Right and wrong. Good and bad. With us or against us. This is the discourse of today’s polarized world. People use every available platform to boost their opinions and rally the like-minded. Those who disagree with them are evil, on the wrong side of history, animals, less than human. I’m an internal medicine physician at Sunnybrook Health Sciences Centre in Toronto. Doctors like me aren’t immune to this climate. In fact, we struggle with it regularly, navigating charged conversations on sensitive issues—including ones that cut to the core of our work, like abortion, medical assistance in dying, vaccinations, pain medication during pregnancy and gender-affirming care for youths.

These days, logical debates quickly devolve into personal attacks. James Downar, a critical care and palliative care physician in Ottawa, told me fellow doctors have publicly called him a murderer for providing MAID. An abortion provider I know—I’ll call her Mary—has worked for over 30 years in nearly every province and territory. She told me about a colleague who harassed her daily, saying, “How do you kill 15 babies in one day? Doesn’t it make you sick?” In an online forum for physicians, a surgeon I know saw colleagues being called “fat-phobic” and “bigoted” for asking questions about Ozempic and discussing exercise regimens. And one emergency doctor, who organized petitions and lobbied for community support to keep the women’s health program open at her hospital, was publicly attacked by hospital leadership. They called her crazy, and one of the senior physician leaders said, “Is something wrong with her mental health?”

This kind of incivility is frighteningly widespread in medicine. A 2024 article in the Canadian Medical Association Journal highlighted that more than 75 per cent of health-care workers have seen physicians engaging in uncivil conduct. Nearly one in three doctors are subjected to rude, dismissive and aggressive behaviour by other physicians on a weekly or even daily basis.

Many physicians who lash out at colleagues aren’t driven by malice. They........

© Macleans