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PTMA Newsletter – Issue 6 2014

Opportunities for CMA members to participate in General Council

CMA’s 147th Annual Meeting/August 17-20, 2014
Ottawa Convention Centre

On behalf of the Ontario Medical Association (OMA) and the Canadian Medical Association (CMA), our collective members are invited to participate in the annual meeting of the CMA’s governing body, General Council (GC), when it meets in Ottawa from August 17-20, 2014.

General Council brings together 270 delegates from all provinces/territories and from 50 of the CMA’s affiliated societies. It functions as our profession’s Canadian Parliament.

This year the meeting is undergoing a major update to make it more relevant to members. These changes are being made in response to suggestions from General Council delegates and observers and other stakeholders with a focus on ensuring the sessions promote meaningful debate on issues that matter.

There are many ways to get involved online or in person:

  1. Come and experience GC first-hand and see the CMA’s democratic processes in action. As a member observer they may attend any or every day of GC and the CMA’s Annual Business Meeting free of charge (including several sessions that provide CME credits). Registration is free. Visit www.cma.ca/gc.
  2. Participate in the CMA Members’ Forum online or in person: This 75-minute interactive information session allows members to pose questions to CMA leaders. The session will take place Monday August 18 from 3:15 to 4:30 pm (EST). Members have the option to see and participate in real time at cma.ca by sending their questions in advance to membershour@cma.ca and watching the live streaming of the session. Please feel free to have members send their questions in today.
  3. Participate in the GC Theme survey: This online survey gives members with the opportunity to provide input on GC-related issues from their home or office. Member input will make the CMA Board of Directors aware of members’ perspectives on these topics.
  4. GC TV: daily newscasts will be posted to CMA YouTube to keep you up-to-date on GC motions and debates (youtube.com/canadianmedicalassoc).
  5. Tweet comments to the GC Twitter Wall during CMA’s medical marijuana education session (twitter.com/cma_members) or participate in the live chat which will run simultaneously with the GC live webcast.
  6. Participate via other opportunities on cma.ca. Live streaming of General Council sessions,YouTube interviews and comments offered via our Twitter feed. Visit cma.ca/gc for more information.

We hope our members will take advantage of this opportunity to observe and provide input to your national Association and its representatives. Additionally we invite you to observe as well as some of the most pressing issues facing Canadian medicine are debated.



CMA redesigns cma.ca with physicians’ needs in mind

The Canadian Medical Association has launched a completely rebuilt cma.ca website to better serve the needs of Canadian physicians.

“The new cma.ca has been designed to meet the needs of Canadian physicians in all stages of their career,” said CMA President Dr. Louis Hugo Francescutti.

“CMA members have been involved in building the new cma.ca from the start,” notes Dr. Darren Larsen, who was involved in the redesign process.

“I’m probably most excited about the enhanced search capabilities,” states Dr. Michel Sauvé, another CMA member involved in the rebuild. “I have a 5- or 10-second window for searches, so in order to provide the best possible patient care, I need to be able to quickly access the most relevant clinical information with a single search on my desktop or mobile device.”

“I’m most looking forward to accessing the new mobile-enabled cma.ca to quickly retrieve medical resources that are relevant to my studies," says medical student and CMA member William Parker.

Take a guided tour of the new features, or explore them on the site itself at the new cma.ca.



Court decision on refugee care applauded

The Canadian Medical Association (CMA) joined other groups in welcoming a Federal Court decision ruling federal government cuts to refugee health care as being unlawful and unconstitutional.

As a result of changes to the Interim Federal Health Program (IFHP) implemented in June 2012, refugees, except those who are government-assisted and victims of human trafficking, lost access to coverage for medical care unless it is urgent or essential. For some groups, such as refugee claimants from designated countries of origin, even essential medical care was denied, with treatment being provided only if there is a risk to public health or public safety.

“The 2012 modifications to the IFHP potentially jeopardize the health, and indeed the very lives, of… innocent and vulnerable children in a manner that shocks the conscience and outrages Canadian standards of decency,” the Court decision stated.

"This is a victory for reasonable compassion and a big step for natural justice," CMA President Dr. Louis Hugo Francescutti said in a news release.

The Canadian Doctors for Refugee Care (CDRC), Canadian Association of Refugee Lawyers (CARL), and Justice for Children and Youth (JFCY), together with two individual patients who were severely impacted by the cuts, challenged the legality of the IFHP cuts before the Federal Court of Canada.

“The impact of the federal Conservative Government’s cuts has been devastating,” said Dr. Philip Berger, a founding member of CDRC and Medical Director, of the Inner City Health Program at St. Michael’s Hospital, Toronto in a news release.

“For more than two years now, doctors across Canada have seen these cuts place the pregnancies of refugee women at serious risk, cause denial of treatment for sick children, and deprive refugees with cancer of coverage for chemotherapy. We are pleased to see the Federal Court put an end to this unwarranted suffering.”

“With today’s decision, the Federal Court has recognized that the government’s cuts to refugee health care violate the fundamental rights enshrined in the Charter of Rights and Freedoms, without any lawful justification”, said Lorne Waldman, president of CARL and lead counsel on the case. “This decision gives life to Canada’s commitment to protect refugee rights. It sends a clear message to government that it cannot abdicate its responsibility to meet the most basic health care needs of vulnerable refugees and refugee claimants”.

The court decision came just two weeks after the CDRC launched the third annual day of protest against the cuts.

Francescutti noted that a broad coalition of provinces — Alberta, Manitoba, Saskatchewan, Nova Scotia, Ontario and Quebec — had the wisdom to voice objections to the cuts and to take steps to restore various levels of coverage to refugees. He urged the federal government – which has stated it will appeal the decision - to sit down with the provinces and territories and work on a policy that is acceptable to all.



Canada ranks next to last in comparison of health systems

The reputation of the Canadian health care system suffered collateral damage in a new Commonwealth Fund study highlighting how poorly the U.S. health care system is performing relative to other developed countries.

While the U.S. ranked last in an international comparison of 11 countries in terms of five measures of performance, the report “Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally- 2014 Update” rated Canada only slightly better in 10th position.

The Commonwealth Fund study used survey data from the last three years to compare the health care systems in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Quality indicators were grouped into four categories: effective care, safe care, coordinated care, and patient-centered care.

Despite the U.S. having the lowest score overall, Canada scored last on a number of measures:

  • Wait time for emergency care being two hours or more;
  • Wait time to see a specialist being two months or more;
  • Visiting an Emergency Department for condition that could have been treated by a general practitioner if he or she had been available;
  • Delays in patients being informed about abnormal laboratory test results;
  • Knowing who to contact about a condition or treatment;
  • Physician practices being able to electronically exchange clinical summaries and test results with other practices.

The Canadian health care system outperformed the other countries on only one measure – that being in the health equity category where survey results showed patients with above-income and below-income had to wait a comparable time to see a specialist.

“It’s ironic that the one indicator in which Canada outperformed other nations actually reflects that we are doing an equally poor job across the socioeconomic spectrum in delivering timely care to Canadians,” said CMA president-elect Dr. Chris Simpson.

“The results in this study are not a surprise but they underscore the work that needs to be done in Canada to deal with issues ranging from unacceptable wait times to poor co-ordination of care and the less than ideal use of electronic systems to enhance health care delivery.”

“In this regard, being better than the U.S. is a hollow victory indeed.”

The results of this Commonwealth Study mirrored earlier studies from the organization over the past decade placing the Canadian health care system near the bottom of the list in comparison to the U.K. and other European countries.

Just weeks after a new report from the Wait Times Alliance – which Simpson chairs – advocated looking to Scotland for improving wait times for care in Canada, the Commonwealth study ranked the U.K. has the most efficient system among those evaluated.



Online course helps MDs address poverty

A new online continuing medical education (CME) course raises awareness about poverty as a health risk and provides physicians with practical advice on interventions for their practice.

“Social Determinants of Health – What physicians can do about poverty in practice” is the latest in a series of online modules developed by the CMA for its members.

The course represents part of a tangible effort by the CMA to provide physicians with resources they can use to address some of the social determinants of health – those factors beyond the health care system that have a profound influence on health at both the individual and population level.

Earlier work by the CMA had recognized the importance of these social determinants as part of its health care transformation initiative. The course is part of a response to members who had requested tools and resources to be able to address these social determinants in their work with patients.

“Canada’s doctors have come a long way in recognizing the importance of the social determinants of health and the role they play in addressing these determinants both at the bedside and through upstream action,” said CMA President Dr. Louis Hugo Francescutti.

One reason the CMA chose to focus on income is that it strongly linked other social determinants such as housing, nutrition and food security, and early childhood development.

“We also focused on income because in our national dialogue with members of the public in a series of town halls across Canada in 2013, income was identified as the number one issue effecting health,” said Francescutti “How can someone take medication if they can’t pay for it? How can someone eat healthy if all they can afford is a $1.39 McDonald’s hamburger when the price of milk is over $3 a litre? How can someone rest and heal when they have no place to stay in?”

Serving as subject experts for the course are two family physicians who have investigated the impact of poverty on health; Dr. Gary Bloch- Toronto, Dr. Vaness Brcic-Vancouver and Jenny Buckley, research specialist in the CMA Public Health Group.

The aim of the course is to outline the magnitude of the effect of poverty on health, recognize clinical situations where this is critical to address, and identify actions physicians can take to minimize that health impact. The course also provides physicians with user-friendly, web-based resources that can be used to navigate income support systems in clinical practice.



Upcoming PMI physician leadership courses

Members can complement their clinical expertise with practical leadership skills.

  • Developed for physicians by the CMA
  • Delivered by open enrolment, online, or in-house
  • Fully accredited by the RCPSC and the CFPC
  • Sets members on a path to achieve the Canadian Certified Physician Executive (CCPE) designation
  • 25% discounts available for PTMA/CMA members

Conflict Management and Negotiation – September 7-9, 2014, Ottawa, Ont.

Engaging Others – September 10-12, 2014, Ottawa, Ont.

Register Now

Learn more cma.ca/pmi

What physicians are saying…

Physicians often work in silos, trying to help their patients benefit most through their highly proficient and accomplished individual skills. The PMI courses help us understand that in the present environment of health care teamwork can deliver far better services to patients and get better results than the former approach. They also help physicians recognize their own leadership and collaborative skills.

— Ranjit Waghray, MBBS; FRCPC; FCAP, Clinical Section Chief, Anatomical & Cytopathology, Calgary Lab Services/AHS-Calgary Zone, Clinical Associate Professor and AP Division Head, University of Calgary

 



Upcoming events in your province or territory

Date Event City Province Details
19-JulyJr. Jays SaturdaysTorontoONMD Family Event
22-JulyRetirement and Estate PlanningKelownaBCMD Seminar
23-JulyPractice Management CurriculumQuebecQCMD/CMA Seminar
24-JulyUniversity of Calgary Student BBQCalgaryABMD/CMA Exhibiting
25-JulyUniversity of Calgary Student OrientationCalgaryABMD/CMA/PTMA Orientation
25-JulyPhysician Networking Event (Honda Celebration Of Lights)VancouverBCMD Event
30-JulyMcGill University Resident OrientationMontrealQCMD/CMA/PTMA Orientation
1-AugLaval University Resident OrientationQuebecQCMD/CMA/PTMA Orientation
8-AugUniversité de Sherbrooke Resident OrientationQuebecQCMD/CMA/PTMA Orientation
17-AugEstate Planning For Incorporated PhysiciansFort McMurrayABMD Seminar
17-20 AugCanadian Medical Association’s 147th Annual General CouncilOttawaONMD/CMA Exhibiting/Sponsorship
19-AugGolf TournamentMontrealQCMD Event
27-AugMcGill University Student OrientationMontrealQCMD/CMA/PTMA Orientation
28-AugQueen’s University Student OrientationKingstonONMD/CMA/PTMA Orientation
3-SeptUniversity of Ottawa Student Orientation BBQOttawaONMD/CMA/PTMA Orientation
7-11 SeptAll Advisor ConferenceOttawaONMD Event
8-SeptNOSM Student OrientationThunder BayONMD/CMA/PTMA Orientation
8-SeptNOSM Student OrientationSudburyONMD/CMA/PTMA Orientation
11-SeptUniversity of British Columbia Student OrientationVancouverBCMD/CMA/PTMA Orientation
12-SeptNova Scotia College of Family Physicians 2014 Family Medicine AssemblyHalifaxNSMD Exhibiting
16-SeptChallenge Bell (Tennis)QuebecQCMD Event
18-20 SeptCanadian Association of Pediatric SurgeonsMontrealQCMD Sponsoring
19-21 SeptIcebowlWinnipegMBMD/CMA Exhibiting/Sponsoring
19-21 SeptFederation of Medical Women of Canada (FMWC)VancouverBCMD/CMA Exhibiting/Sponsoring
19-20 SeptAlberta Medical Association’s Fall Representative Forum and Annual General MeetingCalgaryABPTMA AGM
25-SeptWine Premier ShowSaskatoonSKMD Event
25-27 SeptSaskatchewan College of Family Physicians - 60th Annual Scientific AssemblySaskatoonSKMD Exhibiting
28-SeptOttawa Fury SoccerOttawaONMD Family Event
1-4 OctCanadian Society of Internal MedicineCalgaryABMD/CMA Exhibiting
2-OctIncorporation and Market OutlookCarleton-sur-MerQCMD Seminar
2-OctCMA Media Awards 2014OttawaONMD Exhibiting/Sponsorship
3-4 OctNew Brunswick Medical Society Annual General MeetingFrederictonNBPTMA AGM
3-5-Oct-2014Weekend RetreatSylvan LakeABMD Seminar
6-OctMarket Outlook: Perspectives and InsightsCalgaryABMD Seminar
7-OctNetworking Evening For Female Physicians (L’Espace MC Chef)QuebecQCMD Event
15-17 OctSymposium francophone de médecine 2014MontrealQCMD/CMA Exhibiting/Sponsorship
21-OctMarket Outlook: Perspectives and InsightsCourtenayBCMD Seminar
22-OctMarket Outlook: Perspectives and InsightsAbbotsfordBCMD Seminar
22-OctNetworking Evening For Physicians (Dishcrawl)MontrealQCMD Event
23-OctMarket Outlook: Perspectives and InsightsSurreyBCMD Seminar
25-28 Oct2014 Canadian Cardiovascular CongressVancouverBCMD/CMA Exhibiting
1 – Nov20th OAGS Annual MeetingTorontoONMD Exhibiting
5-NovWine PairingMontrealQCMD Event
7 - Nov2014 Yukon Medical Association Annual General Meeting and CME Update WeekendWhitehorseYKPTMA AGM
8-NovMovie: Big Hero 6MonctonNBMD Family Event
8-NovMovie: Big Hero 6Saint JohnNBMD Family Event
8-NovMovie: Big Hero 6StratfordNBMD Family Event
8-NovMovie: Big Hero 6FrederictonNBMD Family Event
8-NovMovie: Big Hero 6St. John’sNflMD Family Event
8-NovMovie: Big Hero 6SydneyNSMD Family Event
13-15 Nov2014 Family Medicine ForumQuebecQCMD/CMA Exhibiting
27-NovWine PairingQuebecQCMD Event
27-29 NovOntario College of Family PhysiciansTorontoONMD Exhibiting

For additional information please contact Marie-Anne Abboud.



Medical aid must not lead to fragmented care

How Canada can better deliver humanitarian medical aid to other countries was the topic of a major workshop recently hosted by the Canadian Medical Association.

With representation from more than 25 Canadian medical organizations, universities, non-governmental organizations and charities, the meeting ended with a clear call for the need to document current Canadian activities and programs prior to developing any national framework for providing care.

The meeting was prompted by a report prepared for the CMA that noted there are a number of Canadian health care professionals who travel abroad to volunteer to help in poor communities for strictly humanitarian reasons. Canada is one of the top four countries from which physicians provide short-term medical services.

However, the report added “this trend has raised a serious number of professional and ethical concerns, especially the fragmented, uncoordinated and ad hoc manner in which some choose to participate,” report added.

It was to address these concerns and to more fully discuss issues of training and education, professionalism and ethics involved with delivery humanitarian medicine that the workshop focused.

Dr. Jeff Blackmer, executive director of ethics, professional and professional affairs, who helped organize the meeting said the meeting represents a watershed moment in helping the Canadian medical profession meet its humanitarian commitments to developing nations more effectively.

“We have a wealth of eager and committed medical students, residents and physicians who want to help, but we need to provide better tools and training for them to do so,” he said.

The British Medical Association (BMA), an acknowledged expert in this field and the BMA’s Director of Professional Affairs Vivienne Nathanson, director of professional affairs, provided opening and closing remarks for the meeting.

She said the role of the BMA in supporting their membership to volunteer overseas has been a critical factor in facilitating the successful work of British doctors in low-to-middle income countries. Part of this support has involved a development of an ethics toolkit for medical students.

Another speaker, Dr. Shafik Dharmasi, associate professor at the University of British Columbia, highlighted what can happen if Canadian volunteers are not culturally sensitive and don’t respect human dignity.

Dr. Lisa Schwartz, associate professor, McMaster University, followed this by noting many volunteer physicians and students may suffer moral distress when serving as volunteers. She noted the attrition rate among returning Médecins Sans Frontiers volunteers are as high as 50%.

Other speakers discussed the importance of proper training for medical volunteers as well as the need maximize the outcomes of short-term medical volunteerism through advocacy, research and innovation.

Nathanson closed by identifying the need for a Canadian organization to assist in coordinating humanitarian activities and also for a need to outcomes research to identify where humanitarian medicine could make the most impact.



Advance Care Planning – a task everyone should do!

In the June issue of this newsletter we talked about the public town halls that took place on the topic of End of Life Care. These town hall meetings also included important discussions about advance care planning (ACP). A number of calls for action resulted from these town halls. Some were specific to ACP, such as:

  • All Canadians should prepare advance care directives that are appropriate and binding for the jurisdiction in which they live.
  • More education about palliative care approaches and services as well as about how to initiate discussions about advance care planning is required for medical students, residents and practicing physicians

The CMA report that summarizes these town hall meetings, End-of-life care: A national dialogue, notes that while the topics of euthanasia and physician-assisted dying were indeed quite controversial, there was widespread agreement on the importance of advance care directives.

As part of a suite of policies on end-of-life issues, the CMA’s Committee on Ethics (CoE) is currently revising the Advance Directives for Resuscitation and Other Life-saving or Sustaining Measures (1992). The CoE will seek approval of the CMA Board to circulate the revised policy to stakeholders in the fall/winter of 2014/15.

In 2010 the Quality End of Life Care Coalition of Canada (QELCCC), of which the CMA is a founding member (2000), published its second Blueprint for Action (2010-20). One priority of the QELCCC is to encourage Canadians to discuss and plan for end of life. To further this goal the Canadian Hospice Palliative Care Association oversees the Advance Care Planning Canada project. One deliverable of ACP Canada was to develop the National Framework for ACP in Canada.

The National Framework and ACP tools are promoted on the ACP Canada’s website and through the Speak-up Campaign. The tools on ACP Canada’s website include information and links for national and provincial resources for all aspects of advance care planning, from creating your own plan to encouraging others to do theirs.

ACP Canada will have a booth at General Council – if you are attending this meeting please stop by, talk with the very knowledgeable staff and pick up some of the useful resources they will have available.

For additional information contact Kelly Higdon.