Published on 10 September 2026

The CanMEDS framework, used as an educational standard, defines the core abilities and skills doctors need to provide high-quality, patient-centred care.

These are grouped into seven distinct roles, one of which is Health Advocate: supporting patients and contributing to improvements in the health system.¹

I find myself advocating for my patients in many different ways.

Sometimes, it means challenging a clinical decision when the response does not seem to be in my patient’s best interests.

I referred a patient to a higher level of care because of episodes of tachycardia consistent with paroxysmal supraventricular tachycardia (PSVT). She returned with a diagnosis of an anxiety disorder. In fairness, she did also have generalised anxiety disorder.

However, I remained concerned that her episodes of tachycardia had not been adequately explained. I made an effort to capture an ECG during an episode of her abnormal heart rhythm and referred her again. She was subsequently referred to cardiology, where the cardiac problem was addressed.

In another patient with extreme hypermobility, I suspected an underlying genetic disorder. When I referred him to the next level of care, he was referred back with a diagnosis of generalised hypermobility disorder and the advice that no further investigations were indicated.

I took the initiative to refer him directly to the genetic clinic at the nearest teaching hospital. A hereditary genetic disorder was subsequently confirmed.

For this patient, the diagnosis did more than provide a medical explanation. It validated his symptoms and reassured him that he was not malingering.

Sometimes, advocacy is simply about following things through.

It might mean chasing a delayed histology report, phoning the pathology department and asking to speak directly to the attending pathologist because the result is urgent.

On another occasion, after referring a patient, I was given the attending doctor's contact details. I phoned repeatedly. Sometimes there was no answer; sometimes I was told the doctor was unavailable. I kept trying until I eventually got through.

It can be frustrating and time-consuming, and at times it feels like pushing against a system that makes it unnecessarily difficult to get things done.

But when the patient eventually gets the attention they need, it feels worthwhile.

Health advocacy isn't always about speaking loudly. Sometimes it means simply not giving up when your patient needs you to keep going.

¹ CanMEDS 2015 Physician Competency Framework – Royal College of Physicians and Surgeons of Canada https://www.royalcollege.ca/content/dam/document/standards-and-accreditation/canmeds-full-framework