Canadian Medical Association


8 BUILDING BLOCKS FOR BETTER HEALTH

How the CMA laid the foundation for a vibrant profession and a healthy population in 2019

STANDING TALL FOR PHYSICIAN HEALTH



BY BUILDING A DEDICATED TEAM

We created a physician wellness team, which is developing the first national analysis of the Canadian physician health and wellness landscape, identifying gaps and opportunities for impact.

Many different groups have been doing amazing work in developing physician health and wellness initiatives, and what we’ve noticed is that they often work in silos, even if they’re doing similar things. We want to create collaborations, to scale up our ability to make a real difference for physicians.

– Dr. Caroline Gérin-Lajoie, vice-president of physician health and wellness


BY INFORMING CHANGE THROUGH DATA AND ANALYSIS

We released a new report on wellness and work, Physician Health and Wellness in Canada, to provide an in-depth look at occupational and behavioural factors that may be linked to burnout, depression and other wellness factors.  This report built on data collected from 3,000 physicians and residents in the CMA’s 2018 National Physician Health Survey. 

We published the 2019 Physician Workforce Survey results, creating a valuable snapshot of how Canadian physicians work today. Collecting data from more than 6,700 physicians, we helped provide insight on physician workload, use of digital health tools in patient care, support for national licensure and other topics.


BY CREATING A MOVEMENT TO ADDRESS WELLNESS

We gathered more than 325 physicians, learners and stakeholders to learn about programs, research and approaches to physician health and wellness at the Canadian Conference on Physician Health in St. John’s, Newfoundland.

We enabled 47 speakers and 67 abstract presenters with expertise on physician health and wellness to share their initiatives and research at this conference.


BY INVESTING IN WHAT MATTERS MOST

We helped provide funding for projects supporting the health and wellness of physicians, through our Affinity collaboration with MD and Scotiabank.  Some examples of these projects include:

For the past few years we’ve been addressing the issue of physician wellness by putting our fingers in the dike, jumping around where people identify a need. Everyone wants to address physician wellness, so the demand has increased exponentially.  We now have the money to do this right and do it on a big scale. Collectively, we can get done in the next three years what it would probably have taken our current team another 10 or 12 to do.

– Dr. Jane Lemaire, CMA member and team leader for Well Doc Alberta

The CMA Foundation is supporting the next generation of physicians through the CMA 150th Anniversary Bursaries and Awards Program. More than 34 medical students across Canada benefited from the program this year, sharing $399,500 in bursaries and awards.


BY PROMOTING A CULTURE OF RESPECT WITHIN MEDICINE 

We launched a conversation about building a more collaborative and respectful professional culture, co-producing a consultation paper on equity and diversity in Canadian medicine with the Federation of Medical Women of Canada.

We sought feedback on equity and diversity challenges in the medical profession and drafted a policy on equity and diversity in medicine. This policy is being reviewed by members and stakeholders, to be finalized for January 2020.

We’re not going to get very far by tearing each other down. We need to support each other. Through equity, we’ll all rise up.

– Dr. Gigi Osler, CMA past president

We helped bring together physicians who are passionate about equity and diversity in medicine through our Communities of Interest Grants program.


BY RESPONDING TO PHYSICIANS’ FINANCIAL WELLNESS

We responded to members’ calls for a national physician pension plan, retaining an independent pension expert to examine Canada’s retirement savings system and propose possible options. While the report concluded that current legislation prevents the CMA from establishing a physician pension plan, we’re exploring other solutions that would help provide physicians with greater financial security in retirement. 

PUTTING HEALTH ON THE POLITICAL AGENDA



BY SPEAKING UP FOR HEALTH DURING THE FEDERAL ELECTION

We mobilized physicians and the public to give health a strong voice during the federal election, pressing candidates across the country to learn what they and their political party can do to improve the health of Canadians. Our physician-members held 33 face-to-face meetings with candidates to deliver campaign boxes and sent 469 letters to campaign offices, while our CMA presidents met with a total of 16 candidates from the Liberal, Conservative, NDP and Green parties.

Physicians have a voice that’s respected in the community and by politicians — we have the responsibility to speak for our patients who might not be able to speak for themselves.

– Dr. Leisha Hawker, Halifax physician, CMA Very Involved Physician (VIP) member

We spoke to six key issues identified as top concerns among physicians, health professionals and patients.

  • Climate change and health
  • Access to care
  • Virtual care
  • Seniors care
  • Pharmacare
  • Youth mental health

We trained a select group of physicians and medical learners on how to most effectively share their own experiences with political candidates and politicians during our Election Readiness Day.


BY TRAINING PHYSICIANS TO BE ADVOCATES

We created a new program — CMA Advocacy Caucus — to help physicians and medical learners engage in grassroots advocacy. More than 590 members joined the caucus, to help advance health issues during the election campaign and beyond.

As a physician I felt it was my role to sensitize people to climate change and its effects on our health and to push the government to act.

– Dr. Renée Turcotte, CMA member, Moncton family physician and climate change rally organizer


BY CALLING FOR FEDERAL INVESTMENTS IN HEALTH

We called for new federal investment and leadership in health, proposing a demographic-based top-up to the Canada Health Transfer as well as a new primary care transition fund. This work was supported by a new economic analysis from the Conference Board of Canada, commissioned by the CMA, The Fiscal Health of Canadian Governments. We met with Premiers during the annual Council of the Federation meeting in Saskatoon, to advance this work.


BY ADVOCATING FOR IMPROVED SENIORS CARE

We proposed a new federal Seniors Care benefit to directly support seniors and caregivers by helping offset the high out-of-pocket health costs they face. This proposal was supported by a Conference Board of Canada report, commissioned by the CMA, Measures to Better Support Seniors and their Caregivers.

Building on this work, we briefed seniors and health ministers at the federal/provincial/territorial Forum of Ministers Responsible for Seniors in Charlottetown on the looming seniors care crisis.

Taking care of seniors comes at a high price for many Canadian families. Current programs are inadequate, and the issue will only get worse as our population ages. We must address this and provide the kind of support seniors and their families not only deserve but desperately need.

– Dr. Gigi Osler, CMA past-president

CREATING MOMENTUM TO DRIVE BETTER HEALTH CARE



BY LEADING THE WAY FOR VIRTUAL CARE

We are co-leads with the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada on a national Virtual Care Task Force, with representatives from regulatory bodies and medical, health care and patient organizations.  The task force will be releasing its final report and recommendations in January 2020.

Virtual care not only has the power to improve patient care and access to care, it can also make physicians’ practices more efficient. We’re looking to provide a road map for Canadian physicians on how to provide high-quality virtual care within our publicly funded system.

– Dr. Gigi Osler, CMA past-president and co-chair of the Virtual Care Task Force

We created a community of interest on virtual care as a place for CMA members, experts and stakeholders to generate ideas and recommendations on virtual care.

Given the rapid changes in virtual care technologies, an adaptable, flexible approach to education and training might hold promise — for example, a series of short, CME-accredited, easily digestible modules profiling best practices, and how they might be adapted to the varied practice and remuneration models across Canada

– Dr. Rashaad Bhyat, CMA member and participant in virtual care community of interest

We launched a national discussion on virtual care in Canada supported by a policy backgrounder and held a virtual care policy discussion at the CMA Health Summit.


BY HOSTING AN ANNUAL HEALTH SUMMIT

We brought together more than 1,000 physicians, patients and policy-makers at the CMA Health Summit in Toronto to examine how to build stronger health care systems, communications and approaches to improve care.

We featured 27 speakers and panellists — a range of physicians, patients, policy-makers, innovators and regulators — who presented a breadth of perspectives on reimagining medicine in the digital age.

We need to break through that fear factor in health care and start engaging with AI technologies in more meaningful ways.

– Dr. Alexandra Greenhill, Health Summit keynote speaker

We launched the Future of Connected Health Care report, which revealed Canadians’ attitudes and expectations about technology in health care. The report made national headlines and helped set the stage for discussions at the Health Summit. 

Canadians think their beloved, although struggling, health system needs a technological fix but worry that it could open the door to privatization and loss of privacy, according to a new poll commissioned by the Canadian Medical Association.

– André Picard, Globe and Mail, Aug. 8, 2019

BRINGING FORWARD THE PHYSICIAN VOICE



BY HELPING SHAPE CANADA’S HEALTH POLICIES

We helped shape Health Canada’s position on key issues, bringing forward the physician perspective on drug shortages, food guide, vaping labelling and marketing, reducing youth access to vaping, as well as cannabis health products and cannabis edibles.

Immediate action is needed to respond to the crisis in youth vaping. We have enough evidence from decades of work in tobacco control. We don’t have to reinvent the wheel. What we need is political commitment.

– Dr. Sandy Buchman, CMA president


BY VOICING OUR SUPPORT FOR PHARMACARE

We presented the physicians’ perspective to the Advisory Council on the Implementation of National Pharmacare, advocating for a single-payer public pharmacare program. We welcomed the council’s recommendations — released in June 2019 — to develop a Canada-wide single-payer public pharmacare program, with a low co-payment.  


BY DEVELOPING FUTURE MEDICAL LEADERS

Our popular Ambassador program is helping students, residents and early-career physicians connect with their peers. We sponsored attendance at events such as the SingularityU Canada Summit, the CMA Health Summit, the Canadian Conference on Physician Leadership, Election Readiness Day and the Canadian Conference on Physician Health.

Where I work in Alberta, I would never get the opportunity to be able to sit informally with a senior leadership colleague — someone I would usually have to wait weeks or months to meet with officially. It was a great benefit.

– Dr. Thilinie Rajapakse, CMA Ambassador who attended the Canadian Conference on Physician Leadership

CONNECTING PHYSICIANS ACROSS CANADA



BY HOLDING FORUMS FOR PHYSICIANS TO MEET FACE TO FACE

We connected directly with members across the country — holding day-long forums in Halifax, Montreal, Ottawa and Edmonton, along with online discussions for members who were unable to attend in person.

Anytime there’s an opportunity to meet in a forum like this to discuss the needs and challenges of the profession, I like to be involved.

– Dr. Christopher Grant, CMA member and participant at the Halifax forum

Members helped set the agenda, focusing on two pressing issues facing the profession and patients: Canada’s physician workforce, and physician health and wellness.  Members also shared other ideas for the CMA’s advocacy and policy work during “Open Dialogue” sessions.

We captured the ideas and suggestions brought forward and used these learnings to guide our future work.

We heard from our members that physicians want more control over their work, health policies and how they practise medicine.

– 2019 Regional Member Forums roll-up summary report


BY HOSTING A NATIONAL ANNUAL MEETING

We gathered with more than 300 members at our Annual General Meeting in Toronto, where our board chair and president answered questions and listened to members’ ideas for our future direction.


BY SENDING OUR PRESIDENT TO MEET PHYSICIANS IN THEIR HOME PROVINCE OR TERRITORY

Our president visited provincial and territorial medical associations across Canada to meet with, listen to and learn from members about the issues facing physicians in different regions.


BY UNITING THOSE WHO SHARE COMMON GOALS

Through our new community engagement platform, we’re enabling members and other stakeholders to connect on specific health topics and to share their feedback and ideas with the CMA.  Since its launch in early 2019, more than 470 CMA members and 95 stakeholders have joined the platform.

A number of communities of interest have been created on the platform by physicians, learners, health professionals, patients and the CMA, on topics such as equity in medicine, virtual care, and physician learning and practice improvement.

The platform has provided us with a space for CPD professionals from many organizations to come together to share our experiences, resources and ideas, and advance the quality and impact of CPD across the country. It’s still early days, but we’re feeling very optimistic about the impact that an engagement tool like this will have on “raising the bar” for CPD in Canada and strengthening our community.

– Dr. Jeff Sisler, chair, and Fran Kirby, program Coordinator for the CPLPI community of interest

BY HELPING MEDICAL STUDENTS ENTER RESIDENCY 

We held CaRMS training sessions at every medical school city in Canada, helping 1,100+ medical students prepare for their interviews – leveraging the experience of 130+ resident physicians who worked as coaches and hosts.

SPOTLIGHTING PHYSICIAN LEADERS



BY CELEBRATING OUR SHINING LIGHTS

We celebrated our members’ dedication to health through a cross-country campaign on National Physicians’ Day (May 1). On Twitter, our hashtags #nationalphysiciansday and #journéenationaledesmédecins were used more than 1,100 times over two days.

We showcased 12 members making change in medicine through our Physician Changemakers feature on CMA.ca, sharing how these leaders are developing innovative programs, influencing public health policy and advocating for the best care for their patients.

We honoured 11 medical leaders — physicians, medical students and an administrator — at the CMA Awards gala, sharing stories and videos about their passion for medicine and how they’re helping build a healthier Canada.

You get to learn about people, things they may never have told anyone else, and you’re able to use that information to help them to lead healthier lives. I think that’s one of the most amazing things you can do for another person.

–  Dr. Ali Damji, recipient of the CMA Award for Young Leaders (Resident)


BY SHARING THE WORK OF MEDICAL INNOVATORS 

Joule helped raised the profile of physician innovators and their initiatives, through videos, podcasts and features on joulecma.ca and the Boldly blog.

Patients and caregivers told me how difficult it was to access care, that care felt fragmented and how tough it was to navigate the system. We saw an opportunity to build a more integrated approach to dementia care.

– Dr. Linda Lee, creator of MINT Memory Clinics and Joule Innovation grant recipient


BY SUPPORTING PHYSICAN-LED ADVANCEMENTS

We help scale physician-led innovation. Joule helps physicians to make a positive impact in health care technology though its annual grant program.

Eight physicians and medical learners shared $200,000 in funding to develop or expand projects to advance health care:

  • Dr. Linda Lee – MINT Memory Clinics: a multi-specialty interprofessional team-based model of care that provides access to high-quality dementia care within local family doctor’s offices
  • Dr. Sheila Wang – Swift Skin and Wound: an app designed to streamline wound assessment at the point-of-care
  • Dr. Bill Wang – iMIRGE Medical: the first cost-effective, portable medical GPS for providers, which brings the accuracy of image guidance systems to the bedside
  • Gabriel Georges – Puzzle Medical Devices (ModulHeart): the first long-term hemodynamic support, assembled inside the patient using a proprietary transcatheter technology
  • Jordan Lewis – Flutter Wear: a mobile app and belly band sensor for expectant mothers that passively detect fetal movements, collecting baseline data and informing the management of decreased fetal movements
  • Philip Edgcumbe – Pico Lantern: a miniature projector small enough to be dropped into the abdominal cavity, allowing surgeons to better formulate their surgical plans and minimize complications
  • Dr. Robert Schultz – Boreas Central Line: a specialized central venous catheter that administers fluids to achieve targeted, deep and rapid cooling of the brain
  • Dr. Devon Livingstone – ENTiD: a company that created a digital otoscope and an AI-powered platform to improve ear disease diagnosis at a low cost

This Joule innovation grant will help us … reach out to health care providers across Canada so that we can spread and scale this model and help to better meet the needs of persons across Canada living with dementia.

– Dr. Linda Lee, creator of MINT Memory Clinics and Joule Innovation grant recipient

BUILDING HEALTHIER COMMUNITIES



BY FUNDING GRASSROOTS PROGRAMS

The CMA Foundation (CMAF) supported youth mental health and/or substance use initiatives across the country through its Healthy Canadians Grants program. The grants helped organizations focused on improving mental health, reducing and preventing substance use, increasing resiliency, reducing stigma and decreasing barriers to mental health.

We know mental health and substance use are two important determinants of health, especially for youth and vulnerable populations. Our goal is to focus on improving the health of Canadians and supporting the profession through impactful charitable giving to further excellence in health care.

– Allison Seymour, CMAF president

The CMAF provided 15 grants of $20,000:

On International Women’s Day, the CMAF helped more than 750 women lift themselves out of poverty through a $25,000 donation to the Canadian Women’s Foundation.

GIVING PATIENTS A VOICE




BY SEEKING PATIENT INPUT

With the help of our patient advisory group, Patient Voice, we developed the CMA’s first-ever patient engagement framework to guide how we consult with patients and the public.

We consulted patients in developing new CMA policies on organ and tissue donation and transplantation, and AIDS, as well as on the applications for the CMA Foundation’s Healthy Canadians grants.     

Finally, we’re at the point where patients are actually being heard and being taken seriously and their opinions are valued.

– Elke Hutton, CMA Patient Voice member


BY BRINGING PATIENTS TO THE DISCUSSION

We made patients an integral part of the CMA Health Summit, with a patient participant on stage in each discussion panel and a patient representative on the planning working group.

No one deserves to be the only holder of information.

– Julie Drury, CMA Patient Voice member and part of the Doctors and patients as information specialists’ panel at the 2019 Health Summit

We sponsored 50 patients to attend the Health Summit, and the event was designated as Patients Included Accredited.


BY HELPING PATIENTS TAKE ACTION

We helped mobilize patients and the public to bring attention to health issues through our new public engagement platform, CMA Health Advocates. More than 9,000 supporters joined the platform, and more than 81,000 letters were sent to federal election candidates through the platform.