Harassment and bullying of emergency physicians
March 2026
Trevor Jain, Lisa Salamon, Kaitlin Stockton, Blair L. Bigham, Paul Parks, Brittany Ellis, James Stempien
Preamble
Advocating for better patient care, health system reform, and physician rights is a core physician competency and professional responsbility. Behaviors, which include intimination and retaliation, create toxic work environments, compromise patient safety, adn contribute to physician burnout and attrition.
Position Statement
The Canadian Association of Emergency Physicians (CAEP) unequivocally condemns all forms of workplace harassment, bullying, and intimidation of emergency physicians by organizational and system-level administrators, colleagues, medical leadership, health system officials, and politicians. CAEP advocates for a safe, respectful, and supportive work environment where emergency physicians can provide optimal patient care and advocate without fear of retribution or discrimination.
Key Principles
1. Zero tolerance for harassment and bullying:
CAEP affirms that workplace harassment and bullying, including coercion, threats, intimidation, or administrative violence, must not be tolerated.
Clear policies and mechanisms should be in place to report and address such behaviors in a transparent and fair manner.
Physicians in clinical and administrative roles must receive regular training on these policies and procedures.
2. Protection Against Retaliation:
Emergency physicians must be able to advocate for patient safety, proper resource allocation, and workplace conditions without fear of punitive measures. They are expected to conduct their advocacy in line with professional expectations consistent with all of their CanMeds Roles
Whistleblower protections should be established and enforced to prevent retaliation. Institutional policies governing professional behavior should not limit advocacy.
The Canadian Medical Protection Association (CMPA) and provincial medical associations should increase awareness of their support services for physician advocates/whistleblowers.
3. Accountability:
Administrators must be accountable to existing anti-harassment and anti-bullying policy and legislation.
Leaders must foster a culture of respect and professionalism, for valuing advocacy, and for adhering to anti-harassment and anti-bullying policies.
4. Mental health and well-being:
Organizations must prioritize physician wellness, recognizing that harassment and bullying contribute to moral injury, burnout, and workforce attrition.
Mental health resources and peer support programs should be effectively promoted and readily available.
5. Equitable and fair conflict resolution:
Transparent conflict resolution processes by a body, free from administrative and governmental bias, should be in place to address disputes and whistleblower complaints between emergency physicians and hospital administration.
Call to action
CAEP urges hospitals, health systems, and policymakers to:
Implement and enforce anti-harassment and anti-bullying policies with accountability.
Implement effective whistleblower protection.
Ensure fair and unbiased due process for physicians facing administrative conflicts.
Create independent reporting structures for workplace mistreatment.
Foster and institute a culture of respect and collaboration between administration and physicians. Implement key performance indicators annually to ensure anti-harassment, anti-bullying, and whistleblower policies are being followed.
Deliver training and education for administrators on anti-harassment and anti-bullying policy and legislation.
CAEP is willing to meet with provincial and territorial medical associations to help with a pathway to address and enforce these calls to action.CAEP remains committed to advocating for the rights, well-being, and fair treatment of emergency physicians, recognizing that a respectful and supportive work environment is essential for high-quality patient care.
Definitions
Advocacy—The act of supporting, defending, or speaking on behalf of physicians and patients. Advocacy takes place in institutions, communities, or political arenas and aims to change policy, improve workplace safety, and optimize the safe care patients deserve.
Activism—A more direct, often disruptive approach to calling for system change. While advocacy works within existing structures, activism may involve protests, petitions, and public campaigns that challenge entrenched practices harming physicians and patients.
Harassment—Repeated, unwanted, or hostile behaviors intended to humiliate, degrade, or exert control over physicians. This can take many forms including verbal abuse, unfair disciplinary actions, excessive scrutiny, or social isolation within institutions.
Bullying—Persistent abuse or coercion by colleagues or administrators that diminishes a physician’s ability to work effectively. This may include public humiliation, professional sabotage, exclusion from decision-making, or psychological pressure.
Intimidation—The act of instilling fear with the intent of suppressing a physicians’ advocacy. This can involve threats to employment, legal actions, professional blacklisting, or issuance of warnings that discourage whistleblowing or advocacy.
Administrative violence—Systemic harm inflicted through policies, bureaucracy, and institutional practices that harass, bully, or intimidate physician advocacy efforts. Examples include unfair performance reviews, termination without due process, excessive workloads, refusal of promotions, or retaliatory audits.
Threats—Explicit or implicit warnings that aim to stop physicians from advocating for their workplaces or their patients. These can range from loss of privileges, career stagnation, legal actions, or personal safety concerns.
Whistleblowing—The act of reporting unethical, abusive, or harmful behavior within medical institutions. It includes exposing the bullying of physicians by colleagues or superiors that affects their well-being and patient care. Whistleblowers often face personal and professional risks despite acting in public interest.
Declarations
Conflict of interest All authors declare no conflicts of interest.
Ethical approval This statement is CJEM board approved.