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PTMA Newsletter - Issue 9 2014

CMA Board of Directors October Meeting Summary

Board professional development session held with Prof. Janice Stein

  • Session focused on the Board’s role in the new governance structure which includes CMAH 2014 and NewCo.

Major discussion topics

  • Professionalism and how CMA can productively address the issue
  • CMA restructuring plans and issues
  • Role of the CMA President
  • Challenges of member recruitment and retention
  • Plans for future accommodation for CMA

Upcoming appointments
Subsidiary Boards Search Committee
The Board of Directors unanimously approved several items from the committee including:

  • Profiles for members of Newco and CMAH 2014 Boards of directors
  • Lengths of terms for Newco and CMAH 2014 Board directors
  • Compensation for Newco and CMAH 2014 Board directors
  • Initially CMAH 2014 Board of Directors will meet a minimum of 5 times/yr and the Newco Board will meet very two months

CMAJ
CMAJ Editorial Independence Board Working Group created

  • 5 voting members
    • CMA President (chair)
    • 2 CMA Board members
    • 2 Journal Oversight Committee members
  • 2 non-voting members
    • VP for Products, Services and Leadership
    • CMAJ Editor-in-Chief

To report to Dec. Board meeting

CMA Restructuring

  • An extraordinary meeting of the Board of the Directors will be held in Toronto, Jan. 16 to allow Board members to appoint and meet the new CEOs of CMA and NewCo, the chair of the NewCo Board and the two independent members of the CMAH 2014 Boards of Directors

Program review

  • Update on Program Review process with final report to be presented at Dec. Board meeting
  • Board will be asked to weigh in on decisions having meaningful financial or reputational risk or where significant number of employees will be impacted.

Emerging Issues - Ebola

  • CMA committed to ensuring front-line physicians are fully supported

Professionalism

  • Strategic initiative on professionalism endorsed
  • Enhancing medical professionalism one pillar of new CMA strategic plan
  • Formal work plan to be developed for review by Board

End-of-Life Care

  • Panel discussion on how CMA dealt positively with issue at GC
  • Committee of Ethics revising CMA policy on assisted dying and bringing to Board for approval in Dec. or March
  • CMA will continue to promote palliative care

Medical use of marijuana

  • Endorsement of draft “gold standard” on authorizing marijuana for medical purposes
  • Document to be circulated for review using standard approach
  • CMA will maintain current strategy and resources and not invest additional resources

CMA Workplace Accommodation

  • Board members stressed the importance of the issue and need for more extensive evaluation
  • Options cluster around renovating existing CMA headquarters or moving/decentralizing
  • Five Board members were appointed to a working group to consider the issue

Role of the president
Extensive discussion around clarifying the roles of the CMA President, President-elect and Past-president. Issues discussed included:

  • Appropriateness of president having personal agenda and how to deliver on this
  • Need for more support during election process for president-elect
  • Managing schedule and agenda of the President
  • More team-based approach by President, President-elect and Past-president

Appointment

  • Dr. Louis Hugo Francescutti appointed to two-year term as CMA observer to the World Medical Association


Momentum grows for Choosing Wisely Canada campaign

Twelve more medical specialty societies and six community partners have joined Choosing Wisely Canada as momentum grows to change the approach to using diagnostic tests, treatments and/or procedures and encouraging better doctor-patient communications.

The announcement of this new campaign phase brings the number of medical specialty societies participating in Choosing Wisely Canada to 21.

“Our aim is to encourage a culture change in which patients and physicians no longer assume that more is automatically better in high-quality care,” said to Dr. Wendy Levinson, chair of the Canadian campaign.

“This is a physician-led exercise that is based on the latest and best evidence for the right care.’’

The most recent specialty societies to join the campaign have released 61 new recommendations about tests, treatments and/or procedures that may be overused. The goal is to encourage physicians and patients to question whether these interventions are necessary.

Launched in April, Choosing Wisely Canada has received enthusiastic endorsement from several organizations, including all provincial and territorial medical associations and these associations have established mechanisms to support adoption of the lists of tests and procedures needing assessment. The campaign has been favourably portrayed in the media and on social media.

“It (Choosing Wisely Canada) is the right thing to do and as a profession we have a responsibility to deliver the best possible care that is based on evidence,” said Dr. Cindy Forbes, president-elect of the Canadian Medical Association (CMA).

Canada is now one of 10 countries with a Choosing Wisely campaign, said Forbes. She described the campaign as still being in the early stages and predicted “with time it will grow and flourish.”

Levinson noted the campaign is gaining phenomenal support from medical trainees and is starting to impact the culture of how medicine is practised.

Medical societies that have most recently joined the campaign:

  • Canadian Association of Gastroenterology
  • Canadian Association of Medical Oncologists
  • Canadian Association of Pathologists
  • Canadian Association of Radiation Oncology
  • Canadian Hematology Society
  • Canadian Society of Surgical Oncology
  • Canadian Society for Transfusion Medicine
  • Canadian Society of Endocrinology and Metabolism
  • Canadian Society of Nephrology
  • Canadian Society of Palliative Care Physicians
  • Canadian Urological Association
  • Occupational Medicine Specialists of Canada

For more information please contact Dr. Sam Shortt.



NEW! Optimal Prescribing CMA Modules

CMA members can now access Optimal Prescribing, a new series of 12 accredited online CME modules aimed to help physicians prescribe a drug that is safe, effective and most clinically appropriate for a patient’s condition.

Members also have access to a valuable suite of other free drug information resources, included in their CMA membership.

For additional information contact Renée de Gannes-Marshall.



CMA outlines complexity of legalizing assisted dying

Expression of the many practical challenges involved in implementing a system of assisted dying that protects the vulnerable while allowing patient autonomy marked the Canadian Medical Association’s verbal submission to the Supreme Court of Canada earlier this week.

The Supreme Court met on Oct. 15 to hear the Carter case about whether the existing prohibition on assisted death in the Criminal Code of Canada is unconstitutional under the Canadian Charter of Rights and Freedoms.

“The CMA is intervening in this appeal to assist the court by providing a window into the diverse views expressed by its membership, and to highlight practical considerations that must be assessed if the law were to change,” said CMA President Chris Simpson in a release.

The Carter case began in 2011, when the BC Civil Liberties Association (BCCLA) joined Dr. William Shoichet, Gloria Taylor – who had an incurable, progressive disease – and the family of Kay Carter, who also had an incurable disease, to challenge the law against assisted dying.

In 2012, the B.C. Supreme Court ruled the Criminal Code of Canada provisions against assisted dying violated the rights of the gravely ill. The federal government appealed that decision, and the provincial Court of Appeal overturned the lower court ruling in October 2013 and upheld the ban, citing the 1993 case of Sue Rodriguez. The Supreme Court granted the BCCLA, the Carter family and others permission to appeal the case.

The CMA was one of many organizations to address the court during the day-long hearing; the Supreme Court is not expected to render a decision for several months.

Harry Underwood, CMA’s external counsel who made the oral submissions on behalf of the association, referenced the resolution adopted by the CMA in August supporting the right of all physicians, within the bounds of existing legislation, to follow their conscience when deciding whether or not to provide medical aid in dying. He noted that CMA was not appearing before the court to speak for or against a change in the law.

Underwood said the recent CMA policy resolution from General Council reflected an acknowledgment that the profession is divided on the question on professional and ethical grounds. Simpson said the revised CMA policy would “continue to reflect the ethical principles for physicians to consider in choosing whether or not to participate in medical aid in dying…

“Since euthanasia and assisted dying are illegal, we continue to advise our members not to participate in these activities (assisted dying),” said Simpson. But he stated the CMA recognizes assisted dying “is a societal issue and that it is society that will ultimately decide what will take place.”

In his oral presentation, Underwood discussed the practical challenges for physicians in assessing the competence of individuals to choose assisted death and to ensure they’re making an informed decision.

He said there is a “looming concern” such decisions may be made in the emergency room or other area of a hospital, when the patient is in crisis, rather than as the result of a full discussion between patient and family physician.

Underwood noted the primary care environment in Canada is markedly different from those in Belgium and the Netherlands, where assisted dying is legal, because these countries are compact and homogeneous and many people have better access to family physicians.

Both Simpson and Underwood referred to the “patchwork” of palliative care services across this country, and the impact the lack of these services could have on a patient’s decision to avoid pain and suffering by choosing assisted death.

Underwood said that if the law is changed to permit assisted death, physicians who choose to participate and offer this service need legal protection. Those who choose not to participate also need their choice respected and protected.

Simpson noted that going forward, the CMA will continue to advocate and press for a pan-Canadian strategy on palliative care to ensure that Canadians have improved access to such services.



Health Information Technology and eHealth at CMA

Physician members in community-based or ambulatory care settings who wish to integrate e-booking into their practice may be eligible for funding from Canada Health Infoway. Registration is open until December 15, 2014. Learn more.

For additional information contact Conrad Amenta.



News from MD - A Physician-Focused, CMA Company

Did you know that MD Management, the forerunner of MD Physician Services, was launched 45 years ago?

As a CMA member benefit, MD Advisors work with over 100,000 clients consisting of Canadian physicians and their families. You can expect expert advice at every stage of your life and career – from medical school and residency to practising and preparing for retirement.

Danielle Curry, Medical Student and MD client explains, “As a student, I’ve been getting advice from my MD Advisor on how to be smart financially and how to get myself set up. You always worry about your finances but now I’m a little bit more comfortable around what my finances will look like as a medical student, as a resident, as a physician and, eventually way down the road, retired. It eases my worry about how that process works and where I’m going to be at each of those stages.”

Take a moment to check out what’s new at MD, like access to MD ExO™ - Your Expert Office and webinars, helpful videos, educational articles and podcasts.



CMA and Mont Tremblant - The best ski conditions at the best price!

Please feel free to share with members.

Now CMA Members and staff can access the Tremblant Experience at the lowest rate. Take advantage and get discounts of up to 39% by November 28, 2014. Tickets are:

  • Valid every day of the 2014-2015 season and until December 11, 2015
  • Without restrictions
  • Fully transferable, person to person
  • Free delivery for purchases of 8 tickets and more

Visit cma.ca/tremblant for more information.



Upcoming events in your province or territory

Date Event City Province Details
24-NovQCARE+ Financial Seminars for ResidentsKingstonONMD Seminar
26-NovUBC Specialty PMCVancouverBCMD/CMA Seminar
26-NovUS Tax Consideration for CanadiansMississaugaONMD Seminar
26-NovCME Accredited Winding Down Seminar Ft. Tom FaloonTimminsONMD/OMA Seminar
27-NovWine PairingQuebecQCMD Event
28-NovSherbrooke Specialty PMC SherbrookeQCMD/CMA Seminar
27-29 NovOntario College of Family PhysiciansTorontoONCMA/MD Exhibiting
29-NovMadagascar Penguins (Movie)ChilliwackBCMD Family Event
29-NovMadagascar Penguins (Movie)VernonBCMD Family Event
29-NovMadagascar Penguins (Movie)LondonONMD Family Event
29-NovMadagascar Penguins (Movie)OttawaONMD Family Event
03-DecHoliday ReceptionKamloopsBCMD Event
04-DecHoliday ReceptionNanaimoBCMD Event
04-DecFemale Physician Wine Tasting (With Investment Seminar)KitchenerONMD Event
10-DecHoliday ReceptionVictoriaBCMD Event
11-DecInvestment SeminarQuebecQCMD Seminar
11-DecUniversity of Alberta Family Medicine Practice Management Curriculum (PMC)EdmontonABMD/CMA Seminar
25-JanJack and the Beanstalk Show VictoriaBCMD Family Event

For additional information please contact Marie-Anne Abboud.



PMI: Physician Leadership Courses

  • Developed by the CMA specifically for physicians
  • Accredited by the RCPSC and the CFPC
  • Sets physicians on a path to achieve their Canadian Certified Physician Executive (CCPE) designation

Open-enrolment PMI physician leadership courses

2015 Registration NOW OPEN!

If members choose an open-enrolment PMI leadership course, they will learn alongside physician colleagues from across the country, sharing issues and experiences unique to their profession in a collaborative, friendly environment.

In-house PMI physician leadership courses

Bring customized physician leadership courses to a workplace, event, conference or annual meeting. The CMA will work with your organization to determine a physician leadership course that will be most useful to your audience. Training can be offered to physicians alone or to interdisciplinary teams that include physicians, other providers, managers and administrators.

Online PMI course: Leadership begins with self-awareness

This discussion-based, facilitated online course focuses on developing personal leadership skills. Derived from the CMA’s PMI leadership development program, the course is designed to help participants gain valuable insights into the personal attributes essential for effective leadership.

The course promotes greater self-awareness by teaching the skills associated with examining your own values and principles, thinking patterns, assumptions and emotional skills, and addressing strengths and limitations.

Course duration:

The course consists of six online modules and lasts six weeks. Each week’s module will require four to five hours of study.

Accreditation:

  • Accreditation by the RCPSC (MOC section 1) up to a maximum of 22 credits
  • Accreditation by the CFPC (Mainpro-M1) up to a maximum of 22 credits
  • A foundation for the open-enrolment PMI physician leadership face-to-face courses


Online CME courses

NEW! Anti-Stigma

This interactive online module intends to educate family physicians and specialists in the recognition of stigma related to mental illness. The module is designed to provide participants with an opportunity to recognize attitudes and behaviours that could potentially lead to stigma, as well as provide an example of a practical clinical approach to helping doctors and patients overcome stigma.

Course Duration: 2 hours

Accreditation:

  • MainPro M1: 2 credits
  • Maintenance of Certification (Section 1): 2 credits

Type 2 Diabetes

Type 2 diabetes is a serious condition with potentially devastating complications. In 2009, the estimated prevalence of diabetes in Canada was 6.8% of the population or 2.4 million Canadians. By 2019, the number is expected to increase to 3.7 million. This will pose a major challenge for health services. It is essential that family physicians have a good knowledge of diabetes management as they currently provide 92% of diabetes care in Canada.

Course Duration: 1.5 Hours

Accreditation:

  • MainPro M1: 1.5 credits
  • Maintenance of Certification (Section 1): 1.5 credits