Resolutions Adopted at General Council

17–19 August 2009
142nd Annual Meeting Saskatoon, SK

Board, Finance, Bylaws

1. The Canadian Medical Association (CMA) approves the Canadian Society of Colon and Rectal Surgeons’ application for CMA affiliate status. (BD 1-1)
   
2. The Canadian Medical Association (CMA) approves the Canadian Society of Endocrinology and Metabolism’s application for CMA affiliate status. (BD 1-2)
   
3. The Canadian Medical Association approves the 2008 audited financial statements, attached as Schedule A to the Report of the Committee on Finance in the 2009 Reports to General Council. (FIN 3-1)
   
4. The Canadian Medical Association will retain PricewaterhouseCoopers as auditors for the 2010 association fiscal year. (FIN 3-2)
   
5. The Canadian Medical Association full membership fee for the year 2010 will be $400. (BD 1-3)
   
6. General Council accepts the bylaw changes as proposed on pages 53-68 of the 2009 Reports to General Council and on page A1 of the Report of the Committee on Bylaws Addendum. (BY 2-19)

Strategic Session

Building a Culture of Patient Care

7. The Canadian Medical Association and provincial/territorial medical associations call on governments to engage patients and the public in the development of a patient bill of health information rights that sets out a vision for the governance of patient health information. (SS 7-7)
   
8. The Canadian Medical Association will engage patients/the public in the development of a Patient Quality Charter that sets out a vision for quality care that includes national standards for patient-focused optimal outcomes. (SS 7-2)
   
9. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates, associates and other stakeholders to develop a business case for quality improvement in health care, including investment in quality training. (SS 7-1)
   
10. The Canadian Medical Association calls upon the Canadian Patient Safety Institute to create an advisory committee to examine and propose strategies and methods for encouraging patient involvement in improving health safety. (SS 7-5)
    
11. The Canadian Medical Association and provincial/territorial medical associations will work with governments to develop effective and stringent requirements for protection, privacy and security of personal health information with the goal of implementation within the next 12 months. (SS 7-8)
    
12. The Canadian Medical Association will work with provincial/territorial medical associations (PTMAs) to urge governments to collaborate with PTMAs in the implementation of a program that will identify and manage “orphan” patients who do not have access to a family physician. (SS 7-4)

Incentives for Enhancing Access and Improving Quality of Care

13. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, affiliates and associates, will call on the federal government to provide appropriate funding for development of and physician access to Canadian clinical practice guidelines, including an up-to-date database that provides summaries for use at the point of care. (SS 7-12)
    
14. The Canadian Medical Association will work with provincial/territorial medical associations to define patient-focused funding in the Canadian context before proposing a methodology for implementation. (SS 7-10)
    
15. The Canadian Medical Association will develop a discussion paper on international experience and research related to pay for performance and quality measures in family medicine. (SS 7-13)
    
16. The Canadian Medical Association will work with affiliates to enhance and adapt existing programs for evidence-based continuous quality improvement for specialties that currently do not have access to such programs. (SS 7-9)
    
17. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, calls on governments and health authorities to examine internal market mechanisms, which could include a role for the private sector, in the delivery of publicly funded health care in Canada. (SS 7-11)

Enhancing Patient Access Across the Continuum of Care

18. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, affiliates and associates, will communicate to governments that insufficient access to long-term care at all ages is an obstacle to improving the health care system. (SS 7-14)
    
19. The Canadian Medical Association believes that in the context of increased chronic illness, the transformation of the health care system requires both a strengthening of primary care services as well as improved access to technical and specialty services for primary care physicians. (SS 7-17)
    
20. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates, associates and other stakeholders to develop mechanisms to regularly and systematically document patients’ wishes for end-of-life care upon their entry into the home care and community care systems. (SS 7-15)
    
21. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates, associates and other stakeholders to develop and implement wait-time benchmarks for accessing home and community care services. (SS 7-16)

Helping Providers Help Patients / Building Accountability

22. The Canadian Medical Association believes that in the context of increased chronic illness, the transformation of the health care system must involve the creation of interdisciplinary teams. (SS 7-23)
    
23. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, urges governments to promote the implementation of practice models that make optimal use of the respective expertise of general practitioners and specialists. (SS 7-25)
    
24. The Canadian Medical Association and provincial/territorial medical associations call on governments to ensure that institutional and organizational health information technology projects consider the requirements of physicians’ offices to facilitate information flow. (SS 7-32)
    
25. The Canadian Medical Association and provincial/territorial medical associations call on governments to ensure completion of an evaluation of the impact of health information technology that considers the level of functionality and assesses its effect on patient and provider experience of care, population health and per capita costs. (SS 7-33)
    
26. The Canadian Medical Association will work with provincial/territorial medical associations to develop sustainable funding models for collaborative care in community-based practice. (SS 7-19)
    
27. The Canadian Medical Association and provincial/territorial medical associations will develop a five-year implementation plan with clear targets for accelerating the adoption of health information technology in Canada. (SS 7-20)
    
28. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates and associates to maximize the added value that physicians bring to patient care by reducing physician involvement in services that can be more appropriately delegated to other members of the health care team. (SS 7-21)
    
29. The Canadian Medical Association and provincial/territorial medical associations urge the federal government to immediately transfer to Canada Health Infoway the $500-million investment announced in the February 2009 Economic Action Plan in order to accelerate the adoption of electronic medical records in physician offices by 2011. (SS 7-28a)
    
30. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates and associates to develop a systemic framework for accountability and quality in health care. (SS 7-37)
    
31. The Canadian Medical Association and provincial/territorial medical associations will work with governments to accelerate the introduction of e-prescribing in Canada to make it the main method of prescribing by 2012. (SS 7-31)
    
32. The Canadian Medical Association and provincial/territorial medical associations urge governments to ensure that the $500-million investment in Canada Health Infoway announced in the February 2009 Economic Action Plan be available for up to two years following the transfer of the funding. (SS 7-29a)
    
33. The Canadian Medical Association will work with provincial/territorial medical associations to carry out an inventory and assessment of the payment arrangements across Canada that foster the emergence of new practice models based on an interdisciplinary approach and the use of new information technologies. (SS 7-24)
    
34. The Canadian Medical Association requests the federal government to create a National Health Care Innovation Fund to finance projects initiated by physicians, or groups of professionals including physicians, in order to foster the emergence of new organizational models for improving the quality and effectiveness of health care services. (SS 7-22)
    
35. The Canadian Medical Association and provincial/territorial medical associations will work with governments to create, by Dec. 31, 2010, basic interoperability standards that will ensure secure, reliable, effective and rapid transmission of data across point-of-care information technology systems. (SS 7-30)
    
36. The Canadian Medical Association will work with provincial/territorial medical associations to demand that governments recognize that the flow of information from the patient record to the electronic health records is the professional responsibility of physicians. (SS 7-36a)

Implementation

37. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, will incorporate in its Toward a Blueprint for Health Care Transformation: A Framework for Action a call on governments to include timely access as a dimension of care quality. (SS 7-6)
    
38. The Canadian Medical Association will incorporate in its Toward a Blueprint for Health Care Transformation: A Framework for Action a call on governments to ensure that there is adequate funding of community-based teaching programs for medical students and residents. (SS 7-35)
    
39. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, affiliates and associates, will incorporate in its Toward a Blueprint for Health Care Transformation: A Framework for Action a call on governments to ensure that operating room time allocation includes consideration of the increased time required to teach students and residents. (SS 7-34)
    
40. The Canadian Medical Association will incorporate in its Toward a Blueprint for Health Care Transformation: A Framework for Action a call on all levels of governments to ensure that change initiatives in health care be clinically driven from inception to implementation and include appropriate physician representation from practising physicians who are representative of and accountable to their colleagues. (SS 7-43)
    
41. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, affiliates and associates, will create a Health Care Transformation Implementation Working Group which will:
    1. analyze key elements of the Health Care Transformation Framework, evaluating the feasibility of implementing each of the key elements within the Canadian context;
    2. outline actions to be taken for implementation, with realistic goals for transformational change; and
    3. provide a report to the Board prior to the 2010 General Council meeting. (SS 7-38)
       
42. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates and associates to examine the impact of health care transformation on all aspects of physicians’ practices, in a diverse range of settings; primary and specialty care, including the relationship between them; undergraduate and postgraduate education and continuing professional development; and health and health care services for patients. (SS 7-47)
    
43. The Canadian Medical Association will work with provincial/territorial medical associations to determine whether the continuum of health care in Canada can be sustainably funded in the same way as the European models described in the health care transformation discussion paper. (SS 7-46)
    
44. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, will incorporate in its Toward a Blueprint for Health Care Transformation: A Framework for Action a call on governments to ensure that resources and training are made available to adequately support physicians’ adoption of improved practice and patient management techniques aimed at increasing access and quality. (SS 7-26)
    
45. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates, associates and other stakeholders to assess the feasibility of a national repository to evaluate, disseminate and promote the adoption of best practices in the organization and delivery of health care, directed at continuous quality improvement. (SS 7-39a)
    
46. The Canadian Medical Association believes that it is essential to involve patients in the health care system transformation process and will adjust its communication strategies accordingly. (SS 7-41)
    
47. The Canadian Medical Association will incorporate in its Toward a Blueprint for Health Care Transformation: A Framework for Action proposals for patients’ active participation within the new health information technology environment. (SS 7-27)
    
48. The Canadian Medical Association will incorporate in its Toward a Blueprint for Health Care Transformation: A Framework for Action measurable outcomes for each of the document’s listed “directions,” including measures of the patient and provider experience of care, population health, and per capita costs. (SS 7-44)

Delegate Motions Session

Health Promotion and Prevention

49. The Canadian Medical Association, in collaboration with provincial/territorial medical associations and affiliates, calls upon governments to implement a routine deafness screening program for newborns. (DM 5-3)
    
50. The Canadian Medical Association urges the federal government to make mandatory the current voluntary federal regulations that restrict the use of industrially produced trans fats at the Canadian food-supply level. (DM 5-6)
    
51. The Canadian Medical Association urges the federal government to continue funding of the national immunization strategy at levels consistent with the original three-year funding program. (DM 5-10)
    
52. The Canadian Medical Association recognizes addiction as a chronic, treatable disease and urges that it be included in national and provincial/territorial efforts to improve chronic disease management. (DM 5-5)
    
53. The Canadian Medical Association will work with other national health care organizations to inform and educate Canadians about the adverse impact salt intake has on hypertension and cardiovascular disease and to lobby the food industry to reduce the salt content in processed food. (DM 5-9)
    
54. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, will work with national Aboriginal organizations and governments to set specific goals for Aboriginal and First Nations health over a generation and will monitor and publish the collective progress annually. (DM 5-34)
    
55. The Canadian Medical Association encourages all physicians and other health care providers to be immunized for influenza annually. (DM 5-16)
    
56. The Canadian Medical Association, provincial/territorial medical associations, affiliates and associates recommend that governments define tobacco dependence as a chronic disease, systematically offer treatment to tobacco users, and ensure that cost-effective treatments (including counseling and pharmacotherapy) be considered and covered as government-funded health care benefits. (DM 5-7)
    
57. The Canadian Medical Association supports the Canadian Lung Association’s call for the House of Commons Standing Committee on Health to study the health impacts of federally regulated airline policies that allow pets to travel in the cabin of airplanes. (DM 5-1)
    
58. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates, associates and other stakeholders to ensure that governments provide adequate lifelong services for patients with attention deficit/hyperactivity disorder. (DM 5-4)
    
59. The Canadian Medical Association will:
    1. update its policy on medical marijuana; and
    2. ask the federal government to update the medical marijuana access program and regulations following appropriate consultations with stakeholders and scientific advisory committees, and reinstate support for research into the safety and efficacy of medical marijuana and cannabinoids. (DM 5-2)
       
60. The Canadian Medical Association, in collaboration with the provincial/territorial medical associations, calls upon governments to establish a jointly funded, independent centre for excellence in Canadian population health outcomes to undertake research and report annually to Parliament on achievements made in reaching national health goals. (DM 5-33)

Isotopes

61. The Canadian Medical Association demands that the federal government:
    1. retain Canada’s leadership and ability to produce and export medical isotopes and reconsider its decision to withdraw from their production;
    2. immediately appoint an international expert panel to thoroughly review the decision to abandon the MAPLE I & II nuclear reactors at Chalk River, Ont., which would have produced a domestic and international supply of medical isotopes; and
    3. expeditiously release the conclusions and recommendations of the panel to the public and medical organizations. (DM 5-13)
       
62. The Canadian Medical Association demands that the federal government conduct open, meaningful and ongoing consultations with nuclear medicine physicians and their respective national associations on any and all federal decisions directly affecting the supply of medical isotopes. (DM 5-11)
    
63. The Canadian Medical Association, in collaboration with provincial/territorial medical associations, affiliates and associates, calls upon governments to invest in a five-year action plan, including an emergency fund, to increase the use of positron emission technology and the production of associated radiopharmaceuticals across Canada. (DM 5-14)
    
64. The Canadian Medical Association is deeply troubled that the prolonged and unpredictable shortage of medical isotopes continues to compromise patient care and expresses its appreciation and admiration to health care providers across the country for their dedicated efforts to meet patients’ needs during this ongoing extraordinary, stressful and demanding time. (DM 5-12)
    
65. The Canadian Medical Association urges the federal government to immediately invest heavily in research of new technologies that could present viable alternative solutions to the production and use of technetium-99m. (DM 5-15)

Medical Education / Physician Resources

66. The Canadian Medical Association calls on national and provincial/territorial medical education and licensing bodies to expand training and support for physicians in addiction medicine, including formal recognition of special skills and improved training and support opportunities for primary care physicians. (DM 5-28)
    
67. The Canadian Medical Association will work with the Association of Faculties of Medicine of Canada, the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada to initiate a review of the specialty mix of postgraduate training positions in Canada relative to emerging population health needs. (DM 5-27)
    
68. The Canadian Medical Association will work with provincial/territorial medical associations and the Federation of Medical Regulatory Authorities of Canada to develop a tracking database to monitor and assess the impact of mutual recognition of professional credentials on the mobility of physicians in Canada. (DM 5-30)
    
69. The Canadian Medical Association in conjunction with provincial/territorial medical associations will call on provincial/territorial governments and medical regulatory authorities to seek methods other than the provision of conditional and restricted licensure when trying to influence physician distribution. (DM 5-29)
    
70. The Canadian Medical Association with provincial/territorial medical associations, affiliates and associates will encourage medical schools to reinforce to medical students and residents the necessity for every physician to contribute to the education of future physicians. (DM 5-26)
    
71. The Canadian Medical Association will explore, in partnership with others, the development of a Canadian medical careers forum to help physicians who are in the midst of or contemplating a career transition and to aid students and residents in career selection. (DM 5-24)
    
72. The Canadian Medical Association encourages the federal government to join the efforts of organized medicine to make innovative pan-Canadian continuing medical education available to enhance the quality of care. (DM 5-25)

Health and the Environment

73. The Canadian Medical Association encourages all Canadians, and especially those who smoke tobacco, to test their homes for radon. (DM 5-21)
    
74. The Canadian Medical Association calls upon the federal government to ban the sale of household antibacterial products due to the risk of bacterial resistance and to recognize that soap and alcohol-based solutions are as effective in preventing household infection. (DM 5-20)
    
75. The Canadian Medical Association calls upon the federal government to:
    1. support the international designation of chrysotile asbestos as a hazardous chemical;
    2. eliminate the use and exportation of asbestos; and
    3. support the proper management of asbestos that has been used, including remediation. (DM 5-19a)

Collaborative Care / Access

76. The Canadian Medical Association will work with other national health care professional organizations to create a common evaluation tool for proposed scope-of-practice changes. (DM 5-22)
    
77. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates and associates to create a rapid process for consulting one another and other medical organizations when proposals for scope-of-practice changes are introduced by governments. (DM 5-23)
    
78. The Canadian Medical Association advocates that, when physicians are required to provide information about wait times, deadlines for such reports be reasonable and physicians should not be penalized or threatened in the course of assembling such reports. (DM 5-36)
    
79. The Canadian Medical Association will work with relevant national specialty societies and provincial/territorial medical associations to develop guidelines to help provincial and territorial governments include mental illnesses under the definition of chronic diseases in fee codes and funding programs. (DM 5-37)
    
80. The Canadian Medical Association will work with provincial/territorial medical associations, affiliates, associates and other stakeholders to develop and implement wait-time benchmarks for health care services provided to patients with attention deficit/hyperactivity disorder. (DM 5-35)

Emerging Issues

81. The Canadian Medical Association, provincial/territorial medical associations, affiliates and associates urge governments to ensure that front-line care providers in practice and training are provided with adequate information, resources (including ventilators, masks, gloves, medications and vaccines) and personal and family disability and life insurance if performing clinical duties in the context of an epidemic or other public health emergency. (DM 5-17)
    
82. The Canadian Medical Association supports efforts to protect the integrity of representation and bargaining rights for physicians across Canada and will financially support the New Brunswick Medical Society in its court challenge concerning government legislation and policy that violates duly negotiated and ratified agreements and unilaterally suspends access to third-party arbitration. (DM 5-40a)
    
83. The Canadian Medical Association in collaboration with the provincial/territorial medical associations will vigorously oppose all attempts to remove legislated evidentiary protection currently afforded to those expressing opinions before quality assurance committees. (DM 5-31)
    
84. The Canadian Medical Association, while recognizing the importance of disclosing adverse events to affected patients in a timely manner, recommends that regional health authorities, institutions and professional associations develop policies to ensure the confidentiality of medical quality assurance deliberation, unless public notification is required to mitigate any possibility of ongoing harm. (DM 5-32)

Other

85. The Canadian Medical Association calls upon the federal government to honour its commitment to allocate 0.7% of Canada’s gross domestic product to international aid. (DM 5-39)
    
86. The Canadian Medical Association will establish a Canadian physician support trust to provide timely financial and personal support to physicians in need as a national program administered by the provincial/territorial medical associations. (DM 5-18)
    
87. The Canadian Medical Association urges the Canada Revenue Agency to collaborate with Service Canada and Human Resources and Skills Development Canada to reduce redundant requests by sharing relevant patient health information, while at the same time respecting the privacy and confidentiality of patient records. (DM 5-38)