSO policy is clear, understandable, and to be congratulated for its intent in communicating the importance of minimizing disruptive behaviour, while the Guidebook provides good resources, insights, suggestions, and considerations.
Organization
[May 05, 2023 8:18 AM]
Professional Association of Residents of Ontario (PARO)
Response in PDF format.
Organization
[April 28, 2023 9:50 AM]
College of Nurses of Ontario (CNO)
Thank you for the opportunity to review and provide feedback on the physician behaviour policy and guidebook. Overall, the Physician Behaviour in the Professional Environment policy is clearly written, easy to understand and relevant. The responsibilities set out in the policy are helpful for articulating the practice expectations of the profession. We have a couple considerations that may support your update of the policy:
  • Under the “Responsibilities to Other-Care Professionals” heading, consider adding in disruptive behaviour towards new learners (e.g., students).
  • Under the “Disruptive Behaviour” heading, consider adding expectations related to diversity, equity and inclusion (DEI). For example:
    • Not acting on any stereotypes or assumptions
    • Identity factors and personal attributes based on the Ontario Human Rights Code.
In addition to the above, below are high-level responses to the disruptive physician behaviour survey questions.
  • Related to the “Responsibilities to Patients” heading, specifically the physician’s role of advocating for the patient, we suggest considering the following:
    • Advocating to improve the quality of the practice setting and the supports for safe patient care
    • Advocating for conflict management
    • Advocating for timely healthcare
    • Advocating for equitable and culturally safe environments
    • Promoting health relationships and advocating with the healthcare team by managing and resolving conflicts to ensure the best care is provided. For matters related to causes of disruptive behaviour, we suggest considering adding self-awareness, professional accountabilities, and modeling.
  • For matters related to burnout and mental health concerns, given the current state of healthcare demands, we agree that these are both important topics and can impact a physician’s behaviour. It is important for healthcare providers to self-reflect on their own health and seek help, especially if their health affects their ability to practice safely.
Please see below for feedback related to the Guidebook for Managing Disruptive Physician Behaviour:
  • Consider updating this resource as it is lengthy and may not capture changing societal expectations (e.g., DEI, and new roles and responsibilities from the broader healthcare team).
Thank you for the opportunity to provide feedback. Please let me know if you have any questions.
Physician (including retired)
[April 12, 2023 8:40 PM]
From policy: Disruptive behaviour: inappropriate words, actions, or inactions by a physician that interfere with (or may interfere with) the physician’s ability to collaborate, the delivery of quality health care, or the safety or perceived safety of others.

Comment: The phrase "perceived safety of others" is open to a range of interpretation these days, particularly when some people believe that speech is literally violence in some cases. In the current environment, it is not difficult to envision a physician receiving a complaint for saying something true that is now considered politically unacceptable and "dangerous" to some person or group of persons.

From policy (examples of disruptive behaviour): Arguments or outbursts of anger including throwing or breaking things. (In a footnote, the policy states: Respectful discussions, in which disagreement is expressed, are not arguments.)

Comment: Definition of argument, according to Merriam-Webster: The act or process of arguing, reasoning, or discussing; a coherent series of reasons, statements, or facts intended to support or establish a point of view. The word "argument" has no place in this policy. Whatever it intends to convey, this is the wrong word.

From policy: (examples of disruptive behaviour): Comments or actions that may be perceived as harassing or may contribute to a poisoned professional environment.

Comment: The emphasis on perception without consideration of intent is an unfair proposition, particularly in an increasingly politicized environment where some argue that intent does not matter at all and only the victim's (in this case, the person who believes they have been harassed) perception matters in understanding an interaction. I have been involved in cases where good faith feedback (from a manager or a teacher/instructor) has been perceived as harassment, followed shortly by medical leave and formal complaints. Relying solely on one person's perception is not reliable in all cases.
Physician (including retired)
[April 10, 2023 10:54 PM]
The Physician Behaviour policy is very well written and very clear. And I like how the word 'must' is in bold face. I don't think it requires any changes. Inasmuch as the CPSO is kind of a foreboding body, I read once that a hallmark of first world medical systems is the presence of a regulatory authority. Countries too poor to afford expensive pills or a functioning CT scanner do not have the extra cash to pay for oversight that is key to a high bar.

I do like the candid nature of the comments on this forum. To the point of GP's feeling dumped on by specialists, I've not experienced this personally, but I do wonder what would happen if the GP wrote back, "Order the investigations yourself - that is precisely why I consulted you." That might elicit an interesting conversation with the CMPA, who I think would lean towards the specialist being the responsible party. This is a murky area and I don't feel it could be easily worded into the CMPA policy. If GP's want this to change, then as a group they'd have to form their own CFPC policy, which sounds arduous but nevertheless useful. Maybe more specialists would burn out. haha.
Physician (including retired)
[April 09, 2023 8:14 PM]
The patient is first that we get it since our residency over and over again. Yes some credit should be given to the physicians as well for always managing unrealistic and sometimes inappropriate behavior of patients and their families in a professional manner.

Most physicians are responsible and brought up with critical evaluation in the residencies and usually have the skill and training to represent themselves professionally in an upright manner.

How the CPSO helps physicians have an optimal work environment, have the government enumerate us for our increasingly higher overhead costs and administrative time including excessive paperwork is something that should be looked into as well. The CPSO should also advocate for us to increase general physician well being and supportive environment for physicians.
Physician (including retired)
[April 08, 2023 6:23 PM]
Frivolous complaints against physicians at times due to the patient's unconscious bias towards the physician-often labelled as 'unprofessional behaviour' by the College. Context matters.

Similarly, the unavailability of timely access to primary care(even those registered with a FP)results in 'scapegoating' of physicians providing urgent care by frustrated patients. Directing such patients to seek longitudinal comprehensive care from their own physician rather than episodic care may expose one to a College complaint!
Physician (including retired)
[April 08, 2023 6:36 AM]
Section 8c “… Use, attempted use, or threat of violence or physical force with patients, colleagues, and others involved in the provision of health care…” should somehow be reworded. There are situations where force must be used in a careful, usually brief manner - for example when restraining a patient in the emergency department who is psychotic, severely intoxicated etc.
Physician (including retired)
[April 07, 2023 4:44 PM]
I agree with this completely. Too often, hospital admin/Medical Affairs try to silence physicians who speak out against policies or practices that are detrimental to the community they serve. Physicians have no recourse for this without great expense and duress.
Physician (including retired)
[April 06, 2023 11:43 AM]
“Physicians must act in the best interests of the individual.6 This includes acting respectfully toward patients, their families, friends or visitors, and prospective patients, even under stressful situations.”
There is an old adage that 10% of people cause 90% of the problems. And that is nowhere more true than in medicine. The small minority of people with rude and abrasive attitudes and behaviours and unreasonable expectations not only tax our health care providers mentally and emotionally, working as a leading cause of physician and nurse burn-out and attrition, but also take away resources from the other majority of patients who are not disruptive and demanding. This is either due to the more immediate resources diverted to placate the patient in order to avoid a CPSO complaint (whether it be time spent on de-escalation or conflict resolution around unreasonable behaviours and demands, or diagnostics and therapeutics only administered to comply with patient demands), or due to the greater impact of workforce shortages or compassion fatigue that are caused by the previously-mentioned burn-out. I suspect that putting undue pressure on physicians to accommodate and placate the unreasonable, verbally abusive and disruptive patients actually causes more harm to the majority of the patient population whom the CPSO is also charged to protect and for whom the CPSO should also be advocating, even if they by their nature do not file often frivolous complaints. While physicians should make reasonable efforts to de-escalate or negotiate with patients, I see no protection or even mention in this statement in support of physicians who act on behalf of the patient population as a whole by putting and enforcing limits on unacceptable patient behaviours and demands. Ultimately, the CPSO must recognize that health care resources (including time, and – yes – compassion and empathy) are not infinite, and should make its statements on professional behaviour with a view to improving health care delivery for ALL patients, not simply the ones who file a CPSO complaint.
Physician (including retired)
[April 06, 2023 11:32 AM]
This has been fantastic reading and one of the few times ever when docs are not inhibited expressing themselves on the CPSO website for fear of retribution. This forum has been an opportunity for internecine fighting between primary care and specialists with the latter taking their licks for dumping and downloading. I am a specialist who does primary care because my patients cannot see their family doctor in a timely manner or in person. I fill out forms , refer to other specialists because my patients are desperate.
Bedside manner is important, we cannot be robots for fear of "offending a patient". When 99/100 of patients enjoy some lighthearted humour that makes them feel at ease, we are forced to worry about the 1 person who reports and complains because they felt slighted.
I reject any supposition that I treat any patient differently because of the usual list of criteria. For 40 years, through several generations of families I have provided sensitive, empathetic and compassionate care to everyone I have the privilege of looking after. Nobody ever asks them. 40,000 patients, 5 CPSO "complaints".
The general theme I read is that we are vulnerable, exploited, threatened , defensive. Work should not be a walk in a minefield, yet this is where we find ourselves.
Physician (including retired)
[March 25, 2023 11:27 PM]
The problem is that physicians who are acting this way do not believe they are behaving inappropriately or negatively impacting anyone else so they do not see themselves in the policy. So the policy puts fear into people who don't behave this way and then those people are afraid to speak up for fear of being called inappropriate, disruptive or unprofessional and those physicians who don't get it and actually are 'disruptive' continue to act this way without consequences perpetuating toxic work environments for everyone. A physician complaint about another physician's professionalism is sure to be countered with an accusation of unprofessionalism for complaining.

This policy needs to make it clear that physicians are responsible for their own work and that it is unprofessional for them to dump work on other physicians. For example, a physician who is consulted by a referring provider and making recommendations for a patient that they intend to follow up with needs to order those investigations and action them themselves - not treating other physicians overwhelmed with their own work as their administrative staff or an underling. Similarly starting a medication needs appropriate follow up. If a medication is within your scope to prescribe, then prescribing it and monitoring for any complications of that medication is also within your scope - even if managing the complication is not - at that point you would refer to the appropriate colleague.

It should also be clear that physicians should directly quote what patients say about other health care professionals, rather than making a statement in the medical record that appears definitive about what a colleague did or didn't do or say as if it is a fact.

The word disruptive is problematic and stifles advocacy and innovation. Pick a different word. Disruption is necessary in a broken system to make it better.

The policy touches on lots of actions but misses a lot of inaction which is unprofessional and much more prevalent - for example, refusing to participate in process change or modernization or not communicating clearly to patients and expecting others to do this. Physician engagement is needed to move things forward.

Be clearer on when it is reasonable for a physician to stop providing care to a patient who has been abusive to them without being called unprofessional. What is the standard of behaviour for patients? What is reasonable for us to put up with under the guise of professionalism?

There needs to be a mechanism to point out unprofessional behaviour without it being a full on complaint with a goal of self-awareness and behavioural change. You are only hearing about a fraction of unprofessional behaviour for this reason (similar to mandatory charges for domestic violence reports....people just don't report because they don't want charges, they want help).
Physician (including retired)
[March 23, 2023 3:21 PM]
don't let that designation mislead you. The College is self-regulated, not physicians. If you really think physicians really "self-regulated", you are living in clouds and need to stop dreaming.
Physician (including retired)
[March 18, 2023 3:43 PM]
I am concerned about the statement "Physicians must act in the best interests of the individual. This includes acting respectfully toward patients, their families, friends or visitors, and prospective patients, even under stressful situations."

The MUST is concerning. At times, we do face abusive, aggressive patients or their family members doing the same. Our safety should not be superseded by anything. At time we need to exit the situation. Doing so, for our own safety, should not be against CPSO policy if exiting is not in the patient's best interest
Physician (including retired)
[March 17, 2023 7:57 AM]
Agree with all above. Patient was followed by eating disorder clinic I referred to and specialist would not fill out forms for patient. Specialist never sent consult letters so not only did I have to fill out form that was not something I was the main treating doctor for and had to guess at management, I had to bring patient in for an appointment to find out what exactly was happening in treatment. Waste of patient time and mine. And this happens many times. As well specialists such as adhd doctors who monitor meds by phone but ask patient to see me every dose change for vitals check…why can’t they do this if prescribing? I have also always felt like t was unfair to refer patients back to me for staple etc removal post op. I have no nurse, sometimes this takes an extremely long time depending on the extent of surgery, and when there is an area that has a problematic spot such as wound opens when staples removed, I can’t do much and surgeon needs to be accessed. This has used often half an hour or more of my time. Surgeons have nurses and residents who can do this. This should be part of their post op care.
Physician (including retired)
[March 14, 2023 10:43 PM]
Like any other profession, we need to be held to a standard of conduct, and in principle, I agree with this policy. The question that needs to be addressed is around who defines the disruptive behaviour and who is involved in evaluating that behaviour and the process by which that gets resolved. In some cases, hospitals have used the code of conduct process as a tool to manage what is painted as disruptive behaviour to serve a purpose and other physicians who clearly have disruptive behaviour continue to work because they are needed or favoured by the hospital to fulfill a service.

Physicians should be allowed to and protected when they advocate for patients, both within hospitals and publically. We are expected to work in substandard conditions, often under resourced and not able to speak up. Any advocacy must go up through a chain of communication which is controlled, and private, within the hospitals, without any checks and balances. Physicians are muzzled to speak out with the code of conduct process. This process, which is needed, should have more than administration as the judge, jury and executioner. Medical Staff Association should hold real power or presence and have a voice.
Physician (including retired)
[March 11, 2023 7:39 AM]
Hello,

As a family physician I am often feeling overburdened by specialists downloading their tasks to me. Usually these are tasks that are unpaid, but time consuming, that the specialist simply prefers to avoid, leaving me to do unpaid work to their benefit.

I am often getting requests to order investigations such as imaging or bloodwork related to the work up that a specialist is conducting. They may ask me to order a test that is outside of my scope of practice, then forward them the result. This is an inappropriate use of my time, it is purely administrative and should be handled by their office.

Another inappropriate request is for staple and suture removal/ post operative follow up - this is part of the surgeon’s responsibility and should not be delegated to the family doctor.

Lastly when a patient requires forms/notes for time off pertaining to a specific medical condition- it should be the physician managing the condition in question who completes the forms based on their assessments. Sometimes it is falsely assumed that all forms should be done by the family doctor, but again this is simply a delegation of an unpaid, or poorly paid, task that a specialist prefers to avoid.

In the atmosphere of family doctors feeling undervalued and overwhelmed, in one of the lowest paid areas of medicine, and an evolving massive shortage of primary care physicians - there needs to be a culture shift where specialists do not feel entitled to download their undesirable work to us.
Physician (including retired)
[March 10, 2023 7:49 PM]
Hello,
I wanted to send an email to add my voice of fed up family physicians experiencing “dumping” from physician colleagues.
It’s problematic because it adds to burnout, devaluing of family medicine (we are not their admin, resident or nurse), adds to rising overhead costs and is not good for patient care. It delays patient care, affects the relationship as well because there is confusion about what and who is responsible for what.
 
Some examples:
  • consultation to psychiatry. Psychiatrist asking me to do blood work for xyz and to prescribe a medication - telling me the dose, etc but has follow up in 4 weeks or whatever (I’m not talking about a one time consult), they want me to send the rx for their visit, have a follow up and tell me what med change needs to happen, follow up and repeat
  • cardiology informing patient to call my office to get instruction on beta blocker for stress test they ordered. Patient followed by this cardiologist on a regular basis for cad
  • internal medicine asking me to order a chest X-ray and thyroid nodule that they detected on their exam (I did not)
  • orthopaedics and neurosurgery asking me to remove staples, sutures for their surgical patient in the same vicinity/city
It’s sad that it has come to this point.
That we see so many fantastic family doctors leaving comprehensive primary care. The administrative load is a big reason. Family doctors have rising costs with overhead, we have lots of tests to order and things to follow up on. We can’t also be responsible for ordering, prescribing or doing other doctors work.
Physician (including retired)
[March 10, 2023 9:50 AM]
Hi,
I am a family doctor in a FHT in Toronto.
I along with my Family doctor colleagues I am frustrated with the behavior of certain specialists who basically treat family doctors as interns as they dump work on us. This is adding to the burnout of family doctors and the early retirement or leaving comprehensive longitudinal care.
Often we are asked to follow up on results ordered by the specialist, asked to order investigations for them before their visits or prescribe medications that the specialist could have prescribed when the patient was there. They send the patient back to the family doctor if they feel the patient should be referred to another specialty when if that is of their opinion they can do this as well. They will not fill out forms that may be more appropriate for them to fill out. I have too many examples to put in an email. It should be the responsibility of the doctor seeing the patient to follow up on these and not make more work for the family doctor or their administrative staff who are already inundated with work and calls.
Family doctors are overworked and exhausted. Adding to their burden of work does not help and is a major reason why we are leaving primary care.
This needs to be addressed now as it will take years to fix. We do not have this luxury of time with so many without primary care physicians.

If you would like more examples I have collected many from my colleagues and can get many more. I have permission to share these with you.
Physician (including retired)
[March 09, 2023 11:52 AM]
Physicians are privileged to be a self-regulated profession. The CPSO is bound to act in accordance with the wording and spirit of its enabling legislation. I think what the CPSO should do is clarify what constitutes unprofessional behavior, particularly towards fellow physicians. As privileged members of society, each physician has a role to play in upholding the CPSO mandate and we should start with role modeling this within our own member society. This means that our inaction can be as viewed as unprofessional as our actions. This “reset” way of thinking will take some education.
Physician (including retired)
[March 08, 2023 2:24 PM]
When I have been a patient (and you know, sometimes we switch roles), I don't know any doctor that put me first. Some of them don't even want to treat me as soon as they find out I am another doctor - being too scared of this organization as I guess doctors file more complaints against other doctors. Putting the patient first "always" doesn't work like in the real world.
Physician (including retired)
[March 08, 2023 2:22 PM]
“when providing care to a patient, a physician should always put that patient first.”

Is that a new oath? because I still go by the Hippocratic oath. You shouldn't try to redefine a 2500 year old oath for us.

by the way, the only 2 people in this world that I ALWYAS put first are my 2 toddler kids. key word being "always".
Physician (including retired)
[March 07, 2023 8:02 PM]
I read the policy as existing, thinking it was a new policy you had written requesting consultation on. I was shocked. Why was it so simple, straight forward, and reasonable? Where were all the secondary documents clarifying all the ambiguous newspeak? Why was there no mention of critical race theory and microaggressions? Where was the pandering, self-contradictory political agenda?
 
Then I realized I was reading the EXISTING policy and it all made sense. The EXISTING policy was likely written by normal people and normal doctors trying to create a reasonable policy a few years ago so that it would make clear sense to any average person and no one would find disagreeable.
 
Why specifically are you interested in revising it now?
 
What specific problem do you think it is not solving already?
 
Let me guess.
 
The "problems" with this policy as the current CPSO would define them:
  • No mention of critical race theory.
  • No insinuation all doctors are secret racists and bigots who must constantly atone for their existence.
  • No presumption of guilt for doctors before proving innocence.
  • No vague, unprovable, and indefensible political weasel terms like "microaggressions."
  • No requirements for doctors to be active political activists against the so-called "microaggressions" of others.
  • No requirements for land acknowledgements, recognizing intersectionality of oppression, or being cognizant of climate change.
  • No statements that doctors should defer our judgment to the patient under all circumstances (even if their requests go against our best judgment).
  • No 2000 word secondary summary of all the ways such contradictory political doublespeak should be interpreted so that it can be used by the CPSO to selectively punish doctors when needed.
I can already predict the new version. Your pattern of behaviour has been consistent over the last few years. Whoever has hijacked the CPSO is constantly and overtly trying to write their political activism into our policies and it is corruption.
 
Please stop this nonsense and return to the days when this original policy was written. Ie. When the goal was not political indoctrination and enforcement but rather simply ensuring doctors are providing safe and reasonable care that would be defined as such by any person of any background in the public.
 
There is a common standard of professionalism that applies to all people regardless of ideology, and that is the standard already defined by this policy. That is the only standard that should apply.
 
But let me guess: That's not what you're here for anymore is it? That's not why you ran to join the CPSO is it? Ask yourself if your behaviour is ethical and if not, correct it. If you don't have honourable intentions, please stop corrupting the CPSO, and let someone else do the job more honesty instead.
 
Those of us who actually care about patients and medicine sufficiently to practice full time rather than engage in political bureaucracy to escape the medical office and hospital do not need this nonsense. For the CPSO to be credible and useful for the public and doctors it must remain politically neutral and practically oriented.
 
There is no significant, objective, or politically neutral problem with the existing policy.
Physician (including retired)
[March 07, 2023 12:25 PM]
As physicians, we are held to a high standard however the pendulum had shifted to the point where doctors feel always Venerable and threatened and unable to function appropriately.
Physician should put patient first but also patient should have accountability for their actions too.
Physician should have recourse for trivial and vindictive complaints.
Physicians should have the ability somehow to defend themselves in public forums also rather being blackmailed by certain websites and this is a fact well-known to the college.
Physician (including retired)
[March 07, 2023 10:03 AM]
I believe the standards in the policy are sound. I understand the concern about frivolous complaints but that is very difficult to deal with. We must let complaints be voiced and reviewed. If we do not address them in a fair and transparent fashion we will lose our credibility of impartiality. There might be a way through the legal process to address frivolous complaints so that who have submitted in a malicious manner can be held accountable--but that in itself would be a long and arduous practice. It may be that we just have to live with it and hope that our practices and communications skills do not open us up to complaints, frivolous or not.
Physician (including retired)
[March 07, 2023 9:55 AM]
I agree with the content no changes needed
Physician (including retired)
[March 07, 2023 7:57 AM]
Physicians should be held to a high standard of behaviour but should also be supported not persecuted by the College. Physicians should be allowed to advocate against institutions and government about policies that they feel are unsafe or impede patient care and should be supported in doing so. Physician safety and appropriate patient behaviour should also be supported. Physicians should be protected from unsafe/threatening patient behaviour and threatening institutions that muzzle physicians and the College should support this also.
Physician (including retired)
[March 06, 2023 4:46 PM]
“when providing care to a patient, a physician should always put that patient first.”

Everything is a balance in life. Absolute statements like this are too idealistic and improbable. Things do not work out that way in real life, and hence make the policy impractical and thus ignored. The wording should be tweaked a bit by perhaps adding the word "reasonably" before always.
Physician (including retired)
[March 06, 2023 2:34 PM]
Everything seems now walled against a Physician whereas it was the five A's when I started it has snowballed into, you think it, they have got it. At no stage do I say the Physician's ethos of Professionalism needs to change but Society has changed, and Abortion laws have changed.The College need to consider the impact of more complains in the future,the cost of it and whilst fully supporting the right to complaint, there is no recourse for Frivolous complaints despite the fact that PTSD is a common occurrence when complain about!
Physician (including retired)
[March 06, 2023 1:52 PM]
As physicians, we are held to a high standard. This policy serves to exemplify our behaviour within the public sphere as it should be. However, there are a few items tat should be clarified or modified in the policy. One that stands out is:

Our responsibility to our patients is primary, and is clearly stated early in the policy. At the same time, this must ensure our personal safety, both physically and mentally. I would change the first part where "Physicians MUST act in the best interest of the individual" to one where they should act in the best interest of the individual as long as they are safe, under no duress, and can do so without psychological harm.