Health advocacy traditionally involves physicians educating patients and the general public about good health. Physicians may participate in any number of activities in their role as a health advocate. Health advocacy activities may include a family physician speaking to school children about the hazards of smoking, a cardiologist speaking to seniors about lipid reductions on a website, or a dermatologist participating in a social media campaign about melanoma awareness.
Both the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada recognize health advocacy as a key competency and responsibility of physicians. The CMPA also acknowledges the important role physicians play in health advocacy and in debates about health care policy. However, it is important to be aware that this type of activity carries with it the same obligations of professionalism that apply in all aspects of a physician’s role. Medical regulatory authorities (Colleges) have established expectations for physicians and generally require that physicians engaging in health advocacy act in a respectful and thoughtful manner. Failing to communicate respectfully may lead to allegations of defamation, College complaints and/or human rights complaints.
The CMPA’s general principles with respect to assisting members engaged in health advocacy are as follows:
Assistance will generally be available for matters arising from health advocacy relating to the professional practice of medicine, recognizing that assistance will not generally be available for matters arising primarily from personal or business issues.1 Where a member is engaged in health advocacy directed at a non-medical audience, they will generally be eligible for assistance in Canada regardless of the forum or medium chosen (e.g. virtual, live, or through various media, including social media). Members engaging in health advocacy directed at a medical audience will generally be eligible for assistance in or outside Canada regardless of the forum or medium chosen. Assistance is also generally available whether or not the member received a financial benefit for participating in the health advocacy activity. However, where a medico-legal difficulty is related to the promotion of a particular product or service, the member will not generally be eligible for CMPA assistance.
A word about social media
The Association’s previously published principles respecting advocacy and health promotion were developed before social media became an established part of mainstream communications. Social media communications offer a way to disseminate information widely, but unlike traditional media there is little or no editorial oversight. Unfortunately, these platforms have evolved in such a way that injudicious, inflammatory, and sometimes malicious comments have become commonplace. Such comments have sometimes appeared in social media posts by physicians engaged in health advocacy. Members should be aware that the Canadian Medical Association and a number of regulatory Colleges across Canada have established expectations for respectful professional communications by physicians engaged in social media.
Defamation
Defamation involves making a false statement about a person that is damaging to the person’s reputation. Members may face allegations of defamation in a variety of situations where the member has made negative verbal or written statements about another individual or institution. For reasons identified above, social media presents an opportunity for a particularly high risk of defamation claims.
The following suggestions may help members avoid defamation actions:
- Avoid impulsive, malicious verbal or written commentary.
- Think about how the recipient might feel and react to a statement that could be inflammatory.
- Be aware of obligatory reporting responsibilities under regulation or legislation.
- Address any concerns, after appropriate reflection, to the next immediate level in the applicable administrative structure.
- Be very cautious when using email or social media—which can be distributed widely without the sender’s knowledge—for communicating sensitive issues.
- When expressing a concern within your institution, do not share correspondence outside the applicable administrative structure.
When will the Association generally assist in defending a defamation lawsuit?
- Where a member faces allegations of defamation, the CMPA will consider whether the allegations arise out of the member’s health advocacy activities that relate to the member’s professional practice of medicine. CMPA assistance will not generally be available for health advocacy matters primarily arising from business or personal issues.
- Where a member faces allegations of defamation arising from a legally or ethically obligatory report or statement to representatives with a corresponding duty to receive such reports, CMPA assistance will generally be available.
Relevant CMPA publications
Extent of assistance:
Guidance and advice:
1. Matters primarily arising from business and personal issues include allegations arising from statements made in the role of spokesperson for an organization, personal attacks and matters of a marital or familial nature.
