Organization
[August 31, 2021 11:36 PM]
Ontario Medical Association (OMA)
Response in PDF format.
Organization
[August 29, 2021 10:33 PM]
Medicinetoo
Response in PDF format.
Member of the public
[August 27, 2021 5:41 PM]
Response in PDF format.
Member of the public
[August 27, 2021 3:56 PM]
Under this proposed policy could College consider discipling the OMA for its recent online suggesting that the vaccination status of patients could be shared without the patients' consent? It is an absolutely obscene suggestion by the OMA.
Physician (including retired)
[August 26, 2021 9:39 PM]
The old policy was quite good... The current policy is MUCH more over-reaching with limitations than the previous version and gives the overall impression of limiting free speech. These policies have a lot of power during any complaints or investigations process and can be finely combed word-for-word to find causes for discipline. Given that most new policies apply stricter and stricter limitations on what physicians must or must not do, it is crucial that there be added statements protecting physicians, outlining what we CAN do, to help establish the line of "reasonableness" or the "right touch" as sought by the college. There are already many comments on this board outlining problems with the policy regarding free speech, impingement, etc. and so assuming the college won't be abandoning the plan to revamp the policy I will instead suggest to the college a few solutions to improve it instead: -> I highly recommend adding a paragraph at the beginning of the policy or advice document stating the desire to find the right balance between free speech with professionalism and respect, in order to set the overall tone of the policy NOT to give the impression of impingement of free speech. It is worth stating the Charter of Rights and Freedoms and the right to free speech that a physician has, to which we are applying our medical values of professionalism, respect, and all the CANMEDS roles, etc. -> To even the tone of these documents, and all policies for that matter, I recommend the college consider listing examples of what physicians ARE permitted to do to help counter-balance the ever-growing list of the "must NOT do" items. In this policy, for example: - express your opinions on world events - engage in respectful discussion about emerging or unconventional medical therapies - speak with personal family members or friends with their own reasonable expectations for personal privacy in those conversations Other issues 1) Posting information that retains our ability to express our medical opinion even if it constrasts with the mainstream medical narrative (lines 62-64). While this may cause "mistrust" among public, science and medicine are built on discussion and weighing opposing opinions or evidence for vs against a particular theory/therapy. There needs to be a permission to engage in this discussion as it pertains to medicine in all platforms including social media - yet this can certainly be done professionally and respectfully. 2) The policy may also be over-reaching by including material that "might be percieved as" racist/discriminatory or microagressions etc. as this depends on the users interpretation of the material. It would be worth adding a statement about accepting that we cannot control how what we say could be interpreted, or adding a note on how to react professionally and respectfully to concerns with our content as pointed out in the C.A.R.E.S acronym from the Temerty link. Thank you for inviting feedback on your policies and for reading all our comments carefully for consideration.
Organization
[August 26, 2021 1:29 PM]
OMA Section on Plastic Surgery
Response in PDF format.
Physician (including retired)
[August 25, 2021 10:28 PM]
You need to define social media more narrowly. My communication with my family on Whatsapp for example is under normal circumstances none of your business and has no bearing on my capacity as a doctor. You also need to distinguish between personal and professional use of things like Facebook. Yes, it is entirely possible to maintain two accounts on most services - eg. one for your clinic if you are choosing to use it for that and one for your friends and family. As long as I'm not giving medical advice on my online account then I should have the right to use it personally and that also shouldn't be your business except in the most extreme situations which would honestly be improbable to encounter. Lack of professionalism should not also be defined by whether or not a doctor's opinion on something "causes offense" in some member of the public but rather some objective measures. Anything can "cause offense" including appropriate medical care in our job depending on the public person's perspective. Someone being offended does not automatically by definition mean a doctor has done anything wrong. If I counsel someone for example on their uncontrolled worsening diabetes and include advice around weight loss, I can be as sensitive as possible, but if they have a preconceived notion this is "discriminatory" then they may be offended no matter what I say. Such an offense would not mean on its own that a complaint by them would be justified. That is true in our regular office practice and it is true online. I feel like you have vastly expanded the criteria by which we can be judged "unprofessional" in this document way beyond even the standards applied in our regular office practices which is bizarre to me. What is the purpose of this? Were you not receiving enough complaints about Ontario doctors as it is? I had heard CPSO complaints have been going up annually every year for a while now. Is the goal to increase the volume further by allowing more and more complaints for any negative subjective sensation in any member of the public's mind? You are essentially saying our speech on "social media" (ie. any online communication, even with our families) must be even more highly regulated than when we are working as doctors, which is crazy. When we are working as doctors is when the highest standard ought to apply, as that is us in our professional function. When I am talking to my kids or wife on a text app, there is no justification for even higher levels of CPSO oversight, or really any type of CPSO oversight under any normal circumstances. Let's have a reasonable policy that protects the public while also recognizing doctors are not robots but rather people with our own lives to live. The CPSO should not want to be regulating every aspect of our personal lives for little good reason. Is there some hidden epidemic of problems being caused by doctors talking candidly to their families on Facebook and Whatsapp that we are not aware of? If so, could the CPSO explain the reasoning for why this must be so tightly now regulated? Or if there is no such epidemic of problems, can the CPSO recognize they do not need to regulate places of our lives where there are no relevant problems occurring?
Physician (including retired)
[August 25, 2021 9:58 PM]
I am concerned about the increase in anti-Semitism in society at large and in medical publications in particular. I concur with the suggestion made to the CPSO by DARA that the IHRA (International Holocaust Remembrance Alliance) definition is helpful in trying both to understand and to define what constitutes anti-Jewish prejudice (antisemitism). The IHRA definition is an anchor as an interpretative tool. I believe that it should be adopted by the CPSO as part of its new policy on social media.
Physician (including retired)
[August 25, 2021 4:37 PM]
This is a timely moment in history of the world for CPSO to adopt DARA’s proposed inclusion for recommendations regarding Social media platforms addressing Anti-semitism and specifically includes its definition This should be enshrined in a code of ethics It is not enough to be civil and professional Anti-semitism should NEVER be tolerated
Physician (including retired)
[August 25, 2021 4:14 PM]
I share the views of many that this exercise is fraught with difficulty balancing free speech with the need to root out hate speech, and allowing physicians to reasonably be able to say vs speech that might bring the profession into disrepute. It is education that is the key! I look forward to more in the area of education. Given the spate of incidents recently that are reportedly anti-Semitic and/or leading Jewish students and others to feel threatened and under attack, I advocate for the formal adoption by the College of the IHRA (International Holocaust Remembrance Alliance) definition of anti-Semitism, as countless other governments and institutions have done worldwide, in order to assist the College with adjudicating matters that arise, where this may be relevant. There may be a need for something similar in other areas of hate speech but I am not aware of anything that is as universally accepted as the IHRA definition is, in the case of anti-Semitism. And did I happen to mention that I believe education is the key? Good luck!
Organization
[August 25, 2021 10:55 AM]
Professional Association of Residents of Ontario (PARO)
August 24, 2021 Thank you for the invitation to provide feedback on the CPSO Social Media Policy Draft and Advice to the Profession: Social Media. Overall we found this policy and advice document provides clear guidance to physicians, and clarifies many of the questions we had regarding the existing Social Media policy. We do have suggestions for areas that may need further consideration or clarification: Advice to the Profession: Social Media • The document advises that physicians who see colleagues posting content that might be in contravention of the policy should reach out to the physician to suggest they remove that content. While we believe the advice is sound, it is unclear to us to what extent the CPSO believes that physicians have a responsibility to in some way respond to content posted by their colleagues. In this same section, the document advises that where physicians have the ability to moderate comments, they use their judgement to do so where necessary; similarly, we wonder whether the CPSO views this as an obligation, or as a best practice for responsible use of social media. • The document seeks to clarify what is meant by the "reputation of the profession" as laid out within the policy, noting that the determination is contextual and that the CPSO will use a number of guiding documents as a framework. We appreciate the effort to provide further information, though we still found this section to be too vague to provide usable, easily actionable guidance for physicians. We believe more specific guardrails are required to be actionable by users of social media. • The document states that: "In some circumstances, physicians expressing opinions that contradict generally accepted views can cause confusion and mistrust among the public and impact overall public health and safety." While we appreciate that the intent of this language is likely to combat medical misinformation, we are concerned that the phrasing of "contradict generally accepted views" may present an unacceptable limit on physician advocacy that is both necessary and appropriate. The nature of advocacy necessitates sometimes speaking out against commonly held views and systemic norms in order to enact change - and this may, at times, involve questioning elements of common medical practice. If the intent is specifically to limit the expression of views that do not have appropriate scientific evidence or may cause the public to take actions that put their health at risk, we would suggest this be made more explicit. Social Media Policy • 7.a.i - This section sets out that physicians must not disseminate information that is misleading or deceptive. While we agree in principle with this statement, we do wonder about how this requirement might limit healthy debate over the outcomes of trials or new research. In scientific fields, information is often evolving, and data requires interpretation. Physicians often have healthy debates about results of studies or trials, which is part of the scientific process. Some individuals may find certain conclusions of studies to be misleading, while others may not; in our view, this process is part of the appraisal and evaluation of the quality of information. Further, not all individuals will have the scientific education to appropriately interpret scientific data. We wonder about the potential responsibility of physicians who share scientific information that is new, controversial, or emerging, but do not intend to provide misleading information. In short, the CPSO should be certain that the guidelines are not more or less restrictive or permissive in social media than what is appropriate to any format. We do, as always, appreciate being included in the CPSO's consultative process.
Member of the public
[August 25, 2021 10:25 AM]
This policy and advice does nothing to address the lack of clarity between advocacy and advertising on social media. This is a key area that needs to be addressed, and frankly needs to be completely re-imagined. I believe that the CPSO and other governing bodies in Canada should be encouraging physicians to be advocates of health on social media rather than police them. Unlike television, radio or even websites where we can limit the amount of spill-over content from the US, social media is global so Canadian patients are seeing and being influenced by content from around the world. There is far too much misleading or incorrect information being disseminated on social media by non-medical, so-called "experts". There are many US-based "doctor influencers" on social media with massive populations of Canadian followers that are actively advocating for patient health, yet there are so few Canadian physicians doing the same. This can be partially attributed to restrictive and out-of-touch policies such as this. For example, when it comes to self-care OTC/BTC/NPN/Personal Care products, social media is flooded by "influencers", many of which are paid by industry to promote specific brands and products to the general public. The impact these influencers have on the patient population may at times be detrimental to patient health. Physician's should be encouraged to get online and advocate for patient health and help patients navigate the complex self-care drug store aisles. They should be encouraged to recommend or display specific products or brands in their posts that are approved for use in Canada and present factual, evidence-based information about them to patients. They do this within the confines of their clinical practice but when it comes to social media, based on the regulations and policies, this can be perceived as advertising and/or "unprofessional". We also need clarity on "paid partnerships" in social media. Paid partnerships are a norm with non-medical social influencers and have become a norm with many US-based physician influencers as well. I've recently seen several paid partnerships with Canadian physicians promoting various personal care products on Instagram and TikTok. What are the rules and policies around social media paid partnerships between physicians and industry in Canada? It seems to me that this sort of activity circumvents the policies and guidelines, though nowhere is it spelled out clearly and you would have to navigate various websites to try to figure out whether a paid partnership can be considered advertising or advocacy. Is it the nature of the content that would determine if it's advocacy or advertising or is the fact that the physician is paid to post content that automatically qualifies it as advertising or a conflict of interest? As there are Canadian physicians actively partnering with industry on paid partnerships, I assume it is either spelled out clearly somewhere or not clearly at all. This policy and advice does not cover any of this and if you are drafting a new policy, it's an area that requires distinct clarity and examples.
Physician (including retired)
[August 24, 2021 11:16 AM]
Response in PDF format
Other health care professional (including retired)
[August 23, 2021 2:30 PM]
Thank you for opening these documents for public consultation. I feel that, for the most part, they cover the concerns I've had about physician posts on social media, especially within the current public health environment. I particularly like section 5 in the policy document as I feel it addresses the inappropriateness of content of quite a few posts - including by prominent physicians - that I have read. Although I'm not a physician myself, I also feel that the expectations set forth in the policy document are quite reasonable and within the ability of physicians to meet. Physicians are educated and intelligent people who should be more than capable of advocating, commenting, providing information and responding to (even unfortunate, vitreolic or inappropriate) rebuttals in an intelligent, professional and respectful manner - so I don't think the expectations in the policy document are unattainable. Just a note to perhaps consider adding in the supporting Advice document...at times, refraining from saying anything at all might be the wise thing to do, even if one is/feels slighted or insulted by a response or comment - it's unfortunate when this happens but use of social media carries the risk of it occurring. I'm sure physicians are aware of this risk when they use social media. Sometimes, as the document mentions, an insulting response could be an opportunity to redirect the exchange in a constructive manner...but if you can't think of a professionally appropriate way to do that, silence is sometimes the least harmful response. There are two areas I might suggest changes, please: 1) In the policy draft, section 5, lines 46-48...several areas for potential discrimination are listed...I wonder if you might consider adding "Profession" in there...I've seen physicians post insults and other remarks about other professions (including but not limited to complementary/alternative medicine fields) that could be condoned as discrimination but are not supported by evidence. I've also seen physicians deny invitation to review suggested (scientifically solid) works from valid, regulated health professions, basically deeming - in language that leaves no doubt about how they feel - that profession's work, research, regulatory and education framework unworthy without having reviewed the suggested source or the profession's body of work. Whereas it might be appropriate for an informed physician to provide respectful constructive opinions or feedback on the work of another profession, I feel this 'slamming' of - at times basically laughing at - other professions is unprofessional and uncalled for and physicians should refrain from doing so. Therefore, please consider adding 'profession' to the list of possible areas for discrimination in section 5 of the policy draft. 2) In the Advice document, lines 91-96....I feel this section should be included in the Policy document as a must, not an 'advisable' course. If a physician has a concern with comments that an individual is making - particularly if that individual is a colleague or another health care worker - and feels that this concern requires action beyond a rebuttal/response on social media, that physician should first contact the individual to discuss it privately with them prior to escalating to the body to whom they are responsible. If after speaking with the individual the physician deems escalation necessary, this should be done in a professional manner - a respectful private communication to the organization/body to whom the individual is responsible - and NOT, for instance, through a comment that is defamatory to the individual or the body/organization to which they report on that, or any, public social media platform. Thank you, once again, for the opportunity to comment on these two documents.
Organization
[August 10, 2021 9:20 AM]
Office of the Information and Privacy Commissioner of Ontario (IPC)
Response in PDF format.
Organization
[August 06, 2021 1:07 PM]
Doctors Against Racism and Anti-Semitism (DARA)
Response in PDF format.
Physician (including retired)
[August 05, 2021 2:35 PM]
Physicians who use social media for both professional and personal use should have 2 separate accounts. Also M.D.'s should not use social media to criticize or attack colleagues or patients. Physicians should not use social media to speak on behalf of other people or organizations without first asking their permission. I would also like to address the rate your doctor web-sites which in my opinion have done a lot of harm to good doctors . the C.P.S.O should address this issue in their new policy. Does the physician have a right to respond to malicious social media posts that are put online by a disgruntled patient?
Physician (including retired)
[August 04, 2021 2:11 PM]
Thank you for your efforts to provide guidance to the profession on this increasingly important issue. It will be important to clarify what is meant by "professional" discourse, and "the reputation of the profession" and that neither of these statements is meant to enforce conformity at the expense of important and often essential advocacy and debate. I believe that what the policy intends is to remind physicians who identify as such on social media that they have a responsibility to convey information that is informed, evidence-based, and within their scope of practice, unless they clearly state they are commenting on an area where they do not have relevant training or expertise, and are therefore simply offering an opinion. If the latter, I believe it is reasonable that if the opinion directly contradicts current and well supported medical research that the individual either does not use their professional account to disseminate but limits such content to a personal account where they are not self identified as a physician, or alternatively makes it clear they are offering a personal - rather than professional - opinion outside their area of clinical expertise, which is contrary to current medical scientific understanding of the issue.
Other health care professional (including retired)
[July 30, 2021 6:33 PM]
Great post. All good, valid questions
Other health care professional (including retired)
[July 30, 2021 3:31 PM]
The problem is when "verifiable and supported by available evidence and science" becomes open to interpretation depending on the political feelings/agenda of the reader. During covid, I feel we have lost the ability to have a discussion with one another. We've lost the ability to agree to disagree. It has become easy to call someone "dangerous" and "possibly misleading" if you simply don't agree with them, due to the nature of the public health issue One physician could post their concerns about the covid vaccine and deem to be incorrect and "not following the science" Another physician could also make a post praising the safety of the covid vaccine and also be deemed incorrect and "not following the science" Science is discussion. Sometimes disagreement. Science involves citing your sources, rather than making commands without supporting information for why you are making these commands. I don't want to see physicians silenced anymore. I want to know the opinions of physicians, whether I agree with them or not, because they have valuable insight the public is not privy to.
Physician (including retired)
[July 30, 2021 11:46 AM]
I agree with many of the comments below that this policy is an overreach of the CPSO's mandate. Professional organizations exist to protect the public from negligent ot inappropriate practice of the profession. This mandate has hypertrophied over time. These organizations have become politically driven and with this policy wish to micromanage physicians' lives. This is an impractical policy that in its application will lead to the arbitrary application of the world-views of a plitical élite. Most scientific ideas begin as marginal, unsubstantiated hyptheses. Once a scientist was thrown in jail for expressing his opinion that the earth was round. It was not the prevailing scientific opinion. At the beginning of the pandemic the health ministry and physicians representing our institution ridiculed a colleague and myself for expressing our opinions that masks were necessary and that asymptomatic individuals could transmit the virus. Under this policy my colleague and I could be sanctioned. THE COLLEGE SHOULD ONLY REGULATE PROFESSIONAL BEHAVIOUR IN THE EXERCISE OF A PHYSICIAN'S PROFESSIONAL ACTIVITY.
Physician (including retired)
[July 29, 2021 8:52 PM]
"disinformation" is that information you don't agree with?
Member of the public
[July 29, 2021 8:12 PM]
Wonder if the college has ever heard of civil liberties? Silencing people is a violation of human rights. I wonder if unpopular opinions in places like Myanmar should also be silenced. That way we can just keep listening to popular opinion. In the end all comments can be offensive to an individual, literally anything. So what is the plan? Someone puts their hand up to complain about a comment and the College steps in? Why? Or is this only for comments that are made in relation to medicine. Can a political statement be made? Come on CPSO. Do you not have enough of a history of bullying and causing physicians stress and anxiety over your overzealous probing.
Physician (including retired)
[July 29, 2021 12:37 PM]
I am glad to see this issue being discussed given the amount of disinformation being propagated by some of our colleagues during the past eighteen months of the Covid pandemic. Speaking as an MD on social media demands that the information presented be based on the science and the evidence and does not seek to undermine the public good. I think the intention of the document is good and necessary. The negative media reports on the policy do not, in my view, actually reflect the document itself. I think, for the most part, the document/policy is fair and reasonable. Sometimes it strays into a little "Big Brother" territory and attempting to determine what is profane, for instance, is going to be open to interpretation and appropriate challenge. Calling for separate personal and professional accounts is ridiculous and doesn't reflect today's reality. All in all, a good document. Thank you.
Physician (including retired)
[July 29, 2021 11:24 AM]
Physicians should be able to post on social media as private citizens, including a full range of political and religious views; as long as one don't identify as physicians while doing so. If one is speaking as a physician, abiding by CPSO policy would be appropriate and necessary but the policy itself is too restrictive, tantamount to silencing.
Physician (including retired)
[July 29, 2021 10:14 AM]
"Social Media" needs to be clearly defined. A private WhatsApp chat group should not be considered "Social Media." Does the CPSO really want to get embroiled in the private lives of its members??
Physician (including retired)
[July 29, 2021 10:08 AM]
Any proposed or existing CPSO regulation/policy cannot run afoul of the basic rights of all Canadians (including physicians) as enshrined in the Canadian Charter of Rights and Freedoms. Here is a recent landmark US Supreme Court decision related to the first amendment rights (freedom of speech) of a high school student who took to social media to protest: https://www.supremecourt.gov/opinions/20pdf/20-255_g3bi.pdf
Member of the public
[July 29, 2021 9:52 AM]
There is now a full-on assault on free speech in Canada by the gov and the elite. Examples are the gov bills C-10 and C-36. It's not coincidence that College is doing this too now at this point after its threats to suppress an disagreeing physician opinions on controversial things like lockdowns and forced masks. when you can't win with better ideas, those in charge resort to censorship. For those of us who lived in oppressive regimes before coming to Canada, this is classic authoritarianism. unfortunately it's taking much longer for people who never lived under those regimes to clue in - too much cognitive dissonance. My past experience from these consultation is that, they always go nowhere. The College does what it's supposed to do based on gov and politically correct mandates and these things are just an illusion of a democratic process.
Physician (including retired)
[July 29, 2021 9:35 AM]
I am concerned about guideline #5 which speaks regarding "unprofessional" behavior. This vague unclear wording and does not clearly identify if matters whether it is from a professional social media profile or a personal one. I do not think the college should have any say regarding the policing of personal social media if it has nothing to do with patients or medical advice.
Physician (including retired)
[July 23, 2021 7:44 AM]
"Physicians must conduct themselves in a respectful and professional manner while using social media." Who decides what is respectful and professional? You may recall #medbikini where, under the guise of research, the authors spied on women physicians' personal social media accounts and reported them as unprofessional for wearing a bikini. Too often, "respectful and professional" is defined by the powerful few and used as a whip against marginalized people, whether it's women or BIPOC. The College should stop physicians who spread medically inaccurate information such as antivaxxers, but it's not up to you to censor me and every other physician out there with your arbitrary and vague standards. You should allow the membership to define respectful and professional. I have used social media to encourage masking and vaccination and speak out against racism, all of which are important health issues. Many physicians discuss cases privately online in order to provide better care. If you trust physicians with your lives, why can't you trust us with using social media? The College uses the stick instead of the carrot 99% of the time. I'm extremely wary how you will define and enforce this new policy.
Member of the public
[July 22, 2021 4:38 PM]
These are the comments I provided within the survey itself: he term "disruptive behaviour" is not only insultingly paternalistic; it is equal in ambiguity to the obnoxious term "hate speech." Both concepts are so open to arbitrary interpretation and prosecution as to have NO place in a free and democratic nation-state, which Canada USED TO BE. I am certain that 99.99999 % of Canadian doctors are mature professionals not only entitled, but expected, to provide their own thoughtful conclusions and perspectives on all matters of health science and patient care. So this very notion of trying to gag what they say in the name of "collaboration" or "safety" is frankly ridiculous and downright dangerous. Physicians, like everyone else in Canada, must remain free to speak their minds on any subject. Let the public "health care consumer" decide whether or not they find him or her credible. That is how a free market is supposed to work. These are "loaded" questions, designed to give free licence to the prevailing, accepted "narrative" already being enforced by the pharmaceutical industry and its countless political and bureaucratic puppets, all falling in line to do as they are told. This set of questions presupposes agreement that there will be times that it will be acceptable for any physician to access anyone's health information, without consent. All of my previous comments apply here. I reject the very premise and purpose of this entire project aimed at muzzling "diverse" opinions of Canadian doctors.
Organization
[July 22, 2021 10:53 AM]
The Canadian Medical Protective Association (CMPA)
Response in PDF format.
Physician (including retired)
[July 20, 2021 9:59 PM]
"As a physician, while you can express your personal views or show support for opinions expressed by others online, your conduct will need to be guided by the values of the profession articulated in the Practice Guide and the expectations set out in the policy." It states we may only express our personal views IF THEY DO NOT VIOLATE THE POLICY. Ie. The policy which defines anything a doctor says that is offensive to any person of the public as a potential professionalism violation that can cost us our license. Ie. The policy that will regulate our personal communications on WhatsApp with our family and friends as strictly as our medical Facebook pages (if we have one). This policy is absolutely absurd and one only needs to compare to a reasonable policy like BC's to see it. The CPSO's policy sounds like it was cooked up by Orwell's Thought Police or the Chinese government. It allows the CPSO to punish virtually anything a doctor says in public/private conversation if a member of the public doesn't like it, the CPSO deems it "not evidence based" (even though evidence is constantly changing and our protocols for treatment of almost every disease change over time and sometimes are routinely done with no evidence), or it even simply features a swear word. Why was something like the BC guideline not enough? Why does the CPSO need such strict measures to regulate every word an Ontario doctor says, even among family and friends? Are Ontario doctors such dangerous renegades compared to BC doctors we need the CPSO to monitor our daily private conversations and allow the public to challenge our license for anything we say in public or our private lives? According to this policy, if a doctor says one swear word on WhatsApp to a family member, that family member can then make a professionalism complaint. How is that rational or reasonable? This policy will ensure doctors cease electronic communication altogether, even in private, or face the threat of endless frivolous complaints for it. This is beyond ridiculous and you won't find a single "social media" policy outside of a communist dictatorship so regressive and controlling. It is so unCanadian it's hard to believe anyone can think this makes sense. Read the BC guideline and you'll see what a Canadian "social media" regulation should look like. Even their definition of "social media" is more rational. There is no need to write such a heavy handed and controlling policy. This goes way beyond what is necessary to ensure doctors maintain basic standards of professionalism. It takes away so many rights from doctors in a completely unnecessary fashion. Copy-paste the BC guideline and be done with it. This is insane.
Member of the public
[July 20, 2021 10:48 AM]
Line 56 of the Advice document clearly states that doctors are allowed to express their opinions or support others’ opinions, as long as the values of the profession are adhered to.
Physician (including retired)
[July 19, 2021 2:03 PM]
The other difference with the BC regulation you will see is their definition of social media: "The term “social media,” for the purposes of this guideline, refers to websites and software programs used for social networking, such as Facebook, YouTube, LinkedIn, Twitter and blogging sites. It does not include non-public encrypted electronic communication platforms." Do you see the difference? They make a distinction between public and private electronic communication. The CPSO does not do so. According to the CPSO, a doctor's family WhatsApp group is equally within their realm to regulate as a doctor's public Facebook page. This is also completely inappropriate. The BC guideline and definition makes perfect sense. The CPSO's is completely detached from the standards of other regulations across Canada and basic Canadian values. The BC guideline sets basic standards for decency and professionalism that doctors should intuitively follow. No one would have a problem with those types of reasonable guidelines. The CPSO guidelines sound more like something out of Communist China or the George Orwell book 1984. The CPSO is attempting to tell doctors what they are allowed to think or debate or say on every level, including in private conversations, and this is completely inappropriate and not connected to the other Canadian guidelines in place or basic Canadian values. Canadian doctors are paid contractors for the Canadian government. It is a privilege to be a doctor, but as much or more than anyone, it is also important for us to freely discuss and debate matters of public social/political/medical concern and provide our voices. We are not employees of Joe's Meat Co. We are representatives of the government and our rights should be representative of the basic Canadian rights and values the government protects for all Canadians. The BC guideline enforces decency and good behavior without trampling on the basic rights and freedom of speech of BC doctors. Can the Ontario guideline do the same?
Physician (including retired)
[July 19, 2021 1:06 PM]
This is absolutely false. The BC College's policy just published in February is here: https://www.cpsbc.ca/files/pdf/PSG-Social-Media.pdf It is a completely reasonable and normal expected document with normal and reasonable policies. They state: When using social media, registrants should: •Maintain clear boundaries with patients in accordance with the College’s Non-sexual Boundary Violations and Sexual Misconduct practice standards. •Refrain from establishing online connections with patients on personal social media accounts. In some circumstances it may be appropriate to connect with patients, such as when registrants are using social media accounts for professional purposes. •Exercise caution when posting personal information on social media platforms. Assume content on the internet is public and widely accessible to all. •Only post identifiable patient information or patient images to social media if the patient has provided consent—even in a closed or private online forum. Treat photos and videos of a patient made in the context of patient care as part of the patient’s medical records and abide by the principles set out in the College’s Medical Records, Data Stewardship and Privacy of Personal Informationpractice standard. •Read, understand, and apply the most appropriate privacy settings to maintain control over access to information. Be aware that privacy settings are imperfect, can be compromised and may change over time. •Respect the privacy of patients, colleagues, and co-workers by carefully managing information acquired about them from social media. Do not search online sources for private patient, colleague, or co-worker information. •Maintain professional and respectful communications with colleagues, other members of the health-care team, and the public. Avoid derogatory, defamatory, or culturally insensitive statements and disengage from conversations that are disrespectful in tone and content. Defamatory statements published online (e.g. discrediting another registrant or health-care professional) may result in allegations of libel or slander. •Be aware that plagiarism,copyright infringement and non-compliance with restrictive licensing agreements, trademarks, or terms of usage can lead to legal action. Always provide credit and links back to original sources when sharing information. Represent credentials accurately and declare conflicts of interest where applicable. •Be mindful of and remain in compliance with all relevant professional, ethical,and legal responsibilities, including College standards and guidelines. If the CPSO had copied and pasted that policy there would be no problem. That is a normal and rational policy. Instead the CPSO is taking on their job as regulating every facet of our thoughts through the filter of their own political agenda, and allowing the public to make professionalism complaints if we say anything that someone doesn't like on a personal level. This is absurdist and is effectively silencing any political, religious, or scientific debate from doctors, because ANY opinion a doctor expresses that is not shared by the mainstream population or the CPSO regulators can lead to a doctor losing his/her license. This is not the way a government employee in a free nation should be treated. The government itself advocates for the importance of all Canadians participating in social and political debate. The BC guidelines enforce respect on social media without removing doctors' ability to speak. Why couldn't the Ontario regulations do the same?
Member of the public
[July 18, 2021 7:04 PM]
I have read both the draft policy and the advice document; they are in keeping with what is mandated by other professional Colleges and associations in Ontario, and do not contravene the Canadian Charter of Rights and Freedoms. Freedom of speech/expression is a poorly understood tenet - it is not license to say whatever one wants in public without accountability. An employee in Canada can legally be fired for behaviour (including “free “ speech) that is inconsistent with the goals or values of the employer. If, for example, I state publicly that eating meat should be banned, I am well within my rights to state that belief, and cannot be jailed for it - that is what freedom of speech is. If, however, I happen to be employed at a burger joint, my employer has the right to fire me because my public statement would not be consistent with the goals and values of my employer - that is what accountability for free speech is. Since regulatory Colleges have authority to determine the goals and values of professions, it is absolutely within the purview of CPSO to determine whether a doctor’s behaviour in public (which includes social media) meets the standards set out by the profession. When one speaks publicly, one must take into account more than whether one will be thrown in jail for the content of public statements; there may well be repercussions beyond whether it is technically a legal right. Social media, by definition (social) does not have a reasonable expectation of being private. Being a professional is not a right; it is a privilege that is conferred - and it can also be revoked. When one accepts the privilege of being a professional, one also accepts the terms and conditions of the profession, one of which is being held to a higher standard than is the general public. The discordant rant of one professional reflects badly on the entire profession in the eyes of the public, who are left wondering, “Is that the kind of person they’re allowing into the profession now?” I am very glad to see CPSO address this issue; some of the comments on this page, which are verging on frightening, illustrate that this regulation is needed.
Member of the public
[July 18, 2021 1:38 PM]
If this policy is passed I believe it will contribute to the degredation of the Canadian health care system that is already underway.
Organization
[July 16, 2021 3:44 PM]
Ontario Homeopathic Medical Association
Note: Some content has been edited in accordance with our posting guidelines. The OHMA (Ontario Homeopathic Medical Association) would like to thank the CPSO for addressing a changing and often abused communication tool(s). From the OHMAs point of view, we would like to emphasize the respect needed between regulated health care professionals in Ontario. The CPSO can cite this example as a destructive use of social media.. In this publication by CBC news [redacted] on February 9, 2018 about Georgian College offering a homeopathic diploma program. It quotes a specific medical physician [redacted] who used his professional social platform as a tool to destroy the image of homeopathy and hindered freedom of choice. Our program was cancelled because of this abusive use of social media. To homeopaths, it felt like professional racism. We have many complaints from our professional members about professional medical misconduct, using the patient (individuals needing care) as the weapon against patient choice. The CPSO wording has truth and we as homeopaths of Ontario can only hope. Physicians hold a respected position in society and, in turn, have responsibilities not only to themselves, but to patients, colleagues, the public, and the profession. Medical professionalism involves upholding the values of compassion, service, altruism, and trustworthiness, and demonstrating cultural humility and safety in everyday interactions with others. Relevant expectations are set out in other College policies, including Advertising, Boundary Violations, Physician Behaviour in the Professional Environment, Professional Obligations and Human Rights, and Protecting Personal Health Information.
Member of the public
[July 13, 2021 11:49 AM]
I am completely against this bill as I believe it violates the moral code of a democratic society and the right to free speech. I am particularly concerned about medical censorship on social media platforms and the critical importance of licensed health care providers being able to share their research and findings with peers and the public
Member of the public
[July 12, 2021 10:33 PM]
I am disgusted and appalled that your organization is looking to suppress free speech and debate of your members who took an oath to the public. Your organization wrote a letter to the Ontario Minister of Health seeking approval for CPSO to selectively address Ontarians complaints about such matters as cancelling “elective” surgeries and diagnostic procedures resulting in a massive backlog of thousands of procedures that may lead to many more direct and indirect deaths that many of your members predict will far exceed deaths with/from COVID. How might this policy work if a doctor espouses a risk/benefit response re vaccination of children? Given the lack of messaging from the college and our governments regarding an appropriate risk/benefit discussion, I guess any doctor that simply discusses a principal that we all use to live our lives daily but runs counter to the goal of fully vaccinating 80% of Ontarians 12 and up to fully open the most locked down jurisdiction in the free world, would be offside and subject to discipline from the CPSO. Would physician(s) who indicate they have a problem with local public health departments offering vaccines to minors without parental consent while coercing them with free ice cream and hamburgers, be in contravention of this policy? Or how about a member that speaks out and asks for a fulsome analysis of the data and methods used to construct one or more of the fear inducing models predicting massive upswings in cases hospitalization and deaths only to hugely miss the mark for the upteenth time? As a tax paying Ontarian, I hope I speak for many others who are concerned that many of our physicians who embrace the scientific method and critical thinking are being muzzled while many of the “high profile” docs you are looking to protect are themselves engaging in reckless and unprofessional conduct on social media. Since Science without debate is not science but hearsay, I would expect your organization to devise a social media policy that encourages healthy and professional debate, even if it runs counter to the recommended narrative. The damage your organization and other public health agencies have done to erode our trust and confidence in our medical system is massive and we may not recover from this for many years. We need more debate and discussion, not less, even if a few people end up with hurt feelings.
Member of the public
[July 12, 2021 9:53 PM]
Note: Some content has been edited in accordance with our posting guidelines. What an incredibly far reaching suppression of free speech, debate and repudiation of the scientific method. I have an idea, how about incorporating a free pass for members to debate or critique current COVID policies that are unilaterally accepted by local public health and the medical college without publicly providing the data for all to see and to provide fulsome and evidence based response and follow-up when their fear inducing models miss the mark incredibly? I would think many Ontarians might value and expect debate and pushback on behalf of the public given your members’ oath. Who should hold the unelected health experts accountable for their ridiculous fear inducing models? Would it be a violation of your new social media policy if a high profile doctor claims that we will see 60,000 cases due to the delta variant and reopening with over 70% of the population vaccimated or would the physician(s) who post a response to this ludicrous claim be in violation of your proposed policy?. It is clear that the press do not have the knowledge or the guts to hold the government and unelected health officials accountable. Case in point the ridiculously inaccurate models produced by the Ontario Science Table. Would it be acceptable for a doctor to make reference to the seasonality of corona viruses like we observed last summer when cases, hospitalization and deaths fell off a cliff without vaccines? What if a doctor commented that he would like to see a more full some debate and discussion between the OST and world renowned and published doctors who could challenge our unelected group of health professionals such as requiring masks for all children even though they are at less risk of a bad COVID outcome, vaccinating children with an experimental treatment without parental consent while coercing them with free ice cream, or full societal lockdowns that run contrary to widely accepted pandemic response protocol without a publicly transparent cost benefit analysis of full lockdowns and recognition of the natural antibody and Tcell immunity recognized by such world renowned specialists [redacted]? Why stifle honest and transparent debates about these and other critical issues? Science without debate is heresy
Member of the public
[July 12, 2021 7:49 PM]
I find it hard to imagine a more useless, indeed harmful exercise than what I see here. At a time when it is becoming ever more evident that MSM and social media is attacking actual discussion of science this can only be seen as an extension of that same attack. If a doctor is spreading absolute falsehoods they should be exposed by showing the science that proves them wrong, what we see happening now is ideas that are unpopular with the college or big pharma are being censored without scientific support. A perfect example of this is the debate over HCQ and Ivermectin, the enforcers demand absolute gold standard proof of efficacy while simultaneously supporting the vaccination of all humanity with unproven gene therapy...the irony burns. There is no good reason for authoritarian speech control, we want our doctors to speak as their conscience guides them that is how medicine progresses, advice for patients as always is to get second opinions...and if doctors are allowed only one opinion then we are all poorer and possibly sicker. Let our doctors speak.
Physician (including retired)
[July 12, 2021 11:49 AM]
Guide to the Canadian Charter of Rights and Freedoms This guide explains the Canadian Charter of Rights and Freedoms (the Charter) and its importance in the daily lives of Canadians. This content is not legal advice and should not be taken as legal interpretation of the provisions of the Charter. The legal text of the Charter is published online as Constitution Act, 1982. Fundamental freedoms – section 2 2. Everyone has the following fundamental freedoms: freedom of conscience and religion; freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication; freedom of peaceful assembly; and freedom of association. Under section 2of the Charter, Canadians are free to follow the religion of their choice. In addition, they are guaranteed freedom of thought, belief and expression. Since the media are an important means for communicating thoughts and ideas, the Charter protects the right of the press and other media to speak out. Our right to gather and act in peaceful groups is also protected, as is our right to belong to an association like a trade union. These freedoms are set out in the Charter to ensure that Canadians are free to create and express their ideas, gather to discuss them and communicate them widely to other people. These activities are basic forms of individual liberty. They are also important to the success of a democratic society like Canada. In a democracy, people must be free to discuss matters of public policy, criticize governments and offer their own solutions to social problems. Even though these freedoms are very important, governments can sometimes limit them. For example, freedom of expression may be limited by laws against hate propaganda or child pornography because they prevent harm to individuals and groups.
Physician (including retired)
[July 12, 2021 11:36 AM]
I think the college does not want to address that the body of physicians in Ontario is composed of a wide variety of people. Real people. Who have lives, passions and opinions. We live in a country that celebrates that. Why are you trying to do the exact opposite? We have a charter of rights and freedoms and free speech is part of that. The group may not agree with what people have said (in the case of the anti covid groups I do not agree with them either) but they have the right to say it. If the college chooses to reprimand them as individuals regarding this that may be appropriate. It is NOT appropriate to try to force the entire group to agree to this policy which is totalitarian. What people say may be wrong, disagreeable and nasty. But they still have the right to say it. What repercussions they face because of that is the risk they take. But to assume our entire group needs to nannied due to this is insulting and wrong.
Member of the public
[July 11, 2021 7:25 PM]
Note: Some content has been edited in accordance with our posting guidelines. The CPSO lost the right to implement any sort of social media policy, when it not only condoned, but rewarded [redacted] with an advocacy award. This doctor, advocates for the confiscation of people's lawfully obtained private property, and regularly discriminates against legal firearms owners on social media and in public, in violation of the CPSO's own stated policies.
Physician (including retired)
[July 11, 2021 4:09 PM]
This is against our rights of speech. Honestly it is getting ridiculous how draconian the cpso is becoming. Stay in your damn lane.
Member of the public
[July 11, 2021 2:56 PM]
Note: Some content has been edited in accordance with our posting guidelines. To whom it may concern, Just a short note regarding your current deliberations to provide rules for physicians in regard to social media. In my opinion, it is extremely important at this point in the pandemic that physicians be allowed to speak out freely, without censorship, regarding the current medical approach. You should be aware that the actual science is quite clear that masking, social distancing, and lockdowns are a cure far worse than the illness. We have seen multiple jurisdictions that have rejected this approach and are faring much better than Ontario. As well, many jurisdictions (India for example) have been using safe and effective treatments such as Ivermectin, Hydroxychloroquine with great success. [redacted] and many other physicians have supported these treatments and as a result have been censored. The vaccines that are being rolled out to the entire global population with claims of safety and effectiveness are turning out to be far from safe and effective. The vaccines are proving to be far less effective than claimed and many have experienced serious side effects and death. The long term effects of the vaccines are unknown. It is well known that the chances of children experiencing serious effects of Covid are next to zero, yet many organizations like yours support vaccinating them with this experimental gene therapy. The voices of physicians who believe in alternative approaches, or who have patients experiencing these harms in their practices, must be heard. Attempts by your organization to stifle physicians need to stop immediately.
Member of the public
[July 11, 2021 11:57 AM]
To whom this may concern, Having answered the survey in detail, I will not here go into detail. Generally speaking, I would like to draw attention to the potential harms associated with this sort of policy. The most egregious is the curtailing of the physician's role to engage in productive disagreement. Our culture is presently faced with a misunderstanding of what science and medicine are all about. The scientific method is not consensus driven. Science is data and evidence based: therefore there is no "the science" - a term being bandied about irresponsibly in our present culture. Data is open to interpretation, and it is the area of interpretation of data that accounts for disagreement. Moreover, there is no single set of data points that ought to be promoted at the expense of other (relevant or potentially relevant) data sets. When we hear and see the use of the term "the science," it gives the false impression that there is some extant ledger and compendium holding the one true science, and this one true canonical science cannot be debated or discussed openly. In short, the main danger any policy of this kind must avoid is the promotion of the misguided notion that medicine is a doctrine-based form of knowledge. When Dr Fauci says, "If you're arguing with me, then you are arguing with the science," we must step away and ask ourselves what purpose such a statement serves. Surely, this is not a scientific statement. It's a scholastic statement (medieval in nature) meant to end debate and conversation based on authority. If science and medicine become authority based, all the efforts of rationalism over the last 300 years are lost. Of course, physicians ought to be held accountable for abusive and unprofessional behaviour on social media. Perhaps physicians need some reminding of their responsibilities which are already outlined elsewhere. But they must not be prevented from healthy debate and disagreement. At present, we are witnessing all manner of coercive measures aimed at shutting down healthy debate and disagreement vis a vis COVID-19. Therefore, this policy is fundamentally misguided because it fails to promote those fundamental values that make science and medicine trustworthy. Instead, it is engaging in and supporting various measures that would silence those doctors who are honouring their oath and conscience. The sort of policy that is desperately needed right now is of an entirely different sort - in fact, the reverse agenda from the present one. What requires drafting is a policy that curtails government and public health officials from having the final word on "the science." What is needed more than ever now is a statement and policy outlining the responsibilities of physicians (at all levels) to declare their biases and conflicts of interest. We require policy that ensures open conversation of the areas of disagreement in the public domain. We need policy that addresses informed consent and easy public access to the pros and cons, the potential usefulness and the potential risks involved in the dissemination of various medicines and vaccines. Desperately required now is a policy that encourages doctors to speak up when they perceive safety issues, misguided policy and internal bullying. What we need is protection for whistleblowers. The present policy does not serve the public or the field of medicine. The issues raised here might have been addressed in a memorandum, reminding physicians to uphold the dignity of their profession, or risk losing the public trust. If there is truly a serious problem with physician behaviour on social media, perhaps a training program could be initiated to help them navigate the emotionally charged arena of the medium. Please consider a policy that actually supports physicians who feel the need to speak out, and that instead puts the institutions and officials on notice for any attempts at silencing dissent and disagreement. Kind regards,
Other health care professional (including retired)
[July 11, 2021 9:40 AM]
Note: Some content has been edited in accordance with our posting guidelines. Open debate should be encouraged between all physicians without reprisal, especially if they question the prevailing standard of care. Only in this way can new potentially life saving ideas and treatments emerge. They should also feel free to use every means at their disposal to help their patient, even including social media, which can be a very valuable tool to gather information. [redacted] "Bed rest started as a relatively mild thing. However, as it is with almost all things, it became increasingly ‘radical’. Lown, along with his mentor Dr Samuel Levine, tried to change this. He became involved in trying to get patients up out of bed to sit in a chair:"
Member of the public
[July 11, 2021 8:51 AM]
Dear CPSO, I was disheartened to review the proposed revamp of the CPSO social media policy. As Ontario slowly slides into what some may call an authoritarian abyss, policies such as those you propose won't protect physicians or the College. ITEMS: - Doctors spend a quarter of their life in school to join this profession - in doing so, they have a BUILD IN incentive to act in accordance with common decency, respect for patients, respect for the law, and their oath. The college should not be setting up policies that assume the worst possible motivations of those who speak out against medical group think. - If it is true that the College no longer has the time to investigate all complaints/submissions to the body, why/how does it appear to have endless amounts of time to police the internet for the thoughts of Ontario doctors? Perhaps you should spend more time instead focusing on the very real issues many fearless doctors are raising about current Ontario covid policies? - I object in principle to the College attempting to curtail the free speech of doctors - the college seems to be moving towards a role as the Ministry of Truth for the government of the day rather than a thoughtful and neutral body searching for overreach. Please discontinue the entire social media policy revamp proposal. Respectfully,
Member of the public
[July 11, 2021 8:09 AM]
Hello, I am reading your proposed social media policy for Ontario physicians and am very concerned with the potential impact. Censorship of media, the public or in this case physicians of Ontario inhibits open and free dialogue in pursuit of truth. Your proposed policy handcuffs physicians from making statements and observations that could be valuable for researchers, journalists and the public at large to seek the truth. This would be yet another recent example of institutional power biasing the narrative. Please continue to allow your physicians, who have earned the right to call themselves doctors in Ontario, the opportunity speak up on social media. Cheers
Member of the public
[July 11, 2021 5:26 AM]
IT'S NOT OK TO TURN DEMOCRACY INTO DICTATORSHIP. THIS SOCIAL MEDIA POLICY IS NOT ACCEPTABLE. THE PUBLIC CONTINUES TO SPEAK, WILL YOU LISTEN? WE DO NOT CONSENT TO THIS DICTATORSHIP STYLE SOCIAL MEDIA POLICY OF SILENCING AND CENSORING. WE, THE PEOPLE, BELIEVE IN THE FREEDOM TO GROW, TO SPEAK FEELY WITH OPEN HEARTS AND TO IMPLORE CHANGE THAT WILL ALLOW THE EVOLUTION OF HUMANITY. With LOVE and GRATITUDE,
Member of the public
[July 10, 2021 11:05 PM]
Don't you dare tell my doctor not to share information about treatments that are still under investigation. You have no right to decide what my doctor shares online. This scandalous policy is an Orwellian nightmare and will bring ridicule on the whole province. If I ever get covid I will ask my doctor for a prescription for ivermectin. Yes, I know its an off-label use, but I've examined the growing body of evidence for use in early treatment and you have no right to deny Ontario doctors the ability to prescribe as they see fit based on the available evidence. The wrong-headed nonsense you're coming out with makes me suspect we have a serious problem with regulatory capture. Big Pharma has no business influencing the CPSO and we need more transparency around financial connections between the two. I've lived for many decades but I've never seen such outrageous overreach by such a regulatory body. Stop trying to grab more power. Stay in your own damn lane. YOU ARE NOT THE THOUGHT POLICE.
Member of the public
[July 10, 2021 3:25 PM]
This is a bad policy. For many reasons. It should be scrapped. It will not be because whoever drafted it has no intention of changing it. But you should know, the rest of us know you are cowards. Free speech should be respected. You are killing it because you are afraid to lose your job. That's all.
Member of the public
[July 09, 2021 11:32 AM]
I don't agree with the policy to muzzle physicians. They have taken an oath and public debate should be allowed - even if it goes against what the majority are saying. This is how science progresses. Physicians have a right to speak freely and there is no place for your suppression and blocking of the scientific process through dialogue. People have lost trust in CPSO, you should be ashamed.
Member of the public
[July 08, 2021 12:40 PM]
Commenting on use of social media for promotional purposes and a direction to the advertising rules would be helpful in ensuring that physicians understand their content requirements.
Physician (including retired)
[July 08, 2021 7:47 AM]
Thank you for putting together this draft policy. I agree that there should be guidelines in place in terms of what physicians should post on social media. However it is equally important that CPSO not overreach and infringe on physicians free speech rights and their ability post on topics of their choosing and in a manner they wish. In addition to being physicians we also live in a civil society and the norms of behaviour on social media should really stem from that vs. from a regulatory authority whose scope should really be limited to our professional work. The policy should focus on areas that are clearly "off limits" and limit subjectivity in assessing what is and is not appropriate. To my mind, this means that the policy really should be limited to four main areas: - PHI - in general, attributable personal health should not be posted without clear consent. This should include posting where a patient can be identified or where a particular incident/temporal analysis would make the patient identifiable - Harassment should not be tolerated - this should also include threats, making another person fear for their safety or career - Overt discrimination should also not be tolerated and should include all protected classes as noted in legislation. - Posting information that is dangerous to public health. This approach needs to be approached with caution. Physicians can disagree with prevailing public health views and can post about it as long as they are clear that it is their opinion. There should be no restriction on commentary about governmental or organizational policy (including the CPSO) - be it local, provincial, federal or international as long as it is not personal attacks upon individuals. Specific feedback to the content of the policy: Line 43/44 - Profane is highly subjective based on context - I would remove. In the same way, disrespectful is also subjective as some may view disagreement as disrespectful so I would remove that as well. The rest of these lines is fine Lines 57-65 - this is challenging. As evidenced by the COVID19 pandemic, evidence changes often and what is currently viewed as fact, may change. Perhaps this should be change to "should not knowingly spread misinformation" Lines 67-73 - I agree physicians should not provide specific clinical advice to individuals, however general advice should specifically be allowed - e.g. Getting vaccinated is medical advice and is being spread broadly through social medical channels The term professional behaviour and respectful is used frequently in the document. These are highly subjective terms and it is unclear what norms are being used to judge it. My suggestion would be that policy be significantly cut down to ONLY include the areas outlined above - PHI, Harassment, Discrimination and misinformation in the Public Health Context. I would also suggest that these be framed as guidelines and not rules with MUST everywhere. I think the CPSO is trying to set a standard that is out of scope for them to set or enforce.
Member of the public
[July 08, 2021 7:38 AM]
My Friends, When I read this document, I feel the same deep unease I feel about Canada's residential schools. On the surface, the motive may appear to be one of benevolence and love. But when I peel back that thin bark of supposed goodness, I see the potential for harm, for pain, for suffering. Lines 38-40 state; "Physicians must not engage in disruptive behaviour that interferes with or is likely to interfere with the physician’s ability to collaborate with others, the delivery of quality health-care, or the safety or perceived safety of others while using social media." Yet this policy itself, one of control and censorship, violates the very own principles that it espouses. This policy itself is one that exhibits and promotes "disruptive behaviour that interferes with or is likely to interfere with the physician’s ability to collaborate with others, the delivery of quality health-care, or the safety or perceived safety of others while using social media." Line after line of this policy is about controlling physicians and what they may express. About silencing them. About manipulating their voices when they are allowed to speak. About turning them into spiritless puppets who dance as others demand. It is about shackling those who must be free at all times to say what needs to be said. My people have a saying that I feel applies here. English cannot capture the intricacies of this expression, but I will attempt to translate it anyway. "Listen to the shrieks of the eagle. For as loud and as painful to the ear as they may be, the wisdom they contain is the deepest one will ever discover. Where the eagles are free to shriek, the prosperity is great for all. But where the eagles are silenced, misery is the norm." Our physicians must be free eagles. Peace and blessings,
Member of the public
[July 07, 2021 11:46 PM]
The question in the comment "Whose definition of discrimination are we using" can be answered by the Draft Policy line 46. Most of what is listed as examples are from the Human Rights Code ground of discrimination, therefore the definitions should come from The Code.
Member of the public
[July 07, 2021 11:25 PM]
I just made similar comments to CPSO reviewing the policy. Medical professionals need off-duty time to post whatever they want. Off-duty time is to take off the hat as a physician. Therefore it's reasonable to be asked to use a user name on the personal page that deidentifies you, to the general public, as a medical professional.
Member of the public
[July 07, 2021 11:10 PM]
Your comments are great. The 2, 3 are definitely included in the Draft Policy's line 54 of point #6 regarding hate speech. Your #4 comment can be loosely included by the same.
Physician (including retired)
[July 07, 2021 7:02 PM]
Once we get hate speech and misinformation under control we can focus on profanity. You don’t learn surgery by doing it all on day one. You get food at the approach and suturing before you can do it all.
Physician (including retired)
[July 07, 2021 6:58 PM]
You need to focus on enforcing racism, hate speech, and most importantly misinformation before you regulate what damn swear words are OK. If you don’t do this, you will end up with massive complaints about “bathing suits” and people saying hell, damn, shit, etc on personal accounts and won’t ever get to stop people doing real harm. Start by doing one or two things well (like the horrific amount of misinformation by a certain doctor leading who has already had several complaints) before doing anything else. You don’t get to learn how to fo a full surgery all at once, you start by learning how to open and close an incision. So one thing right, then two, then three. Right now you have to focus on step 1: misinformation and hate speech.
Member of the public
[July 06, 2021 9:59 AM]
Good Lord! This is benevolent dictatorship...
Physician (including retired)
[July 05, 2021 9:00 AM]
I am completely against this policy. CPSO should not be in the business of evaluating opinions of physicians or anyone else. This policy can and likely will be used to bully and force physicians to say what CPSO feels is within "acceptible" limits. Opinions that are not "acceptible" to CPSO may be punished. This is pure censorship. It is WAY WAY beyond the mandate of CPSO. Censorship belongs in dictatorial states not amongst the medical profession in Ontario. I encourage and commend free speech and feel its one of the bedrocks of free and functioning societies. No free speech means no society worth living in.
Physician (including retired)
[July 04, 2021 12:57 PM]
What is the Canadian Charter of Rights and Freedoms? The Canadian Charter of Rights and Freedoms sets out those rights and freedoms that Canadians believe are necessary in a free and democratic society. The Charter is one part of the Canadian Constitution. The Constitution is a set of laws containing the basic rules about how our country operates. How does the Charter work with other Canadian laws? The Constitution is the supreme law of Canada; all other laws must be consistent with the rules set out in it. If they are not, they may not be valid. Since the Charter is part of the Constitution, it is the most important law we have in Canada. Who does the Charter protect and what rights are protected? Any person in Canada – whether they are a Canadian citizen, a permanent resident or a newcomer – has the rights and freedoms contained in the Charter. There are some exceptions. The Charter protects those basic rights and freedoms of all Canadians that are considered essential to preserving Canada as a free and democratic country. It applies to all governments – federal, provincial and territorial – and includes protection of the following: fundamental freedoms and democratic rights. Fundamental freedoms – section 2 2. Everyone has the following fundamental freedoms: - freedom of conscience and religion; - freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication; - freedom of peaceful assembly; and - freedom of association. Under section 2 of the Charter, Canadians are free to follow the religion of their choice. In addition, they are guaranteed freedom of thought, belief and expression. Since the media are an important means for communicating thoughts and ideas, the Charter protects the right of the press and other media to speak out. Our right to gather and act in peaceful groups is also protected, as is our right to belong to an association like a trade union. These freedoms are set out in the Charter to ensure that Canadians are free to create and express their ideas, gather to discuss them and communicate them widely to other people. These activities are basic forms of individual liberty. They are also important to the success of a democratic society like Canada. In a democracy, people must be free to discuss matters of public policy, criticize governments and offer their own solutions to social problems. https://www.canada.ca/en/canadian-heritage/services/how-rights-protected/guide-canadian-charter-rights-freedoms.html#a2a _______________ Canadian doctors as Canadians possess all of these rights and freedoms. These federal government refers to the above rights and freedoms as the "supreme law" and "most important law we have in Canada." Doctors are public servants who work for and are funded by the same system of governance that wrote the above policy. Now understanding this, re-read the proposed policy written by the CPSO and tell me if you can see the problem with what the CPSO is attempting to do. Where does the CPSO recognize that we as doctors still possess these basic Canadian rights and freedoms when we leave the office at the end of the day? The CPSO can only regulate the speech and conduct of doctors: (1) when doctors are giving medical advice and/or acting in a professional capacity, or (2) in the very rare circumstance that a doctor's personal speech or conduct is so offensive to the general public it has PROVABLY damaged the reputation of the profession as a whole. In such a rare case, it should be clear that the burden of proof would fall on the CPSO to demonstrate that a doctor's personal speech or conduct has impaired the profession as a whole, and to such a great magnitude that they must limit that doctor's Canadian rights and freedoms in order for the medical profession to survive. Solution for the CPSO: - Re-write this policy in such a fashion that it does not directly contravene the Canadian Charter of Rights and Freedoms for doctors as Canadians. - Provide doctors a pathway to use of the modern online media in a personal capacity that is separate from any professional use, so that we as individuals can still exercise our basic rights and freedoms as defined and protected by the Canadian federal government. - Please re-initiate a new public consultation once these issues are resolved so we can review again.
Other health care professional (including retired)
[July 04, 2021 12:06 AM]
Note: Some content has been edited in accordance with our posting guidelines. This is pure [redacted]. No one should have any controls over their total free speech. Whether or not some namby pamby pleb is upset. Bloody sheeple and useful idiots faffing about like little Hitlers ruining peoples lives.
Physician (including retired)
[July 03, 2021 10:48 PM]
This policy is not workable and it is likely outright illegal, as it restricts doctors from their basic freedoms of religious and political expression. This is Canada where we value such things. You cannot ban an entire group of people from engaging in basic free political or religious discourse. You simply do not have the right to undermine our democracy or the Charter of Rights and Freedoms in this manner. As long as a doctor is not friends with patients and is not using their page in any professional or medical capacity, then on their own personal Facebook page they should have the absolute right to write any of the following posts (for reference, none of these are things I would personally intend to speak of - they are simply hypotheticals): "Why I believe ___(political party/candidate) is corrupt/fantastic and I will/won't support them." "Why I believe ___(religion) is wonderful and it plays an important part of my life." "Why I do/don't support male circumcision or abortion rights." "Why the opioid/obesity epidemic is a matter of personal responsibility and/or entirely the government's fault." "My feelings on the Israel-Palestinian conflict." "My feelings on American public policy over the past 100 years." "My feelings on China's political policy regarding Hong Kong, the Two Michaels, and Taiwan." "My feelings on Canada's involvement with residential schools." "My opinion regarding how bathrooms, spas, and changerooms should handle transgender challenges." "A painting I created inspired by the struggles of the indigenous people of Canada." "A song I wrote about losing my dad in the war." You may not want doctors to have or express speech as individuals on any of these subjects, but the Charter of Rights and Freedoms enshrines ALL of our rights as Canadians to such opinions and to speak freely in such manners. We have an existing law on hate speech which prevents speech from veering into dangerous territories. This law is already enforced by the government for all Canadians. Our fundamental democracy depends on ALL CANADIANS being able to express themselves freely as private citizens within the limits of this law. You simply cannot undermine this basic function of our Canadian system of rights on the basis of supposedly "protecting the medical profession" or preventing some hypothetical person in the public from potentially being "offended." Any individual in the public might be offended or feel bullied or discriminated against by any of the above posts, regardless of the specific content of the posts. But within any reasonable context, that does not supersede the doctor's right to speech as an individual on those subjects or participation in political/religious/artistic expression in those domains. An individual's "right to not be offended" and the CPSO's mandate to "protect the profession" do not and cannot supersede the Canadian Charter of Rights and Freedoms. You cannot take away the basic rights of an entire group of people (doctors) for those supposed purposes. It is at best questionable whether the reputation of all doctors is impaired by an individual doctor voicing their private opinions when they are not acting as a doctor. Each doctor has his or her own independent professional reputation. I am confident in the strength of my own professional reputation irrespective of what any other doctor says or does. I do not need you to protect my professional or personal reputation in this manner. The high quality health care I provide every day is where my reputation as a doctor comes from, and I can protect it just fine on my own. My personal reputation is between me and my friends and family and again, mine to protect if I seek to. There is no public "crisis of faith" in the medical profession because doctors are expressing their opinions on religion or politics or in the arts or using a swear word on their Facebook pages. If anything, through this pandemic, there has been an even greater public appreciation and respect for the work we do. This policy is using a sledgehammer to kill a fruit fly (which may or may not actually even be there). You have written a policy curtailing our basic Canadian rights and freedoms to "fix" a supposed problem which barely exists, if it exists at all. If a doctor is providing UNSAFE MEDICAL ADVICE or providing UNSAFE MEDICAL CARE you already have many methods to address that. You have plenty of tools by which you can review their medical conduct and assess their competency and quality of care, which are already equally applicable if that advice is posted online or given to a patient in person. If a doctor is using social media for medical purposes then it is obvious the standards of professionalism should apply there equally as in their office practice. However, this has nothing to do with all the various private and personal reasons a doctor may use online platforms and it has no connection to the doctors who do not involve their medical work in their online lives. This policy as written is a gross violation of our rights as Canadian citizens. All Canadians should agree that our democracy and rights to participate as individuals in free democratic society come well before the CPSO's mandate. You do not need to violate our basic Canadian rights in order to ensure doctors provide safe and appropriate medical care to the public.
Medical student
[July 03, 2021 1:46 PM]
Note: Some content has been edited in accordance with our posting guidelines. Race/Ethnicity? Why does that matter? Anyway, we know your agenda, we know what your plans are by your fruits. You would not know "science" if it hit you in the face. [redacted] Harassing Doctors who are honoring their Hippocratic Oaths [redacted]. You may think that "science" trumps God, God who spoke the laws of "science" into existence as you continue to operate in the field of scientism/pseudo-science. God will be your reckoning.
Member of the public
[July 03, 2021 12:03 AM]
The SOLE requirement placed on physicians should be that they carry themselves professionally - and ONLY when they are making public use of their professional credentials. One does NOT give up the RIGHT to free speech when one becomes a physician (or, for that matter, enters any other profession). Any other approach runs the risk of politicization and fascism. The current Covid narrative has been thoroughly politicized, and thus those with the most political clout illegitimately reserve for themselves the POWER TO DEFINE the phrase "the safety or perceived safety of others." And of course this can happen at any time: today it's regarding Covid; tomorrow it'll be something else. We have seen this happen in the CPSO itself: doctors threatened with having their credentials stripped from them just because, in regard to Covid and its treatment, they've espoused an understanding outside the mainstream. Genuine science cannot advance without freedom to dissent - and therefore the "rulers" of the CPSO should be utterly ashamed of how they've treated these dissenting physicians who - as professionals - have proved they care about their patients AND can back up their position with solid reasoning and evidence.
Physician (including retired)
[July 02, 2021 12:26 PM]
The Canadian Charter of Rights and Freedoms, Section 2(b), "Freedom of expression" states: "Everyone has the following fundamental freedoms: freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication." The CPSO does not have the right to circumvent the Canadian Chart of Rights and Freedom and take away doctors' basic rights to freedom of thought, belief, opinion, and expression. The law makes it clear that ALL CANADIANS have this inalienable right, including freedom of the press and other media of communication. This includes "social media." The CPSO has the right to regulate a doctor's speech and conduct AS A DOCTOR, but it does not have the right to limit a doctor's freedoms when they are speaking or acting as a private citizen. The CPSO cannot remove a doctor's rights as a private citizen, or their ability to act as a private citizen. This policy would need to specify that it ONLY APPLIES to doctors when they are using professional social media accounts and/or social media provide medical care or medical advice. Otherwise, doctors have a right to freedom of expression, participation in political discourse, communication, and freedom of expression including the arts and religion in their private lives that the CPSO has no legal right to regulate. This policy is clearly illegal on constitutional grounds. It violates the Canadian Charter of Rights and Freedoms by placing no distinctions between contexts of media use, such as whether the doctor is acting or speaking as an individual (eg. in political debate or religious/artistic expression) or as a doctor (eg. in providing medical advice). It is illegal because it currently would mean no doctor can participate fully in our democracy or their religion unless their opinions and beliefs are first approved by the CPSO or their beliefs do not cause any member of the public to feel any possible offense. All thoughts, beliefs, opinions, and expressions of a doctor are NOT subject to CPSO review. We are all Canadian citizens first and foremost. The government of Canada enshrines our rights as individuals and the CPSO does not have the legal authority to override that. You cannot restrict our personal political beliefs or right to expression of those beliefs. Nor can you restrict our private conversations or interactions with others in our personal lives. Please provide a new draft that honors the Canadian Charter of Rights and Freedoms and clarifies this distinction. At that point, please allow a new public consultation to review again starting from a more reasonable and appropriate starting point.
Other health care professional (including retired)
[July 02, 2021 9:10 AM]
The CPSO must NEVER be allowed to censor medical discussion/debate/alternative views by our medical practitioners through social media or any other platform. If the CPSO stifles freedom of expression they themselves must be investigated. The Sars-CoV-2 issue is a perfect example where freedom of speech by our medical doctors must be heard. I have sought evidenced-based literature from our local health department as well as another Ontario medical college that support the various mandates they imposed upon the public, to no avail. Social media has provided me an avenue to hear the different medical viewpoints and given me the tools to do further research.
Physician (including retired)
[July 01, 2021 10:48 PM]
This policy may be created with good intentions, but it has placed absolutely no limits on what the CPSO can regulate. It gives the CPSO the right to regulate every conversation a doctor has online, including private conversations with partners, spouses, children, parents, or business partners. It includes romantic conversation, political conversation, heated personal arguments, and all manner of private conversation which we may have. Does the CPSO believe its job is to regulate all conversations of this manner? If not, where are the protections that limit the CPSO in terms of which communications it can or can't regulate? The definition of "Social Media" is given as any online platform for communication. This then includes WhatsApp, Zoom, Snapchat, even sites like Facebook Dating. Does the CPSO believe it should be controlling a doctor's romantic advances or conversations with friends and family members on such platforms? If not, where is the protection to limit this? You state "Physicians must conduct themselves in a respectful and professional manner while using social media." Again, no restrictions are placed on what is meant by this. Does this then mean a parent's conversation with their child is subject to "professionalism" guidelines and you will regulate this? Or a doctor's romantic advances on a dating site? Why is there nothing in the policy clarifying such distinctions? Did you leave any clarification out on purpose or was it by accident? You state physicians are barred from any use of "profanity." Does that mean if a doctor says a swear word in a conversation with a family member on Facebook this qualifies as professional misconduct the CPSO can regulate? If not, again, where is the distinction in your policy? You state physicians cannot write personal attacks or disparage others. Does that mean if a doctor and their spouse is going through an unpleasant divorce and something is said between them online, this is also the domain of the CPSO to regulate? Or if a doctor writes an opinion article about the unsuitability of a given political candidate, they are also in violation of your policy? If not, where is the distinction? Where is the protection for private conversation or personal opinions? You state doctors cannot write "hate speech." I am puzzled by this one, as there are already elaborate laws in Canada enforced by the government around what is or isn't hate speech, and hate speech is already a crime in Canada. We are already required to comply with all Canadian laws. So how is this not redundant? Is your intention to bypass the Canadian law on what is or isn't hate speech and create your own definition and process by which to determine what is or isn't hate speech? If so, why do you feel the need to do so? Do you not believe the government and existing legal system is adequately equipped to determine what is or isn't hate speech? Do you believe the CPSO is better able to do this than the existing courts and judges with their checks and balances? Do you intend to provide your own definition or how you will enforce this? In your survey, you gave an example stating doctors should not write anything that may be "perceived as discriminatory." You included weight as an example. If a doctor writes an article about how obesity is a rising problem and what they believe ought to be done in terms of public policy, or how individuals should take more personal responsibility, and someone feels they are "discriminated" upon by this, will the CPSO crack down on them? Whose definition of discrimination are we using? Can you define the term so it is clear? Currently I see no definition in the policy. Is it based on the subjective experience of any person in the public? You state that doctors should only share medical information that is "verifiable and supported by available evidence and science." However, many things in medicine are done without evidence. For example, diclectin is a common treatment for nausea and vomiting in pregnancy which is still considered routine despite the fact that the biggest current studies show no significant effect. If a doctor posted a guideline for treatment of nausea and vomiting in pregnancy that included diclectin, would this be punishable? Where in the policy are they protected? Where does it protect doctors who are acting in good faith based on their best knowledge and experience? You state doctors cannot search a patient's name online without permission. How do you intend to verify and enforce this? Do you believe you have the power to seize a doctor's computers, and personal cell phones, or request records from their ISP to confirm if they did or did not Google a person's name? Why was there a need for an entire second document to clarify the first policy? Why is the policy so incredibly short, and the explanation document so much longer? Why was it not possible to write the actual policy in a way that clarifies it limitations? Is this your implicit recognition of the criticism that you have essentially placed NO RESTRICTIONS on the domain of the CPSO's regulation in the first policy? If you recognize this is a problem, can you fix it in the primary document? One example comes to mind: Ken Jeong is an internist in California. He has practiced medicine for many years. He also is an actor, who among other things, jumped out of a trunk of a car totally naked in the movie The Hangover (with full frontal nudity), has sworn and performed all manner of profane behaviors as a comedian, and starred in numerous TV shows like Community and Dr. Ken. Videos of his most absurd antics are available all over the Internet including on Youtube and Facebook. He remains fully licensed in California. According to this policy, would the CPSO allow him to continue to practice medicine? Or would you have revoked his license for "unprofessional conduct" in social media? Do you think his ridiculous behavior in his personal life makes him an incompetent doctor, or that he is a public danger as a doctor solely because he enjoys having a colourful personal life? Furthermore, would you want your own conversations with your spouses, partners, children, family members, and others held up to scrutiny by the CPSO? Do you believe you should be able to have personal or private conversations? If you want to have other hobbies outside of medicine, like Ken Jeong did, do you believe those should be subject to CPSO approval first? If you believe a doctor should have a right to a private life, where is this clarified in your actual written policy? If it is not already clarified, can you fix this for all our benefit? We all want to be good representatives for our profession. However, doctors should have a right to their own private lives and not every conversation or behavior should be subject to the CPSO's regulation. I hope you can recognize and agree with this. And if you do agree, then I hope you can make this clear in the policy, which currently does not at all express this perspective.
Member of the public
[July 01, 2021 7:04 PM]
1. I find it ironic that you don't want physicians to read up on patients on social media, but you are going to read up what physicians post on social media 2. Homosexuality was once illegal in this country and many physicians stood up against it. This Policy will prevent that from happening. 3. You are basically the judge, jury and executioner in this case. I hope physicians band together for a constitutional challenge.
Member of the public
[July 01, 2021 5:54 PM]
This is outright policing of language. Should physicians ideally act professional online? Yes, of course! Should they *have* to? No! I find it especially concerning when it adresses what cannot be done listed underneath "Professionalism". It is listed that one cannot "bully", "harass", or "intimidate". I find that all of these are interpretive and are also subjective. If I am not to be mistaken, this also infringes on their [the physician's] Freedom of Speech? Taking into account all of the sources, I find it quite scary as to how the government is now policing language and personal conduct. Please rip this policy in two.
Physician (including retired)
[July 01, 2021 4:07 PM]
Should add Russophobia and Sinophobia to the list of prohibited behaviours
Member of the public
[July 01, 2021 10:48 AM]
The policy seems vague and a little too open for interpretation. Define professional and respectful. If a physician has a different point of view than that of the CPSO, does this policy allow the CPSO to deem the physician unprofessional? Clearly define what is considered to be misleading. If there are several physicians that have an opinion and there are studies backing that opinion, but that opinion is not shared by CPSO, is the opinion of those physicians deemed misleading? It is important that physicians be allowed to express their opinions with the public if they are able to back them up with studies and logic. Debate is healthy and needed, especially in situations like our current one where we don't yet have all the information and there is still so much to be learned. This policy should not be used to mute physicians and stop studies and opinions from reaching the public.
Member of the public
[July 01, 2021 9:09 AM]
The CPSO has proven to be politically motivated and anti-science and can't be trusted to determine what is evidence based and science. You should be ashamed of yourselves. Stop harassing doctors who uphold their oath. The Nuremburg 2 trials are coming and many of you should be prosecuted.
Member of the public
[July 01, 2021 8:35 AM]
The proposal to silence doctors on social media when they don't agree with the govt. narrative is akin to communism. The public should be made aware of all opinions to allow them to make their own informed choices vs. having a narrative shoved down their throats.
Member of the public
[July 01, 2021 1:28 AM]
Do not limit any professionals medical opinion in any way shape or form. We already have processes to punish malpractice. Do not need any further for sharing of information. I want to have a doctor patient relationship without the government being involved. If I am not satisfied with my level of care I will seek a different professional. Stay out of where you are not needed or wanted CPSO!
Member of the public
[July 01, 2021 12:37 AM]
Give it up and let them speak. We need honest professionals. Spcially with the propaganda out there right now and since we've decided that politicians are now doctors and medical experts.
Member of the public
[June 30, 2021 9:06 PM]
I reviewed document and came away with distinct impression College wants to control Physicians speech. I think that’s disgusting. Why should Physicians not have free speech. I have been very unimpressed with the College during the pandemic...they were toadies for global Covid paranoia. Why didn’t we debate using the Swedish model. They are considered a very enlightened country but we couldn’t even debate that.
Member of the public
[June 30, 2021 9:06 PM]
Allow all doctors to spout their opinions with no pushback! THANK YOU!
Member of the public
[June 30, 2021 8:46 PM]
This is a mistake. Censoring your physicians is ethically and morally irresponsible, Not to mention goes against all ideas of a scientific discussion in the scientific method. Being able to collaborate share ideas, grow with each other through discussion is an important quality and all of these individuals have a right to speak their mind.
Member of the public
[June 30, 2021 8:03 PM]
I think this year has shown an unprecedented censorship and violation of a basic tenet of democracy. You do not have to agree but you should and must allow debate it is the foundation of a free society. People can make their own decisions it is not up to the CPSO or the media to censure what we can see.
Member of the public
[June 30, 2021 5:30 PM]
I am shocked at this part of the policy: Disruptive behaviour in the context of using social media may include, but is not limited to: • behaviour that others would describe as bullying, attacking, or harassing That is completely subjective, and it's absurd to think the doctors should be responsible for how people interpret their own feelings. • comments that may be perceived as discriminatory (for example, related to race, ethnicity, religion, gender, sexual orientation, age, social class, economic status, disability, weight, or level of education). "May be perceived" as discriminatory? Again, if a doctor stating a fact causes a person to feel a certain way, it's that person's responsibility to handle their emotions. "discrimination (for example, racism, transphobia, sexism)." - What is transphobia, really? Is stating "women have vaginas" transphobic? What about stating the fact that trans women are not women? (they are trans-women). Is that "transphobic"?
Physician (including retired)
[June 30, 2021 10:50 AM]
The proposed policy is overreaching. The policy effectively muzzles the physician by enforcing the "party line" . The scientific method necessarily demands skepticism and debate. Indeed opposing views, vigorous debate and willingness to entertain new ideas are essential. Freedom of speech should be a principle for all people. Doctors are no exception. I believe this policy is a contravention of the Constitution. If it is passed, perhaps the CPSO's overreaching policy of imposing the catchall "unprofessional behaviour" clause should be challenged in Court.
Physician (including retired)
[June 30, 2021 8:48 AM]
I understand that this policy is necessary in terms of disrespectful behaviour not being acceptable on social media. I have some concerns however. I have a professional Facebook page which I use for information and advocacy. I would be concerned about the college's overreach to police my professional page should I post information well backed up by evidence that has not been fully accepted by the our profession's mainstream. My colleague's comment above about aerosol transmission is a case in point. In terms of my personal page which is only open to friends, whom are not my patients, I should have the freedom to post whatever I want without the college getting involved with my private life. The intention of the policy is good, my concern is the abuse of it by CPSO inspectors. Lastly, I would hope that the college will not be scanning and policing our profession's social media, but would only be responding to complaints all the while understanding that many complaints may be vexatious.
Physician (including retired)
[June 30, 2021 6:41 AM]
In considering lines 114-122: Posts on social media by patients and the general population at large are available for public viewing. Patient health information, once posted on social media, also becomes available for public viewing, and this should NOT exclude the viewing of such information by physicians, without the need to obtain consent. If patient information is not to be accessed via social media, it should not be posted on social media.
Physician (including retired)
[June 30, 2021 4:36 AM]
The policy should include: 1. that this pertains to personal social media accounts of physicians as well as those affiliated with medical or university institutions. 2. Physicians must ensure they are not re-posting posts from people with extremists views such as neo-Nazis or posting canards or libels 3. Line number 55: include antisemitism and Islamophobia. 4. Prohibition against calls to boycott certain countries and/or students from those countries I think it would be important to add a section on the consequences for posting against the rules of the CPSO policy including but not limited to formal apologies, removal of inflammatory posts, license suspension, and/or termination of licensure.
Physician (including retired)
[June 29, 2021 6:04 PM]
This is another attempt by the college to silence dissenting voices. The college is am embarrassment to freedom. The registrar is even now trying to silence voices opposed to the indefensible lockdowns. These guidelines stifle debate, which is apparently the colleges goal
Other health care professional (including retired)
[June 29, 2021 5:53 PM]
I’m pleased to see these guidelines, as some social media accounts have been sources of blatant misrepresentation and irresponsible claims throughout the pandemic. Professionals have a higher level of responsibility to the public than others in the community as relates to their areas of expertise, and the claim by another commentator that this is a violation of free speech is nonsense. Professionals are free to say whatever they wish, but they should be held accountable by their colleagues if their speech is harmful to the public or undermines public trust in medicine. I’m assuming that the College is not looking to enforce the policy in a disproportionate manner, and believe that it’s important to have a standard that can guide conduct.
Physician (including retired)
[June 29, 2021 12:49 PM]
This is a very well-thought-out policy document. It is clear and direct. It is professional and respectful. If this policy is not adhered to, what should this behaviour be called, and what are the consequences? PS. This should be a policy for all users of social media. Thank you.
Physician (including retired)
[June 29, 2021 11:32 AM]
Excellent guidelines - we desperately need this now as recently many medical students and physicians have been posting hateful messages on social media about Israeli citizens and about Jews. This is an affront to their Israeli and Jewish colleagues, trainees and patients.
Physician (including retired)
[June 29, 2021 10:41 AM]
There MUST be a confidential reporting system to notify the CPSO of physicians in Ontario who are engaging in blatant bullying and ostracism of colleagues and students in their workplace, and for advocating such behavior in Social Media.
Physician (including retired)
[June 29, 2021 9:18 AM]
I think these guidelines will really constrain rapid dissemination of important public health information in a crisis. Unfortunately, in an event such as a pandemic, knowledge evolves over time, there is little certainty. I note that I have been advocating for better understanding of aerosol transmission of covid transmission on social media for over a year now. That has gone against the grain in terms of consensus opinion of many of my infectious disease colleagues, but has actually proven to be right, over time. I would be concerned that these guidelines, as written, would make it impossible to disseminate information like this without opening oneself up to (potentially vexatious) complaints, and make it difficult to challenge consensus opinion. I wonder whether it is worth considering the unusual circumstances as a distinct event where constraints on social media usage might constitute overreach (understanding as I do that the motivation for updating of this guidance is a direct reflection of some of the shortcomings of existing guidance revealed by the stresses of the pandemic). When we return to "normal life", I do think these revised guidelines will be entirely appropriate.
Physician (including retired)
[June 29, 2021 9:12 AM]
This is an infringement on the freedom of speech. The prime minister and any politician does not have restriction in the social media arena , why should physicians ? Does a physician have to refrain from ,for example, opposing naturopaths or chiropractors on their vaccination stance or oppose them on their over investigation with unnecessary testing/ imaging of patients ? Any opposition could be construed as bullying.
Physician (including retired)
[June 29, 2021 9:02 AM]
My comment is around the item "Health related information and clinical advice. I have seen many statements on social media that are counter to what evidence supports, and these have been around for a long time. Examples that come to mind are naturopathic treatments offered by physicians who offer complementary medicine. We seem to accept these. I am not sure how you would do it, but is there a better way to describe the threshold between "verifiable and supported by available evidence and science" and mostly harmless and accepted and used by society at large. Seems there is a pretty big grey area potentially
Physician (including retired)
[June 29, 2021 8:50 AM]
1.) why is the largest population on the bottom? 2.) learnt during my residency you cannot fight preconceived ideas combined with selective forgettulness and ignoring facts contrary to your beliefs. Even physicians often argue in the wrong way as thr entire school system from kindergsrden on teaches acceptance of prevalent (often erroneous) beliefs instead of rigorous thinking process from Plato to Godel - and proper evaluation of facts by logic and correct statustical methods. Fools are teaching fools but we want them to be correct.
Member of the public
[June 26, 2021 8:57 PM]
Lines 74 to 77 of the Advice document caught my eye and strike me as absurd: "Microaggressions are everyday comments or actions that subtly express a stereotype of, or prejudice towards, a marginalized group. While microaggressions can be inadvertent and unintentional, their impact can be harmful by undermining trust or creating an unwelcoming environment, and lead to worse health outcomes." About 100,000 pre-born Canadians are deliberately killed every year under the euphemism of "reproductive health care." ONE HUNDRED THOUSAND MURDERS ANNUALLY! How about discussing actual MACROaggressions? Obviously the power lies with whoever decides what group is being marginalized or what marginalization is. Free speech is the best policy.