Doctors can practice medicine anywhere in the world because medicine itself is wherever we are, but the challenge lies in learning the local health system, its rules, and regulations, and applying them. Therefore, the main obstacle facing doctors coming from outside Canada is how to integrate into a different health system and understand and apply its laws and regulations.

The topic of integration with systems and laws is not limited to doctors only but applies to everyone who came from different places carrying traditions and customs that may not align with Canadian laws and systems. 

It is common in our Arab countries and perhaps in all Eastern countries that doctors treat their friends and relatives and even take their patients as friends. It is also normal to see a doctor and their patient eating together in a restaurant or cafeteria, and perhaps even traveling together for outings. Moreover, it is not uncommon for a doctor to marry their patient or a female doctor to marry her male patient. 

The doctor who tries in our countries to set boundaries and restrict relationships with patients or tries to act professionally and formally seems complicated and eccentric and is perceived as arrogant and proud. 

When I started practicing medicine in Canada, I felt comfort and happiness with many laws that regulate the work of doctors, including the rule that prevents doctors from treating their friends and relatives, which I applied with joy and immense happiness due to my absolute belief in its importance and benefit for both doctors and patients alike, as well as the constant emphasis that the relationship between doctors and their patients should remain purely professional and formal, limited to the doctor's workplace and should not extend beyond its walls.

It was not easy for patients at first, and the main problem I faced was the difficulty people had in accepting this manner, which seemed strange and perhaps unacceptable to them. 

Patients believed that their frequent medical visits to me, and because I am Arab, turned our professional relationship into a friendship. They even began to believe that they had the right and priority in everything and thought that I might bypass regulations and perhaps laws for their sake. This created many problems due to their difficulty understanding the boundaries I tried to set from day one. Many painful and unfortunate incidents occurred, none of which ended happily in any way. 

Arab doctors suffer greatly from the lack of understanding among Arab patients of the nature of the relationship that should exist between them and their doctors. Doctors strive to keep the relationship purely professional and formal, while patients, with good intentions, try to take it in the other direction—towards social and personal relationships, which ultimately come at the expense of the professional relationship, thereby spoiling the relationship between them and, consequently, affecting the patient's health in one way or another. 

It is in the patient's interest that the relationship between him and his doctor is purely formal so that the doctor's thoughts and work focus only on the medical condition without being preoccupied with matters that do not serve the patient's health.

 The patient's belief that his relationship with his doctor is not only formal raises his expectations from the doctor. When these expectations exceed the doctor's ability and it becomes impossible for him to meet them, this will cause the patient great disappointment and frustration, casting a shadow over their relationship, which negatively affects the patient's health. 

I fully understand the good intentions of the vast majority of patients, but good intentions may not always be enough and may sometimes even be harmful.

Personally, I wish the majority of patients were my friends if the law allowed, and I also wish our social relationship to be deep and comprehensive. However, Canadian laws that regulate the relationship between doctors and their patients prevent us from this because the rule set in this regard is clear and explicit: "Your friend cannot be your patient, and your patient cannot be your friend." Therefore, we must adhere to and strictly apply this rule in the interest of both parties. 

Dr. Jassam

Medheiven Medical Center - Ottawa