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Time to Re-invent the Canadian Medical Association

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Dr Chris Sedergreen - 29 April 2022

The humiliating defeat of the Canadian Medical Association in the Supreme Court of BC is about as clear a statement as it is possible to make that the Canadian Medical Association (CMA) is a failed entity, and that it’s present form should be dismantled forthwith.

‘Humiliating defeat’ you ask? Well, you could certainly be forgiven for not knowing about it, since the CMA, the CMA Journal, and the CMA web site have been deathly silent about it.

The bottom line here is that a dark shadow has been cast over the CMA elected officials by this legal judgement; and for this the only honourable thing for them to do is to resign en masse with their heads down in shame.

But looking at the wider perspective, how many physicians and surgeons from coast to coast to coast think the CMA is of the slightest value to them whatsoever? I believe that less than 1% of all doctors have any time for the CMA at all, and if it disappeared in a puff of smoke no one would notice a difference.

If we were to ask ourselves “do we need a Canadian Medical Association?”, there would probably be a long pause before a positive answer was proposed. So for the sake of the exercise, let’s ask ourselves what we would want a newly invented Canadian Medical Association to look like?

First and foremost it should serve as a critical examiner of, and respondent and contributor to Canadian federal government health care policy. It should do this solely on the basis of informed physician comment from every corner of this vast country of ours, and not merely an elite group in Ottawa or other major metropolitan centre.

Never, to my knowledge, has the CMA painstakingly canvassed the needs and aspirations of practitioners from coast to coast. (Contrast this with the Professional Institute of Public Service  and ) which annually canvasses each of it’s approximately 60,000 members with a multi-page questionnaire regarding their hopes and expectations).

Next the CMA should serve as an effective communication conduit between individual provincial medical professional associations; as well as with international medical professional associations; and should keep members informed about what is occurring in the medical professional world around them. Our CMA has done none of this.

The CMA should also be a trusted and reliable means of communication between the profession and Canadian citizens. Such communication should be in both directions, so that citizens have a chance to tell us what they think of us. (Again it is axiomatic that the CMA must express the known majority held medical opinions).

Communication is separate from advocacy. It is to be expected that we should advocate for ourselves at a political level; but we should also be forthright in advocating loudly for the best medical care for our patients. The CMA should NOT advocate for narrow special interest groups unless there is a very specific medical need. To do so risks creating divisions in society. The CMA should advocate for the highest standards of medical care and denounce those that fall short.

The CMA should be the defining resource for what ‘Professional Standards’ means. (This should not be left the Colleges of Physicians and Surgeons). Ethical conduct and ‘best practises’ should not be defined by an ivory tower group, but through free and frank discussion of the members.

Finally the title ‘Doctor’ derives from the Latin verb, ‘docere’ to ‘teach’. A re-invented CMA would be involved actively in providing high quality continuing medical education across the country to doctors; as well as seeking to educate the public how they might best live healthy lives. We used to do that. The BCMA led the world in cervical cancer screening in the 1960s by means of the Pap test. Ontario physicians led the way in promoting smoking cessation. There’s still much work to be done.

Well that’s a start. I’ll leave it to others to enlarge on what an new CMA should look like.




Right on Chris I agree 100%.

Medical knowledge is not just the majority view

Thank you for starting this important discussion. You offer some useful suggestions. However, I will challenge one point, that "the CMA must express the known majority held medical opinions". When it comes to medical knowledge it is often evident that diversity of thoughts, and even minority opinions, contribute to our understanding, determining the right actions, and progress.

Sometimes, it is the ability to not only tolerate disagreement but to embrace it, that is needed to further our knowledge and understanding. This has been demonstrated with examples like that of Dr Alice Stewart who in 1956 was the first person to demonstrate the link between x-rays of pregnant women and high cancer rates in their children, as described by Margaret Heffernan in Disagreement is central to progress.

It will better serve the medical community and society at large for the CMA to promote openness to different ideas and different medical thoughts as required of physicians, rather than fear of difference and the approach of a large echo chamber. Some of the values and methods to do this are described in the TedTalk by Margaret Heffernan "if we want to have thinking organizations and a thinking society".

The annual CMA General Council meeting was once a very visible way in which the medical profession demonstrated such open debate publicly and attracted national television and media coverage. It has been almost completely lost as the CMA aspires to a corporate model as a conglomerate, rather than a democratic national medical association of physicians.