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Canadian Medical Association


The Canadian Medical Association (CMA) is a national, voluntary association of physicians that advocates on national health matters. Its new strategic plan identifies its primary mandate: driving positive change in health care by advocating on key health issues facing doctors and their patients.[1]

Canadian Medical Association
CMA AMC.jpg
AbbreviationCMA
Formation1867
TypeOrganizations based in Canada with royal patronage
Legal statusactive
PurposeAdvocacy on national health and medical matters
HeadquartersOttawa, Ontario, Canada
Region served
Canada
Membership
more than 85,000 physicians and physicians in training
Official language
English, French
President
Dr. Gigi Osler (2018-2019)
President-Elect
Dr. Sandy Buchman (2019-2020)
WebsiteCMA

The Canadian Medical Association Journal (often abbreviated as CMAJ) is a peer-reviewed general medical journal that publishes original clinical research, commentaries, analyses and reviews of clinical topics, health news, and clinical-practice updates.

Contents

MembershipEdit

The CMA has over 85,000 members[2] and is the largest association of medical doctors in Canada. Its membership includes physicians and medical learners. The CMA represents Canadian physicians from medical school through to residency, medical practice and retirement.

HistoryEdit

CMA's origins may rest with Dr. Joseph Painchaud and other Quebec physicians who in 1844 hoped to find ways to help physicians and, after their deaths, their widows and orphans.[3] There were false starts in attempts to form an association, but soon after confederation, practicing physicians were successful in developing a national body.

CMA's first president was Sir Charles Tupper,[4] the Nova Scotia Premier who led that province into confederation and later became Prime Minister of Canada. The foundation of the CMA was strongly rooted in its Scottish origins as the first three presidents of the CMA graduated from the Edinburgh Medical School.[5]

Among CMA's founding principles in 1867 was to "improve public health and prevent disease and disability," a purpose which remains today.

The fledgling association faced a lot of growing pains in its first 25 years as meeting attendance was small. There was even a notice of motion in 1894 to disband it.[6]

The Montreal Medical Journal was taken over in 1911 to become the CMA Journal.[7]

In 1921, the CMA re-organized with the appointment of its first permanent general-secretary, Dr. T.C. Routley. The association also became more financially stable by raising funds with a bond issue.[8]

Over the years, the CMA and its physician members have contributed to improved health and safety of Canadians. They have advocated on behalf of patients and educated the public to limit the effects of outbreaks, such as the 1918 Spanish flu, SARS in 2002 and the H1N1 influenza pandemic in 2009-2010.[9]

The CMA was instrumental in advancing awareness and treatment of cancer and formed the Canadian Cancer Society (CCS). The association provided most of the funds for the early years of the CCS based on interest generated from public donations made to a fund honouring King George V's silver jubilee.[10]

Since the 1950s, the CMA has warned the public about tobacco use. It successfully fought against promotional tobacco marketing and for new laws that curbed smoking and other tobacco consumption among Canadians.

The CMA also played a central role in the creation of the Registered Retirement Savings Plan in 1957 as a tool to provide its members financial security in retirement.[11] MD Financial Management was developed in 1969 to provide financial services to physicians and their families. It was sold in 2018 to Scotiabank and the sale includes a 10-year collaboration agreement.[12]

In the 1990s, the CMA successfully campaigned for mandatory use of seatbelts across the country.

In 2018, the CMA ended its membership in the World Medical Association to protest the plagiarism found in the speech of the WMA's incoming president.[13][14]

AdvocacyEdit

As a national association of physicians, the CMA often advocates on sensitive medical issues. In developing its positions, it seeks public input through town hall meetings, surveys its members and reviews relevant scientific research. It also seeks input from provincial-territorial medical associations and from its more than 60 affiliate, associate and stakeholder organizations.[15]

Medical Aid in DyingEdit

In 2015, the Supreme Court of Canada, in a unanimous decision, struck down the Criminal Code's absolute prohibition on physician-assisted death.[16] As a result, the CMA developed foundational principles for medical aid in dying[17] to guide discussions with its members and with the federal government on ensuring patient dignity and upholding the rights of both patients and physicians. Consultations included submissions and presentations to the Federal External Panel,[18] the House of Commons Standing Committee on Justice and Human Rights[19] and Health Canada.[20]

The CMA continues to work with government to address outstanding issues including medically assisted dying for mature minors and those who have mental illness as the sole underlying medical condition.

Seniors Care and Demand a PlanEdit

Demand a Plan is a public campaign spearheaded by the CMA with the aim of having all levels of government work together to develop a comprehensive national seniors strategy. Close to 70,000 have signed up in support of the campaign.[21]

The Canadian medical system must adjust to care for the large numbers of "baby boomers" born between 1946 and 1965 and who are now, or soon will be, seniors. By 2024, those 65 or older will account for 20.1% of the population.[22] According to a medium-growth projection, seniors will make up over 40% of the population by 2063.[23] People aged 85 years and older are the fastest growing age group, and by 2063 (again based on a medium-growth scenario) there will be 62,000 Canadians 100 years or older.[24]

The Standing Committee on Human Resources, Skills and Development and the Status of Persons with Disabilities, in a report March 2018,[25] adopted many of the recommendations made the previous year by the CMA on ways to better serve seniors with improvements to housing, income security and quality of life.[26]

Choosing Wisely CanadaEdit

Choosing Wisely Canada was launched by Dr. Wendy Levinson in 2014 in partnership with the CMA to help physicians and patients reduce unnecessary tests, treatments and procedures, and ensure high-quality care.[27] Central to the campaign are lists developed by more than 45 specialty societies to encourage critical thinking that will avoid unnecessary and potentially harmful tests and procedures.[28] The federal government's Advisory Panel on Health Care Innovation urges governments in all jurisdictions to support the initiative.[29]

Drugs: Pharmacare, Opioids and CannabisEdit

The CMA continues to advocate that Canadians should have access to medically necessary pharmaceuticals that are safe, effective, available when and where needed and reasonably priced.[30]

The CMA is an active member of the Pan-Canadian Collaborative on Education for Improved Opioid Prescribing, which is chaired by the College of Family Physicians of Canada.[31] CMA's position is that opioids are important for managing pain, but prescribing them must be based on evidence and include careful assessment and monitoring.[32] The CMA endorsed the collaborative's clinical guideline for opioids,[33] initially published by CMAJ and updated in 2017 by the Michael G. DeGroote National Pain Centre.[34]

The CMA identified potential risks of cannabis use and has addressed them in submissions to House of Commons standing committees.[35][36] [37] Following introduction of The Cannabis Act, the association provided guidance to the federal government on a regulatory framework to protect children and youth.[38]

Health and TechnologyEdit

Through its subsidiary company, Joule, CMA promotes new technologies that could bridge the physical divide between doctors and patients, thereby reducing wait times[39] and health care costs. Technologies such as virtual realities, artificial intelligence and robotics hold significant promise for patients and physicians, particularly for a country like Canada with its large land base and numerous remote communities.[40]

Although electronic medical records improve efficiency, quality, cost-effectiveness and safety of primary care and are increasingly being adopted by physicians in Canada, Canada still lags behind other developed countries in their use.[41] Increased adoption could be facilitated by additional financial and human resources and improved interoperability among information technologies used by physicians, hospitals and pharmacies.[42]

Physician Health and WellnessEdit

A CMA National Physician Health Survey report released in 2018 states that while physicians report high resiliency, they also experience high levels of burnout and depression, particularly among residents and women.[43]

The CMA hosted the International Conference on Physician Health in 2018.[44]

Provincial and Territorial Medical AssociationsEdit

Corporate StructureEdit

The size of the elected board of directors is transitioning to 19. The board includes physician, resident and student representatives. It is the executive authority of the CMA, meets four times a year and is responsible for policy direction.

In 2018, the association announced the CMA Patient Voice, a group of 12 individuals that will provide a patient's perspective to CMA's work.

An annual health summit among a wide spectrum of medical and health professionals as well as patient representatives[45] is held to disseminate new research, information and innovations, and to debate issues facing the medical community and users of medical services.

A public annual general meeting is held to review financial statements and other CMA business matters. As well, the association holds an annual General Council meeting of its members to discuss policy matters.

CMA CompaniesEdit

CMA's subsidiary company Joule was created on September 1, 2014. It delivers continuing education to doctors, resources for accessing medical information online, clinical information resources and summaries of the latest clinical evidence. CMAJ is published by Joule. Joule's grant program funds CMA member innovations that hold promise in the advancement of health care.

The CMA Foundation was launched in 2017 to support charities furthering health care.[46]

CMA AwardsEdit

Each year the Canadian Medical Association invites nominations for CMA awards. Awards are presented at the annual meeting in August.

  • Owen Adams Award of Honour, the highest award the CMA can bestow to a non-physician
  • Medal of Service, to a CMA member making exceptional contributions to the advancement of health care
  • F.N.G. Starr Award, the highest CMA award to a member; recognizes lifetime achievement
  • May Cohen Award for Women Mentors, to a woman physician and CMA member demonstrating leadership in grassroots advocacy
  • Sir Charles Tupper Award for Political Action, to a CMA member demonstrating leadership in grassroots advocacy
  • Awards for Young Leaders, to up to six CMA members for dedication, leadership and commitment in one of these areas: political, clinical, educational, research and community service
  • Dr. William Marsden Award in Medical Ethics and Professionalism, to a member for advancing excellence in medical ethics or professionalism in Canada
  • John McCrae Memorial Medal, for exemplary service to current or former clinical health services personnel with the Canadian Armed Forces

See alsoEdit

ReferencesEdit

  1. ^ "CMA 2020".
  2. ^ "About CMA and CMA Companies".
  3. ^ Howell, W.B. "Men and Books, a review of H.E. MacDermot's History of the Canadian Medical Association, 1867-1921" (PDF). CMAJ. 34(3): 300–331.
  4. ^ "Sir Charles Tupper Award for Political Action".
  5. ^ "Past presidents of the CMA since 1867".
  6. ^ Howell
  7. ^ Ibid
  8. ^ Ibid
  9. ^ "Second Reading of Bill S-248, An Act Respecting National Physicians' Day".
  10. ^ "Our history". Canadian Cancer Society.
  11. ^ "Our history". MD Financial Management.
  12. ^ "Scotiabank completes acquisition of MD Financial Management and begins 10-year collaboration with the Canadian Medical Association".
  13. ^ "Canadian Medical Association (CMA) resigns from the World Medical Association (WMA)".
  14. ^ "Canadian Medical Association Resignation". World Medical Association.
  15. ^ "Affiliates, associated societies and observer organizations".
  16. ^ "Supreme Court Judgments Carter v. Canada".
  17. ^ "Principles-based approach to assisted dying in Canada" (PDF).
  18. ^ "CMA submission to the federal external panel on options for a legislative response to Carter vs. Canada" (PDF).
  19. ^ "CMA Submission: Supporting the enactment of Bill C-14, Medical Assistance in Dying" (PDF).
  20. ^ "Federal monitoring of Medical Assistance in Dying Regulations" (PDF).
  21. ^ "Demand a Plan".
  22. ^ "The Daily - Canada's population estimates: Age and Sex, July 1, 2015". Statistics Canada.
  23. ^ "Highlights, Population projections for Canada (2013 to 2063), Provinces and Territories (2013 to 2038)". Statistics Canada.
  24. ^ Ibid
  25. ^ "Advancing Inclusion and Quality of Life for Seniors".
  26. ^ "CMA submission to the House of Commons Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities" (PDF).
  27. ^ Levinson W, Huynh T. Engaging physicians and patients in conversations about unnecessary tests and procedures: Choosing Wisely Canada. CMAJ. 2014 Mar 18;186(5):325-6.
  28. ^ Levinson W, Kallewaard M, Bhatia RS, Wolfson D, Shortt S, Kerr EA; Choosing Wisely International Working Group. 'Choosing Wisely': a growing international campaign. BMJ Qual Saf. 2015 Feb;24(2):167-74
  29. ^ "Report of the Advisory Panel on Healthcare Innovation: "Unleashing Innovation: Excellent Healthcare for Canada"" (PDF).
  30. ^ "Pharmaceutical Issues".
  31. ^ "What is being done to address the opioid crisis?". Canadian Centre on Substance Use and Addiction.
  32. ^ "Opioids and the CMA".
  33. ^ "The 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain".
  34. ^ "What is being done to..."
  35. ^ "Submission to the House of Commons Standing Committee on Health" (PDF).
  36. ^ "The health and social effects of nonmedical cannabis use". World Health Organization.
  37. ^ Crean, R.D.; Crane, N.A.; Mason, B.J. "An evidence based review of acute and long-term effects of cannabis use on executive cognitive function". J Addict Med.
  38. ^ "CMA Submission: The Cannabis Act, Submission to the House of Commons Standing Committee on Health" (PDF).
  39. ^ "Time to Close the Gap: Report on Wait Times in Canada (2014)".
  40. ^ Beaulieu, Yanick; Kohll, Sonny. "Virtual Care Allows Physicians to Reach Canadians Outside of the Usual Spaces".
  41. ^ "Examining the Relation Between the Use of Electronic Medical Records and the Productivity of Patient Care in Canada: 2014 National Physician Survey" (PDF).
  42. ^ Chang, Feng; Gupta, Nishi. "Progress in medical record adoption in Canada". Canadian Family Physician. 61(12): 1076–1084.
  43. ^ "CMA National Physician Health Survey: A Snapshot" (PDF). p. 2.
  44. ^ "Make It Happen. Make It Matter".
  45. ^ "Patients get floor at Canadian Medical Association inaugural health summit in Winnipeg". CBC.
  46. ^ "The CMA Foundation Celebrates Its One-Year Anniversary".