Creating safe spaces for all in Alberta’s healthcare system

College of Physicians and Surgeons of Alberta CPSA, Medical Matters, Messenger 2 Comments

As some of you already know, our most recent Council meeting in May resulted in some very clear directions to the profession. The Statement of Principles regarding sexual misconduct against patients, our intention to seek stricter sanctions on physicians who commit these offences and to increase transparency in what we communicate to the public all came about because we listened to the feedback we received from Albertans and took appropriate action.

The reality is, these statements really only apply to a very small percentage of the profession. We recognize that the majority of physicians in Alberta are doing incredibly good work and these changes will not have an impact on what they already do every day.

The importance of safety

What is expressed in the Statement of Principles is not new to us, but makes our position crystal clear to everyone else: sexual abuse or sexual misconduct of any kind is simply not acceptable. At no point should a patient, learner, colleague, healthcare provider or anyone working in our field have to endure this type of behaviour.

Sexual misconduct is one thing, but any type of disruptive behaviour should never be tolerated. Any behaviour that makes people feel unsafe at work, increases stress and decreases performance. In the best case scenario, disruptive behaviour leads to someone’s day going poorly; at worst, it results in medical errors, less effective care and potentially, the loss of life.

We have all heard that burnout in the medical profession is as high as 50 per cent and I suspect the number is similarly high for other areas of health care. I believe that at least some of this could be attributed to healthcare providers feeling unsafe and not having a sense of control in the workplace. This is certainly not a new theory and if anyone would like to learn more, I recommend reading one of Simon Sinek’s books on leadership and management.

Gone are the days when inappropriate behaviour is tolerated because we need someone’s special knowledge or skills. A healthcare environment, where people often go for help when they are at their most vulnerable, should be safe and inclusive. Patients and staff alike should never have to fear being treated inappropriately.

Be the change you want to see

Recent changes to Alberta’s Occupational Health and Safety Act highlight the importance of addressing harassment in the workplace, and Canada has a National Standard for Psychological Health and Safety in the Workplace. College Council also just updated our Boundary Violations standard of practice. As well as being the right thing to do, these standards enhance performance of the workforce.

I’ve said this before and still firmly believe that ALL physicians can make a difference here. The vast majority are doing great work, but unfortunately it’s the few who impact the many.

In one of my earlier Messenger articles, I talked about the value of high-performing teams and the influence physicians have on the performance of those teams. Instead of letting the few negatively impact our profession, let’s find ways to curb their influence. Let’s create safe environments by supporting each other and making it clear that inappropriate behaviour of any kind is not acceptable. Doing so will not only benefit our profession and the healthcare system overall, but will lead to better patient care, decreased medical errors and enhanced patient safety.

Let’s all do our part to build safe environments for everyone.

As always, I welcome your comments.


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Richard Falkenstein

Scott: That all sounds nice, and, certainly extreme behavior such as sexual misconduct has to be sanctioned appropriately. However, disruption can sometimes be necessary for patient safety. When a team of health care providers have come up with a plan (somewhat based on their own individual preferences) but without input from some who have to put it into practice; and those some see flaws, the plan may need to be disrupted. I see this, not infrequently, as an Anaesthesiologist: a practitioner whose involvement is integral to the plans’ success, but who often becomes involved only at the last minute. Not… Read more »

Scott McLeod

Good morning Richard, Thank you so very much for taking the time to respond to the last Medical Matters. I could not agree with you more. There are times when”disruption” needs to occur for the sake of patient safety, but how that is done is often the problem. I believe productive and respectful disruption is essential for the success of any organization, but the use of bullying techniques and demeaning others on the team is actually worse for patient care. Studies have shown that health care providers who have been treated poorly in the workplace have poorer concentration on the… Read more »