No one engaging in the unauthorized practice of medicine can rely “on ‘weasel words’ to avoid accountability and gloss over the substance of what [they are] actually doing.” So says an Alberta Court in: College of Physicians and Surgeons of Alberta v Makis, 2026 ABKB 159 (CanLII).
Mr. Makis, a former licensed physician, advocates for the use of ivermectin to treat cancer. The regulator obtained an interim injunction prohibiting Mr. Makis from assessing or treating individuals or from using several protected titles. The regulator subsequently obtained information, mostly from social media sites and electronic communications, that Mr. Makis was breaching the order. The Court found that Mr. Makis was in contempt of the order. The Court made the order permanent and offered Mr. Makis an opportunity to purge his contempt. If Mr. Makis failed to do so, the regulator was authorized to obtain a warrant to have Mr. Makis arrested and be brought to the Court for a sanction hearing.
In reaching this conclusion, the Court made the following points:
- The substance of Mr. Makis’s communication with “clients” involved reviewing their medical history, test results, and records and an individualized discussion about using ivermectin (or other drugs). Mr. Makis characterized the communications as “health coaching” and providing information and research. The Court had no difficulty in concluding that this amounted to the assessment and treatment of patients.
- A finding that he used protected titles can include evidence of the failure to correct others who use such titles when referring to him. Mr. Makis reposted items that contained such titles for him without any clarification or correction. The Court said that the regulator “has proven beyond a reasonable doubt that Mr. Makis continues to make use of or apply prohibited titles and terms to himself, whether directly, by implication or by omission, and has done so deliberately.”
- The authentication requirements for social media materials, even where the burden of proof was beyond a reasonable doubt, is fairly low. In the circumstances, it was sufficient for the witness to identify descriptions or copies of what they saw without “metadata, hash values, timestamps from the platform, or expert forensic analysis to confirm authenticity”.
- Even though the regulator no longer has jurisdiction over Mr. Makis as a registrant, it still has standing (i.e., jurisdiction), as a protector of the public interest, to seek an injunction against his breach of the law.
- So long as Mr. Makis was a resident of Alberta, an injunction could prohibit his communications with others outside of Alberta.
- The freedom of expression guaranteed by the Canadian Charter of Rights and Freedoms does not facilitate the unauthorized practice of a profession or the unauthorized use of protected titles.
When it comes to unauthorized practice, “One must look at the substantive nature of the impugned activity, not the labels used by the actor.”
