Principles of Practice and Duties of Physicians

Overarching principles of practice flow from the values articulated above. The principles of practice, in turn, ground the specific duties of the individual physician.

Physicians accepted into practice in Ontario meet a standard of excellence in education and performance. Patients trust their physicians to be clinically competent in all areas of their practice. However, competence is more than just clinical skills and knowledge; it is also practising safely and effectively. Safe and effective care is achieved when physicians know about and abide by their professional obligations, and are competent as communicators, collaborators, advocators, and managers. It is expected that throughout a physician’s career he or she will maintain his or her competence to ensure that patients receive the best care possible.

The principles of practice listed below encompass these competencies. Duties reflect the profession’s values and demonstrate the principles of practice in action.


A. Individually to the Patient

Principles of Practice

The doctor-patient relationship is the foundation of the practice of medicine. It reflects the values of compassion, service, altruism, and trustworthiness. Trustworthiness is the cornerstone of the doctor-patient relationship; without trust a good doctor-patient relationship cannot exist.

Physicians have a fiduciary duty to their patients—because the balance of knowledge and information favours the physician, patients are reliant on their physicians and may be vulnerable. The patient must always be confident that the physician has put the needs of the patient first. This principle should inform all aspects of the physician’s practice.

Physicians are expected to make their patient’s needs the first priority, but accomplishing this requires a broader focus than the direct physician-patient relationship. In order to meet individual patient needs, physicians should consider their contributions to their individual patients, but also to their own practice, the community, and the health care system. Physicians hold a respected position in society and, in return, they have responsibilities. Physicians should never forget that their primary responsibility is to the patient standing before them, either individually or collectively.

B. As a Member of the Profession, Collectively to the Public

Principles of Practice

That the values of compassion, service, altruism, and trustworthiness apply to the individual doctor-patient relationship is clear. Physicians have responsibilities to patients which, as noted earlier, are paramount. However, these values are also reflected in the individual physician’s responsibility to the profession of medicine, inasmuch as the medical profession works together to serve the public interest.

C. To Themselves and Colleagues

Principles of Practice

The practice of medicine is challenging. Physicians are expected by the profession and the public to meet high standards for excellence in the care they provide to patients. In addition, physicians often face competing demands—from patients, other health care professionals, the health care system, and from the expectations the physician holds for him or herself. These factors can give rise to stress, fatigue, exhaustion and frustration, which can have an impact on both the physician personally and the care the physician is able to provide to his or her patients.

Physicians, as a group, should provide mentorship, support and care to one another, in order to ensure their patients receive quality care, as well as to maintain their own personal wellness.