Canadian Medical Association

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August 2020


Pressing for government action

CMA President Dr. Sandy Buchman meets with federal Health Minister Patty Hajdu to discuss our pre-budget submission. In it, we outline how the federal government can learn from the pandemic to strengthen its response and prepare for what lies ahead. The CMA recommends:

  • bolstering our public health capacity and expanding primary care access;
  • expanding virtual care and addressing inequities in access to digital health services;
  • better protecting our marginalized and susceptible populations, including seniors; and 
  • mitigating the unique risks and financial burdens experienced by physicians and front-line health care workers.

Our advocacy to expand eligibility to the Canada Emergency Wage Subsidy is successful. The federal government has altered the program so physicians in cost-sharing arrangements now qualify, enabling more members of the medical profession to access support.

Dr. Buchman convenes a pan-Canadian virtual meeting between federal Health Minister Hajdu, the CMA, and provincial and territorial medical association presidents. This joint meeting is a first; a unique opportunity to be at the table with government as a profession and discuss next steps for responding to COVID-19.

Supporting physicians' wellness

We host our first virtual group support sessions through the newly launched Wellness Connection platform. The sessions are led by physicians and trained facilitators, and include formal peer support, group support drop-ins and featured sessions such as "compassion rounds" and "psychological first aid."

July 2020


Pressing for government action

The CMA calls on the federal government to address five critical issues to prepare for a second wave of COVID-19, including:

  • Continued development and dissemination of clear, consistent public health messaging
  • Greater access to testing and early contact tracing
  • Better protection of health care providers' physical, mental and financial well-being
  • Better protection of marginalized and susceptible populations, including long-term care residents
  • Support in resuming and providing timely access to health care services postponed during the pandemic

We submit a letter to the federal government regarding its $240M investment in virtual care, with recommendations for making virtual care fee codes permanent.

We develop a federal pre-budget consultation brief that recommends:

  • Mitigating the financial impact of COVID-19 on the medical profession
  • Support in resuming health services and addressing backlog issues
  • Addressing equity issues for vulnerable populations, including seniors

Supporting physicians' wellness

  • The CMA launches the Wellness Connection Platform, a virtual space for physicians and medical learners to discuss shared experiences, get support, seek advice and help each other. Virtual group support sessions are available each week, including formal peer support sessions, group support drop-ins and featured sessions such as "compassion rounds" and "psychological first aid."
  • Building on the Canadian Medical Association Foundation's $250,000 donation to Jack.org, the CMA holds an Instagram Live chat on July 22. CMA Ambassador and medical student Sukhmeet Singh Sachal hosts the broadcast, along with health advocate and Jack.org speaker Jonathan Andrews. The pair discusses youth mental health, including digital tools available to students.

Creating COVID-19 resources

  • In partnership with the Centre for Effective Practice, we continue to update our Re-opening Your Practice Playbook to make it easier for physicians to access the latest information and clinical guidance from across the country. Topics include resuming non-urgent health care services, administrative and operational controls, cleaning, visits with symptomatic patients, and PPE and infection control measures.
  • The CMA website covidquestions.ca — created in partnership with the Royal College, CFPC, Spark Advocacy and many telecom partners — reaches 150 questions and answers, and continues to be a well-used public resource.

The CMA continues to create additional wellness resources for health professionals, including:

  • Episode 11 in our Joule COVID-19 learning series: Dr. Michael Kaufmann, a specialist in addiction medicine and physician wellness, shares the risk factors and red flags to look out for when it comes to your personal wellness.
  • Psychiatrist Dr. Mary Elliott and her team at the Princess Margaret Cancer Centre in Toronto share details on how they developed a successful resiliency program for 1,400 staff, what made it "stick", and how it's helped them cope with the pandemic.

June 2020


Supporting COVID-19 efforts

The CMA welcomes the federal government's new, national contact tracing app. While recognizing its potential in managing COVID-19, we suggest it be complemented by other supports. This includes ensuring public health units are properly funded and staffed to manage contact tracing and to leverage the full potential of the app. We also urge the government to recognize the barriers many Canadians face in accessing technology, and to take steps to help reduce these inequities.

Helping patients access virtual care during COVID-19 and beyond

According to a national poll commissioned by the CMA, almost half the Canadians surveyed have accessed a physician using virtual care options – whether by video, phone, email or text messaging. And 91% of them are satisfied with the medical advice they're receiving.

The CMA sponsors the creation of a how-to guide to ensure people who need virtual care feel comfortable and prepared for their visit. Patients will learn which medical conditions are suitable for virtual care, how to arrange a visit, what tools and information to have on hand, and more.

Supporting physician-led innovation

  • Joule launches a COVID-19 Innovation grant program, which will provide up to $1 million in funding to help scale up members' ideas and innovations to address the pandemic. Grant categories include:
    • Supporting front-line health workers
    • Access to care during the COVID-19 pandemic
    • Population health solutions

Visit the Joule website to find out more.

Addressing physicians' financial security

  • The CMA responds to a Finance Canada consultation on the Canada Emergency Wage Subsidy (CEWS) program, focusing on the need to resolve the technical and administrative barriers preventing some physicians from being eligible.
  • We continue to speak with federal representatives to highlight these important concerns and to share the recommendations outlined in our fiscal stabilization brief.

Supporting physicians' wellness

  • The CMA launches a Wellness Support Line to provide bilingual, specialized 24/7 mental health support and counselling to physicians, residents, medical students and their immediate family. It is a complement to existing resources provided through provincial and territorial physician health programs. Physicians and medical learners across Canada will now have access to wellness support – both during this pandemic and beyond – representing a major step forward in the CMA's ongoing efforts to address physician health. 
  • The CMA Foundation (CMAF) announces a commitment of $250,000 to expand access to virtual youth mental health services through Jack.org. It is part of the CMAF's ongoing funding to support physicians and vulnerable communities during the pandemic.

Creating COVID-19 resources

  • We work with the Centre for Effective Practice to develop an online guide for re-opening physician practices during COVID-19. The guide leverages the latest clinical guidance from across the country, on topics such as conditions for resuming non-urgent health care services, administrative and operational controls, cleaning, visits with symptomatic patients, and PPE and infection control measures.
  • We record episode 10 in our Joule COVID-19 learning series: Organizational psychologist Michael West shares his advice on compassionate leadership models and how they can help organizations overcome some of the hurdles they're facing as a result of COVID-19.
  • The CMA publishes a summary of information for medical students and residents on the impacts of COVID-19 on their studies and training. It includes updates from FMRAC, the CFPC and the Royal College on examinations and licensing.


May 2020


Funding COVID-19 efforts

On May 11, the CMA Foundation (CMAF) announces a commitment of $10 million to address the needs of vulnerable populations affected by the COVID-19 pandemic in communities across Canada.
In collaboration with the Federation of Canadians Municipalities, the CMAF is donating funds directly to municipalities to support their efforts to reach, protect and assist their most vulnerable residents.
The COVID-19 Community Response Fund for Vulnerable Populations will go toward measures such as:

  • creating dedicated spaces to support physical distancing measures;
  • funding medical and support services for people experiencing mental health and substance use challenges;
  • supporting community food programs;
  • providing personal protective equipment for community support workers; and
  • other measures designed to build community resiliency and support sustainable recovery.

Addressing physicians' financial security

The CMA submits a brief to the federal minister of finance with recommendations on how to help physicians grappling with the financial implications of COVID-19. Those recommendations include:

  • Expanding the eligibility criteria for federal support programs to include hospital-based specialists, physician practices that operate a small business but may not meet technical criteria, and physicians delivering locum medical care.
  • Introducing new measures to address the risks and additional costs borne by physicians and other front-line health care workers. These include a new income tax deduction, a doubling of the child-care deduction and a temporary emergency tax deduction for those who've had to seek alternative accommodations to self-isolate.

Pressing for government action

CMA President Dr. Sandy Buchman appears before the Senate Standing Committee on Social Affairs, Science and Technology in their study of the government's response to COVID-19. He calls for caution as governments across the country begin to lift public health restrictions and calls on the federal government to:

  • Continue to ensure adequate supplies of PPE.
  • Learn from the pandemic to make much-needed improvements to the health care system, including scaling up virtual care and revamping the long-term care sector.

Personal protective equipment (PPE):

  • The CMA welcomes further federal steps to improve the supply of PPE for physicians and other health care providers. The federal government announces the creation of the COVID-19 Supply Council, which brings together private and non-profit sectors to advise on building "innovative and agile" supply chains for PPE.
  • With a lack of PPE still causing serious concerns for our members, we will be monitoring the council's progress closely, and continuing to call for more government action to keep physicians and other health care professionals safe and protected.

Scaling up virtual care:

  • The CMA is pleased to see the federal government pledge $240.5 million to further expand virtual services across Canada, including access to mental health supports. From the outset of this pandemic, virtual services have played an important role in helping physicians connect with and provide care to their patients, from the safety of their homes.
  • Earlier this year, we collaborated with the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada to outline 19 key recommendations to pave the way for virtual care in Canada.

Supporting physicians' wellness

The CMA continues to update its wellness resource page for health professionals:

  • Dr. Caroline Gérin-Lajoie, the CMA's executive vice-president of physician health and wellness, shares her tips for how to recognize and prevent moral distress during the pandemic.
  • Psychiatrist Dr. Mamta Gautam explains how, at the outset of the pandemic, she set up a daily video call for physicians to share their feelings and concerns – and why the peer-to-peer network is proving to be so valuable.
  • In her final blog post, CMA President-Elect Dr. Ann Collins reflects on the public outpouring of support for physicians and other health care providers throughout the pandemic and shares her own words of gratitude to Canadians.

Creating COVID-19 resources

  • The CMA creates a new resource page on managing and re-opening physician practices. The page includes information on:
    • Scheduling visits, including factors to consider before seeing patients in-person
    • Suggested office procedures and design to accommodate physical distancing guidelines
    • Ongoing screening of patients for COVID-19
    • Infection control measures and PPE, including how to get more supplies
    • Addressing patients' anxieties around COVID-19
  • We record episode 9 in our Joule COVID-19 learning series: First-year resident Dr. Stephanie Smith explains how the STRIVE mental readiness model she learned in the military (and adapted for medical students) can help medical professionals deal with the stresses of practising during a pandemic.
  • The experts from DynaMed answer physicians' top 10 clinical questions on COVID-19, from whether transmission rates will change with the warmer weather, to what medications patients can safely take if they're infected with the virus.
  • Our Joule librarians compile a list of current research summaries on COVID-19 from Wiley Publishing. CMA members can receive these briefs by email and earn CPD credits by subscribing to POEMs.
  • For a limited time, CMA members are given complimentary access to additional therapeutic content through the CPS online and RxTx app, the Canadian drug reference from the Canadian Pharmacists Association — including information on the management of COVID-19 symptoms.

Shaping our post-pandemic work

  • The CMA convenes a group of experts to review the impacts of the pandemic on the medical profession and health care system. The Post-Pandemic Expert Advisory Group will also be tasked with identifying any emerging issues and considerations in the short-term and highlighting lessons learned to inform our longer-term strategy development. The members represent medicine, allied health, economics, public health and the patient perspective.


April 2020


Funding COVID-19 efforts

On April 21, the CMA Foundation announces a commitment of $20 million, one of the largest COVID-19 donations to date. This funding will be allocated through targeted grants to support urgent needs within the health care system, including:

  • $5 million to the Frontline Fund for Healthcare Workers and $5 million to benefit community hospitals
  • $5 million to the Foundation for Advancing Family Medicine's COVID-19 Pandemic Response and Impact Grant Program
  • $5 million to help address financial challenges for medical learners, in partnership with medical schools
  • $250,000 to the Doctors without Borders/Médecins sans frontières' COVID-19 Crisis Fund

On April 28, the CMA provides $4.6 million to help further support physicians during the pandemic through its affinity agreement with Scotiabank and MD Financial Management.

  • The funds will be distributed to 33 medical associations, who will support members in their respective areas to meet their most pressing needs.
  • This may include introducing new physician health and wellness initiatives, sharing content on relevant clinical matters, developing protocols around COVID-19 and delivering online training modules. 

Addressing physicians' financial security

The CMA continues to raise the issue of income stabilization with the federal government by:

  • meeting weekly with the PTMAs to share developments in each jurisdiction.
  • working with key stakeholders like the Canadian Chamber of Commerce and the Canadian Federation of Independent Business to bring forward our common concerns.
  • The CMA commissions a full report from tax and accounting firm MNP on the federal assistance programs being created for businesses and individuals, and how they can be leveraged by physicians in a variety of practice settings.

Pressing for government action

Personal protective equipment (PPE):

  • CMA President Dr. Sandy Buchman presents to the House of Commons Standing Committee on Health, emphasizing the critical need to secure more PPE and other medical equipment.
  • The CMA releases a second member survey on the current state of PPE on the frontlines. The results point to some very modest improvements in the state of supply, compared to our earlier survey at the end of March, and also outline the mental health impacts a lack of PPE is having on physicians.
  • The CMA shares these insights with the federal government to help make a difference in how they're responding to this critical issue.

Infection control in long-term care homes:

  • The CMA welcomes the federal government's release of new interim guidance on infection prevention and control of COVID-19 in long-term care homes. We also encourage all provincial and territorial governments to adopt these guidelines in their jurisdictions, to complement the measure they've already put in place to help safeguard the health of residents and employees in these residences.

Supporting physicians' wellness

Joule launches a new physician learning series, moderated by Dr. Jillian Horton, designed to support frontline physicians in dealing with different pressures posed by the COVID-19 pandemic.

  • Episode 1: Making virtual care work for you
  • Episode 2: Managing isolation and building resilience
  • Episode 3: Maintaining high performance in times of stress
  • Episode 4: Running on empty: Staying healthy during difficult times
  • Episode 5: Moral distress: When core values are at stake
  • Episode 6: Grief and loss: Lessons from a war zone
  • Episode 7: Building resilience in times of uncertainty
  • Episode 8: Keeping children safe
  • Episode 9: Preparing for the unknown: mental readiness lessons from the military
  • Episode 10: Compassionate leadership in times of crisis

As part of the learning series, Joule also offers online mindfulness workshops to help physicians cope with crisis.

The CMA creates additional wellness resources for health professionals, including:

  • A two-page handout for medical and non-medical personnel on providing brief psychological counselling during the pandemic.
  • Strategies on how to manage stress and anxiety, how to recognize the signs of burnout and information on peer-to-peer support.
  • CMA President-Elect Dr. Ann Collins continues her blog about the physician experience and COVID-19. After spending two weeks in isolation, she writes about her return to practice, resuming care in a hospital setting and the situation in long-term care homes in New Brunswick.

Creating COVID-19 resources

We launch covidquestions.ca – in partnership with the Royal College and the CFPC – where members of the public can get accurate and trustworthy responses to their questions on COVID-19.

Providing access to training

With a multi-year investment from the CMA, Pallium offers four additional palliative care modules to health care professionals in Canada, free of charge. All ten online modules are available until Aug. 31.


March 2020


Fighting to stop the spread of COVID-19

  • The CMA launches advertising and public awareness campaigns on the importance of physical distancing – in partnership with most PTMAs. Spotify ads help us reach a younger demographic.
  • We champion public health measures to stop the spread of the virus and launch a far-reaching campaign with digital and radio, direct mail and web.
  • We publish Stop the Spread handouts for physicians to use with patients – in five languages in addition to English and French: Arabic, Cantonese, Mandarin, Punjabi and Spanish.
  • We also create information posters for physicians to download and share with patients.

Helping members navigate ethical questions

Scaling up virtual care

  • Responding to members' need to quickly ramp up virtual care in their practice, Joule launches a virtual care playbook authored by a leading authority, Dr. Mark Dermer.

Providing access to training

  • With financial support from the CMA, Pallium is providing physicians with free access to six online palliative care modules in response to the COVID-19 pandemic.
  • These modules are designed as an introduction to the palliative care approach and focus on important knowledge and skills required in providing this type of care.

Supporting physicians' health and wellness

  • We launch a series of resources, including a COVID-19 wellness checklist and self-assessment tool for health care providers, along with a resource for health care providers on talking to their kids about COVID-19.
  • CMA President-Elect Dr. Ann Collins blogs about her self-isolation experience after returning from international travel.

Creating COVID-19 resources

Pressing for government action

Personal protective equipment (PPE):

  • Responding to members' urgent call for action on PPE, the CMA launches a national survey on the current state of PPE on the frontlines.
  • The alarming results are shared with government officials and CMA President Dr. Sandy Buchman meets with federal Health Minister Patty Hajdu to emphasize that:
    • more PPE needs to make its way to physicians and all health care workers immediately.
    • better coordination and transparency are needed between the federal and provincial/territorial governments to ensure supplies are tracked and status information is made readily available.

Emergency federal measures:

  • The CMA identifies six pressing recommendations for federal government measures to help manage the pandemic; advocacy on these recommendations is ongoing.

Ongoing actions:

  • The CMA presidents – Dr. Sandy Buchman, Dr. Gigi Osler and Dr. Ann Collins – take to the airways to press for action, share public health messaging and support the overall response.
  • The CMA is at the centre of the federal response, meeting with ministers, participating in the Chief Public Health Officer Health Professional Forum, Health Canada Multi-Stakeholder Steering Committee on Drug Shortages, and Health Canada Tier Assignment Committee.
  • We bring the medical perspective to the public health response – helping devise national action plans to address all facets of COVID-19.

 

 

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