Driving impact, together
The past 12 months have shown how important it is to stand up for a better health system, better working environments for care providers and better access for Canadians. Our strategy, Impact 2040, is on point to deliver that change.
We’ve been hard at work on the key issues confronting physicians and patients. Our advocacy, rooted in our strategy, is helping to address the current crisis, as well as long-term solutions.
We’re working with key stakeholders to advance a national health human resources plan — critical to resolving labour shortages and improving access across the continuum of care.
We’re breaking down barriers to physician mobility so care can be delivered where it’s needed most, relieving pressure on health workers in remote and northern regions and creating better work-life balance for providers everywhere.
We’re developing a framework for physicians’ physical, psychological and cultural safety, including enforcement of new legislation making harassment of health workers a crime.
And we’ve heard physicians loud and clear on how unnecessary administrative tasks are affecting their well-being. We’re committed to reducing that burden.
All of our efforts are focused in areas where we believe we can have the greatest impact. We’re determined to drive ambitious, system-level reform at a national level. Below are some of our markers of success in 2022–23.
VISION: A VIBRANT PROFESSION AND A HEALTHY POPULATION MISSION: EMPOWERING AND CARING FOR PATIENTS
The Canadian Medical Association (CMA) is the voice of Canada’s physicians. As an influential thought leader and capacity-builder, we're dedicated to being a catalyst for impactful change in health, the health system and the health workforce.
Every person has equitable opportunities to achieve optimal mental and physical health outcomes.
Canada’s health system is designed to promote health; and be sustainable, integrated and patient-partnered.
Medical culture in learning and practice is safe, inclusive and health-promoting.
PRIORITY STRATEGIC INITIATIVES
Aging with dignity in the community
Net zero carbon emissions health system
Indigenous-led health transformation supported by a culturally safe, trauma-informed system free of racism
Integrated health workforce plan
Health workforce framework for psychological, physical and cultural safety
Improving physician wellness by reducing administrative burden
Public and private care in Canada: National consultations on shifting balance in care
Public apology to all Indigenous Peoples: The path to an apology for the harms caused to Indigenous Peoples as the national voice of physicians
DRIVERS OF CHANGE
OUR GUIDING PRINCIPLES: equity | diversity | engagement | accountability | transparency | impact
TRANSFORMING HEALTH CARE, NOW AND FOR THE FUTURE
Under the leadership of CMA President Dr. Alika Lafontaine, we welcomed the announcement of historic federal health funding that answers many of our calls for change, including:
- the first significant increase to the Canada Health Transfer in two decades;
- increased physician mobility;
- federal leadership on national health workforce planning;
- scaled-up team-based care;
- expanded virtual care; and
- reconciliation with Indigenous Peoples.
We also sought opportunities to support physician well-being, calling for enforcement of federal anti-harassment legislation; shedding light on wellness challenges and how to tackle them through our National Physician Health Survey; underscoring gaps in support for women and Black physicians; and exploring how to reduce administrative burdens.
Significant breakthroughs on the CMA’s call for pan-Canadian licensure
New federal health funding holds provinces and territories accountable to expand physician mobility, Atlantic provinces launched a regional register and Ontario took steps to recognize the credentials of health professionals licensed elsewhere in Canada.
AMPLIFYING THE PHYSICIAN VOICE
We called for government action at the highest levels, in discussions with the deputy prime minister and deputy health minister and at high-profile meetings of the Council of the Federation and federal/provincial/territorial health ministers.
We shaped the public narrative in health, participating in more than 350 media interviews and supporting high-quality health reporting through a partnership with The Canadian Press.
Championing the health of people in Canada, CMAJ continued to publish relevant content for clinicians, policy-makers, health researchers and patients, including two special issues on Black health. CMAJ content is regularly covered in Canadian and international media and helps inform government and public health responses on key issues. CMAJ’s impact factor (the most important indicator of how widely its articles are cited in scientific literature) more than doubled in 2022 to 16.9; in addition, high open rates for CMAJ emails show its content is highly valued.
Speaking with federal officials face to face more than 170 times in 2022, the CMA earned the top spot in The Hill Times’ annual ranking of health lobbyists.
PARTNERING ON SOLUTIONS
We worked in allyship with First Nations, Inuit and Métis Peoples on how to improve their health and initiate a process that will lead to a formal apology for the harm caused by the medical profession, taking counsel from a Guiding Circle and amplifying Indigenous voices through a series of fireside chats.
We hosted our Health Summit Series: Bold Choices in Health Care, seeking diverse perspectives on health transformation through changes to funding, care delivery and workforce planning.
We provided guidance on retaining health workers, increasing the supply of health professionals and improving health workforce data as a member of Health Canada’s Coalition for Action for Health Workers.
We shared evidence on the health impacts of climate change through an ongoing partnership with The Lancet and supported governing bodies in leading necessary adaptations to health care infrastructure.
A FINANCIALLY SUSTAINABLE ORGANIZATION
The CMA manages its resources with the goal of ensuring financial sustainability and supporting its short- and long-term not-for-profit objectives, including delivering on its Impact 2040 strategy. To ensure a laser focus on strategy, divestments of products and some services such as clinical tools were necessary. This allows us to move forward with greater determination than ever to effect long-lasting change for the benefit of the profession and those we care for.
The Audit and Finance Committee oversees the financial management of the CMA and reports to the CMA board quarterly. The 2023 operating budget, approved by the CMA board, reflects the 2023 workplan and priorities outlined in this report.
2022 financial results
In 2022, a widespread downturn in financial markets resulted in a $402.4M decline in the reported value of the CMA’s wholly owned subsidiary, CMA Impact Inc. Amid a volatile investment environment, the investment portfolio of CMA Impact Inc. decreased by 12%, reflecting unrealized losses that are expected to reverse as economic conditions improve. In accordance with the CMA’s responsible investing priorities, the investment management strategy implemented by CMA Impact Inc. is focused on ensuring the organization’s long-term sustainability in the face of temporary market volatility.
The CMA spent $56M in 2022 in advancing its focus areas, expanding its capacity for engagement with physicians and key partners and continuing its charitable giving efforts directly and through the CMA Foundation; the impact of these investments is highlighted in this report.
The 2022 non-consolidated financial statements have been prepared in accordance with Accounting Standards for Not-for-Profit Organizations, which sets out generally accepted accounting principles for not-for-profit organizations in Canada. As in prior years, the external auditor has issued an unqualified audit opinion. View the 2022 CMA non-consolidated audited financial statements.
We adhere to a formal Responsible Investing Policy and integrate sustainability and Environmental, Social and Governance (ESG) factors into our portfolio management and oversight. As part of this, we’re committed to reaching net-zero greenhouse gas emissions in our investment portfolio by 2050, with interim targets set for 2030 and 2040. Read more about how we’re making strides toward this goal – part of our work to take a health-centered approach to climate change and create a healthier planet for future generations.
EMPOWERING THROUGH TRANSFORMATIVE GIVING
The CMA disbursed $2.1M in 2022 to various external organizations, including provincial/territorial medical and student associations, to support physician leadership training, medical education and health journalism in Canada.
The CMA Foundation provided impactful charitable giving to registered Canadian charities that further excellence in health care and support Canadian physicians and medical learners, granting $3.9M in 2022, including $2M to the Indigenous Peoples Resilience Fund to support Indigenous-led health equity.
Together with MD Financial Management and Scotiabank, we’ve allocated more than $100M to wellness programs across the country that are driving system-wide change and prioritizing physician health and well-being.
MEMBERSHIP BY THE NUMBERS
(As of Dec. 31, 2022)
Annual membership fee: As per our bylaws, the CMA provides an annual update to members on its membership fees. For 2024, the CMA board approved maintaining the membership fee for practising members at $195 (plus GST/HST) and waiving it for medical students, residents and retired physicians.
ANNUAL GENERAL MEETING 2023
At the 2023 Annual General Meeting (AGM), members will have the opportunity to ask questions of CMA leadership, provide input on governance and address other corporate matters, including appointing the external auditor.
Appointment of external auditor: Every year, members vote to approve the appointment of the external auditor who’s responsible for examining the non-consolidated financial statements of the CMA, performing procedures to obtain audit evidence about the amounts and disclosures in the statements, and preparing a report in accordance with generally accepted auditing standards. Members at the AGM will be asked to vote on a motion recommending that Ernst & Young LLP be appointed as external auditor until the next AGM.
Motion AGM-1: Appointment of auditors
The Canadian Medical Association hereby appoints Ernst & Young LLP as external auditors of the association, to hold office as auditors to the association until the next annual meeting of the association or until their successors are appointed.
Governance review: The CMA’s Act of Incorporation and Bylaws (last amended in August 2022) set out the objects of the association and governance parameters. At the 2023 AGM, there will be no motions with proposed bylaw amendments. Instead, consistent with its guiding principles of equity, diversity, engagement, accountability, transparency and impact, the CMA is consulting members on its governance, including:
- who’s entitled to vote for CMA president-elect; and
- the role of the CMA past president as chair of the Nominations Committee.
This consultation process began with a survey sent to all members on May 15, 2023, about their experience and interest in CMA governance; results will be shared at the 2023 AGM as part of the Governance Committee report and member information session.
Members who are interested in learning more about and providing ongoing feedback on CMA governance in 2023 and into 2024 are asked to email [email protected].
Operating rules and procedures: Changes were made to the operating rules and procedures in the past year primarily to update the process the board must follow to suspend or terminate a membership (found in rule 3).
Corporate business proposals: Every year, the CMA welcomes member ideas and input on business- and governance-related matters. The CMA did not receive any corporate business proposals for consideration at the 2023 AGM. The deadline to submit a corporate business proposal for consideration at the 2024 AGM is Feb. 29, 2024.
Report from the Committee on Ethics: As per our bylaws, the CMA provides an annual update to members on the Committee on Ethics’ activities. Under the leadership of new chair Dr. Barry Pakes, the committee is providing ongoing input on an apology to Indigenous Peoples for the harm caused by the medical profession. They also recently recommended that the CMA endorse a new clinical practice guideline on defining and determining death, a joint initiative with the Canadian Critical Care Society and Canadian Blood Services.
NOMINATIONS COMMITTEE REPORT: UPDATE FOR DELEGATES
Every year, the CMA runs a comprehensive process to fill vacant positions on the board of directors and certain committees as well as the position of president-elect. This process is organized by the Nominations Committee, which collaborates closely with stakeholder organizations to encourage candidates to come forward to secure strong and balanced leadership for the CMA.
To encourage participation from historically under-represented groups, a call for expressions of interest is issued to provincial and territorial medical associations, affiliates, associated societies and observer organizations. Candidates are asked to voluntarily self-identify across a range of skills and diversity attributes. The Nominations Committee considers each candidate’s lived experience, professional standing and development, and/or academic credentials and preparation against the role requirements. It also seeks nominations that reflect the diversity and demography of the physician population, specifically with a sensitivity to age, gender, sexual identity, ethnicity/race, Indigeneity, disability and regional balance.
The Nominations Committee will bring a slate of candidates to delegates for ratification at the AGM on Aug. 16, 2023. The Nominations Committee report contains nominee bios and information about the nominations, ratification and elections processes.
Who’s considered a delegate?
As set out in the CMA bylaws, delegates are appointed by virtue of their position, appointed/elected by their provincial/territorial medical association or affiliate society, or invited by the CMA if they are from Quebec (which does not have a provincial medical association). Their role is to ratify certain leadership positions at the CMA.