Home About the CMPA 2025 CMPA Annual Meeting Minutes of the 2024 CMPA Annual Meeting [Draft]

Minutes of the 2024 CMPA Annual Meeting [Draft]

Halifax, Nova Scotia, with virtual participation—August 14, 2024

Welcome and opening address

The 120^th annual meeting of the Canadian Medical Protective Association (CMPA) was held beginning at 2:00 p.m. AT on Wednesday, August 14, 2024, in the Commonwealth A room of The Westin Nova Scotian, 1181 Hollis Street, Halifax, Nova Scotia. Videoconference participation was also available. The meeting was conducted in English and in French and simultaneous interpretation was available for all attendees. The meeting was recorded as a webcast and will be available through the annual meeting page of the CMPA website. There were an estimated 176 physician-members present, with 61 participating in person and 115 virtually.

Call to order

The Chief Executive Officer (CEO), Dr. Lisa Calder read the notice of the 2024 annual meeting of the Canadian Medical Protective Association and declared the meeting to be duly constituted.

Land acknowledgement

The CEO welcomed award winning film-producer and director, writer, facilitator, community activist, teacher, drummer, and the first Mi’kmaw woman film-maker from the Atlantic region, Elder Catherine Martin. A member of the Millbrook Mi'kmaw Community in Truro, Nova Scotia, she is a past Chair of the Aboriginal Peoples Television Network, the first director of Indigenous Community Engagement at Dalhousie University, and she received the Order of Canada in 2017 for her dedication and contribution to Indigenous and Canadian cinema. While drumming, Elder Martin welcomed meeting participants to the land, shared its history and that of its original people, and called upon ancestors to surround attendees.

The incoming President, Dr. Birinder Singh, thanked Elder Martin. Having recalled how his family’s settler story began in Halifax, he recognized Kjipuktuk/Halifax as the unceded territory of the Mi’kmaw People and that this sovereign nation holds inherent rights as the original peoples of these lands. He noted we each carry collective obligations under the Peace and Friendship Treaties. He also recognized that African Nova Scotians are a distinct people whose histories, legacies and contributions have enriched the part of Mi'kma'ki known as Nova Scotia for over 400 years. He paid honour and respect to the lands and the Mi’kmaw People and to all First Nations, Inuit and Métis Peoples throughout Turtle Island.

Introduction

The CEO reminded meeting participants that, as per the CMPA By-law, only active members could vote or pose question. She provided instructions as to how both in-person and virtual attendees could do so.

The President announced he was joined by a number of colleagues from senior leadership, Council and General Counsel, many of whom would either be presenting during the meeting or available to answer members’ questions.

He also acknowledged the presence of four former presidents of the CMPA, Drs. Michael Cohen, Debra Boyce, Jean-Joseph Condé and Peter Fraser; and two former CEOs, Drs. Douglas Bell and John Gray.

Appointment of scrutineers

Dr. Brossard indicated Drs. Jane Healey of Oakville, Ontario and André Bernard of Halifax, Nova Scotia were prepared to act as scrutineers in the event a vote should be required. Absent any opposition, the President identified the membership’s consensus to accept the proposed scrutineers.

Approval of the Minutes of the 2023 CMPA Annual Meeting

The minutes of the 2023 CMPA annual meeting had been posted on the CMPA website.

A motion to approve the minutes of the 2023 CMPA annual meeting, held in person with virtual participation available, was moved by Dr. Michael Sullivan of Toronto, Ontario, seconded by Dr. Michael Cohen of Grand-Falls-Windsor, Newfoundland, and was carried.

A year in review

Dr. Calder reported, last year, the CMPA launched a new Strategic Plan and has since been focused on achieving three goals:

Supporting its members and employees
Strengthening its foundation through collaboration, and
Adapting to the changing healthcare environment through modernization

Support and assistance

The CEO reported that the first goal, supporting members’ medico-legal needs, drives everything the CMPA does and is the core of every enhancement made at the Association. In 2023, the CMPA received over 29,000 requests for assistance and partook in over 49,000 interactions with its members. It provided expert guidance and ethical defence in many College matters, hospital matters and new legal actions, all while continuing to provide just-in-time advice on key issues like the healthcare human resources crisis, medical assistance in dying, treating non-Canadian residents, and more. The work aims to help members reduce harm and practise more safely. 96% say the range of CMPA services meets their medico-legal needs and in the recent member survey, members chose the words respected, responsive, and creditable to describe the CMPA.

Physician wellness

Dr. Calder reported physician burnout and wellness issues continue to be a crisis impacting healthcare and have the potential to impact patient safety and increase medico-legal risk. While continuing to look for new ways to offer an empathetic ear with compassionate support, the CMPA is collaborating with stakeholders to enhance physician wellness across Canada, is piloting a peer-support program for members experiencing emotional distress and conducts one-on-one interviews to understand the impacts of racism, inequity and discrimination. Members who reported high stress levels experienced a 74% reduction in stress after speaking with a physician advisor.

Patient compensation

The President indicated another essential role of the CMPA is to provide timely and appropriate compensation to patients on behalf of members when it is proven they have been harmed through negligent care. In 2023, close to $308 million dollars was paid in compensation to patients on behalf of members. Over the past ten years, a total of approximately $2.4 billion dollars was paid in patient compensation. One of the Association’s main priorities is to contribute to preventing healthcare-related patient harm from occurring, and is advanced through expert advice, learning and research.

Equity, diversity and inclusion

Dr. Brossard reported the CMPA has heard clearly from its members that equity, diversity, and inclusion (EDI) issues intersect with medico-legal complaints, both on the part of physicians and patients. With these issues tied directly to the CMPA’s mission, the Association continues to move forward with creating inclusive and safe spaces for members who call, deepening its understanding of members’ needs through new EDI data collection. The CMPA also participated in the Restorative Leadership Symposium, is implementing an EDI Strategy and growing its EDI office. 96% of members surveyed after a call feel physician advisors provide a safe and non-judgmental environment.

Advocacy and collaboration

The CEO noted results of the new membership survey show a preference for continued advocacy with the governments for changes to contribute to a better healthcare system. While results of the full survey will be shared with members in the fall, in 2023, the CMPA made 34 submissions to government and regulators and participated in 340 stakeholder engagements.

She added the CMPA continues to advocate with its partners on issues corresponding to its mandate, notably on policies that have an impact on physicians, patients and the medical care system. For example, the Association met with all the medical associations and Colleges in the Atlantic region to discuss the implementation of the Atlantic registry, and attended meetings with Québec’s Ministère de la Santé et des services sociaux. In addition, the CMPA continues to provide expertise and explore possibilities and challenges related to artificial intelligence in healthcare. For instance, the Association co-presented a symposium on artificial intelligence with the College of Physicians and Surgeons of Alberta, which helped to identify both risks and opportunities for the cautious adoption of these technologies in healthcare.

Safe medical care

The President announced the CMPA continues to address the new needs of its members by offering innovative data-based learning activities. Generated as a result of CMPA research, these activities are aimed at improving patient safety and reducing harm. Examples include the Association’s ‘How to engage and advocate safely on social media’, a webinar attended by over 300 members; its ‘Patient safety primer’, a workshop attended by over 1,550 resident physicians; its 35,347 completed eLearning activities; and its seven completed ‘Know Your Risk’ reports. The CMPA collects and analyzes data from the medico-legal experiences of Canadian physicians and utilizes this knowledge to help members make enlightened decisions and provide safe medical care.

The President reminded meeting attendees that the above-noted efforts represent how the Association brings value to the healthcare system and supports physicians. We are here for our members, and to help them practice safely and confidently.

2023 Report of the Audit Committee

Dr. Michael Curry, Chair of the Audit Committee, reported that the firm of KPMG audited the CMPA 2023 financial statements and, in an unmodified opinion, attested the statements properly present the results of operations in 2023 and the financial position of the Association as at December 31, 2023.

2023 Financial Report

Financial model

In walking meeting participants through the CMPA’s unique financial model that supports its long-term financial horizon, and in summarizing its 2023 financial performance, Mr. Cory Garbolinsky, Chief Financial Officer (CFO), reported the CMPA has a responsibility to maintain sufficient funds to support its more than 111,000 members and, on their behalf, compensate patients proven to have been harmed by negligent care today, tomorrow, and well into the future. He outlined the key principles that drive the Association’s financial model, as follows:

Principle 1: The CMPA’s occurrence-based protection provides physicians with eligibility for assistance any time in the future, as long as they were members when the care was provided. As a result, the Association must hold funds to support members and compensate patients for up to four decades from the time the care was delivered.
Principle 2: Members pay the expected cost of their protection through their yearly membership fees. In 2023, the Association collected the fees required for the estimated cost of protection for all occurrences taking place in that same year, even though they may not become apparent for many decades.
Principle 3: The CMPA does not seek to generate a profit; its financial goal is to hold at least $1 of assets for every $1 of liability to appropriately compensate patients and support physicians.
Principle 4: The CMPA’s financial model is self-correcting. Upon its actual year-end results differing from its estimated results, as a not-for-profit organization, the Association is not permitted to pay dividends to its members but it may increase or decrease membership fees from year to year to address the difference.

The CFO explained the inter-connectedness of the various components of the CMPA’s financial model. Its net asset position, or the difference between its total assets and total estimated liabilities, is a key factor in determining the membership fees in any given year. Membership fees are used to pay the medico-legal costs of supporting the Association’s more than 111,000 members and compensating patients on their behalf. The changing trends in medico-legal costs shape the size of the assets needed for future and outstanding claims. This is the amount of money needed to appropriately compensate, on behalf of members, patients harmed by negligent medical care and to manage future legal and administrative expenses. The CMPA’s investment portfolio aims to earn income to ensure it can appropriately compensate patients and fund future medico-legal expenses.

Funded position

The CFO reported, as of December 31, 2023, the CMPA’s net asset position decreased by $121 million from 2022 to $983 million. This decline was by design as the Association significantly reduced membership fees in 2023 to lower its net asset position, which was higher than ideal in 2022. The decrease in membership fees collected was offset by a strong return in the CMPA’s investment portfolio.

Membership fees

Mr. Garbolinsky recalled fee reductions were $99.5 million in 2021, $200 million in 2022, and $362.5 million in 2023; this makes for a total of $662 million in membership fee reductions since 2021. He noted membership fees of $199.2 million were collected in 2023. Through prudent adjustments to membership fees, the Association aims to stabilize its membership fee structure over time. While the CMPA strives to maintain long-term fee stability, its ability to do this is in part determined by the performance of its investments, which are managed carefully but subject to market fluctuations.

Medico-legal costs

The CFO explained that the CMPA collects membership fees to pay medico-legal costs such as compensation to patients, legal and expert fees, safe medical care learning programs, and the costs to run the Association. Having described compensation to patients as the CMPA’s single largest expense, he reported that in 2023, the Association paid nearly $308 million to patients injured as a result of proven negligent medical care. While the total compensation amount varies from year to year, the CMPA paid a total of $2.4 billion dollars in patient compensation over the last ten years, or an average of $241 million per year. Having noted that compensation to patients is not equal across the Association’s four fee regions, he reported that while Ontario represents 40% of the CMPA’s members, this fee region has the highest legal fees and compensation amounts awarded to patients and represents more than 50% of the Association’s annual costs. These regional cost differences lead to members paying different fees in different regions. Each region is independent and there is no subsidization between the regions. Similar to members in Ontario paying higher fees than their colleagues in other fee regions, members in Québec pay the lowest fees in the country due to lower medico-legal costs in that region.

Assets for outstanding and future claims

The CFO described the assets for outstanding claims as the sum of all of the expected future medico-legal costs resulting from the care delivered by members up to and including 2023. And for 2023, the CMPA must ensure it has funds available to cover any expense related to care delivered in that year for up to four decades. As of December 31, 2023, the estimate for all outstanding and future claims was $4.2 billion, an increase of $127 million from 2022 based on updated cost-trends. Approximately two thirds of this $4.2 billion amount is for compensation to patients. This amount of assets for outstanding claims was subject to a peer review by Ernst and Young, whose independent calculation strongly aligned with that of the Association and was also audited as part of KPMG’s external audit of the CMPA’s financial statements.

Investments

Mr. Garbolinsky reported the CMPA’s investment portfolio is targeted to match or exceed a 6% investment return over the long term. The Association achieved exceptional returns on its investment portfolio over the past ten years, earning a 7.1% compound annual return. This same portfolio had a net value of $5.6 billion in 2023, an increase of $169 million from 2022, which can be attributed to overall market performance in which the CMPA exceeded its target, earning an investment return of 8.5%. The Association’s positive financial position will help weather the volatile financial markets, fluctuating medico-legal case volumes and costs, and the recent high inflation environment. The CMPA continues to invest responsibly to maintain an appropriate financial position that ensures timely and appropriate compensation to patients on behalf of members, protection and support to physicians, safe medical care learning and research to support patient safety. Should the financial market volatility continue, the Association’s financial position may be further impacted, which could lead to future increases in membership fees.

In conclusion, the CFO summarized three key takeaways:

The Association’s occurrence-based protection allows it to operate with a long-term financial horizon of up to four decades, and to protect members and compensate patients today, tomorrow, and for years to come.
Fee increases or decreases are the primary tool used by the CMPA to manage its overall net asset position.
The Association’s positive net asset position in 2023 should provide confidence to members and their patients that it is there for them when needed.

The full report of the Association’s 2023 financial performance is available on the CMPA website.

2025 Membership fee requirements

The CEO indicated each year, the CMPA sets membership fees to support its financial sustainability while striving to keep fees as low as possible. Membership fees in each of the Association’s four fee regions reflect regional variations in medico-legal costs, the number of physicians in the region, and the risk levels of their different specialties. These medico-legal costs are calculated annually and include the estimated costs to compensate patients and support members for up to four decades. The CMPA is committed to stewarding members’ fees responsibly and to achieving long-term membership fee stability in an environment influenced by volatility in both the investment markets and medico-legal costs. To manage its financial position and help dampen large variations in fee volatility, the Association applies fee debits and credits. Since 2019, members have been provided with increasingly greater fee credits, reaching their peak in 2023 and amounting to close to $670 million over the past three years.

Dr. Calder added that the CMPA had to increase its fees in 2024 due to poor market performance in 2022 and to better prepare for future medico-legal costs. Given the markets performed better than expected and the Association’s financial position stabilized in 2023, the 2025 average membership fees are similar to those in 2021.

The CEO further reported, in response to the regional cost differences across the country, the Association’s four fee regions allow for an equitable allocation of costs. They are British Columbia and Alberta; Ontario; Québec; and Saskatchewan, Manitoba, Atlantic provinces, and the Territories. Given each region is independent and there is no cross-subsidization between them, if one region is in a positive or negative funding position, this does not impact the others. The total cost per region is the amount to be collected in each region, and the average fee per member constitutes the total cost per region divided by the number of members in that region. This fee is only an average, an illustrative number that does not represent the fee that an individual member pays. When determining individual member fees, the CMPA first calculates the total cost for the region and uses this as the foundation to determine regional fees based on the type of work.

2025 Average fee requirement for the British Columbia and Alberta region

Less than pre-pandemic levels, the average fee requirement in British Columbia and Alberta remains unchanged from 2024 at $5,071. While the total average fee for the region increased by $6 million to $154 million, this is a level the Association considers manageable and therefore sees no need to increase the average fee requirement per member.

2025 Average fee requirement for the Ontario region

In Ontario, the cost of providing medical liability protection is greater than in any other region and this is reflected in the membership fee. As with British Columbia and Alberta, the average cost per member in 2025 is not changing from 2024 and is forecast to be an average of $7,287 per member. While the total average fee for the region increased by $11 million to $336 million, the CMPA also considers this a manageable change with no need to increase the average fee requirement per member.

2025 Average fee requirement for the Québec region

After several years of unprecedentedly low membership fees in Québec, the average fee per member will increase from $224 to $448 to be more in line with the anticipated medico-legal costs, and the total regional fee requirement will double from $5 million to $10 million in 2025. Although this is a 100% increase from 2024, it is still much lower than it has been in previous years.

2025 Average fee requirement for the Saskatchewan, Manitoba, Atlantic Provinces and the Territories region

Like Québec, membership fees in Saskatchewan, Manitoba, the Atlantic Provinces and the Territories were unprecedently low in recent years. Also similar to Québec, the average fee per member will increase from $695 to $1,420 to be more in line with the anticipated medico-legal costs, and the total regional fee requirement will more than double from $10 million to $21 million in 2025. Although this is a 104% increase from 2024, it is still much lower than it has been in previous years.

2025 Type of work (TOW) fees

Speaking to a slide and presenting an overview of recent average membership fees by region, the CEO demonstrated that even though 2025 fees have increased in Québec and the Saskatchewan, Manitoba, the Atlantic Provinces and the Territories fee regions, fees across all regions are still below pre-pandemic levels.

Having shared the average fees per member, Dr. Calder presented a practical example of the actual membership fees that family physicians practising in type of work code 35 will pay in 2025, which is the CMPA’s largest type of work code. She noted the full listing of 2025 membership fees was available on the CMPA’s website. Members will be provided an email notification in the fall when the individual annual fee invoices will be available online through the secure member portal on the Association’s website.

The CEO offered the Association’s strong financial position as an assurance that it will continue to be there for its members and to compensate patients proven to have been harmed by negligent care on their behalf, today, tomorrow, and well into the future.

2024 Election results

Having referred to the slide projected to share the 2024 election results, Dr. Calder announced she was pleased to welcome a number of new and returning Councillors from across Canada, as follows:

In British Columbia and Yukon, Drs. Michael Curry, and Fay Leung;
In Manitoba, Dr. Darcy Johnson;
In Ontario, Drs. Gerard Craigen, Paul Healey, Clover Hemans, Michael Sullivan, and Joyce Zhang;
In Québec, Drs. Viviane Khoury, Geneviève Lalonde, and Yanick Larivée; and
For the national resident position, Dr. Victoria Januszkiewicz.

The CEO acknowledged Drs. Fahimy Saoud and Patrick Trudeau, both from Québec, who would be departing Council. She thanked them for their commitment to the Association and to its members during their tenure as CMPA Councillors.

The President also expressed his thanks to the departing Councillors and welcomed new Council members.

Modernizing CMPA governance

The President announced that he would be joined by senior governors, the CEO and Associate CEO, and General Counsel, all of whom would be available to answer members’ questions.

Dr. Brossard spoke to how the CMPA has been helping members and the Canadian healthcare system for over 120 years. He presented a brief history and the timelines related to the governance review process, which was based upon a 2022 CMPA annual meeting motion to review the existing governance model. He went over the non-negotiable elements of the proposed governance model, then walked meeting participants through its recommendations, as follows:

Council size and composition. The CMPA By-law currently mandates 25 to 35 members of Council, and a composition that is determined by geography and specialty. It is proposed Council size be progressively decreased to a total of 15-25 members to enhance agility in the rapidly evolving environment and that its composition continue to be determined by geography and specialty. This total number of Councillors would include Vice-Presidents, the President, and potentially, up to four appointed physician Councillors.
Nomination process. It is recommended the Association’s current two stream nomination process, one via the Nominating Committee and one via the membership, move to a single stream nomination process that allows all members to submit their interest and be evaluated equally by the Nominating Committee based on established criteria. This would also allow the Nominating Committee to put forth a larger pool of candidates for election, whereas now it can only nominate one candidate for each position.
Council is currently divided into 10 geographic areas, which include all provinces and territories. Recognizing adjustments to the regional distribution will need to occur as the size of Council decreases, it is recommended the CMPA maintain regional representation to support the national focus and fiduciary duty of Council and to promote geographical diversity.
Appointing Councillors and term limits. Currently, all Councillors of the Association are physician members who are elected (no appointments) for three-year terms and they may seek re-election without limit. In an effort to enhance diversity and skillsets, it is proposed Council have the ability to appoint up to four physician members to Council when needed, and that 12-year term limits be put in place for all Councillors except for the President and Vice-Presidents during their terms in office. While the option to appoint non-physicians to Council remains available to the Association, it is not currently supported by Council or the membership and is not presented as part of this governance report.
Representation of family medicine and other specialties. The current CMPA By-law notes that Councillors must be considered to practice in one of two Divisions: Division A is for family medicine and Division B is for other specialties. While a balanced distribution is not presently required by the By-law, the Association has made efforts to maintain such via Division A and B positions. It is recommended Council continue to include an appropriate number of family physicians, specialists and other physicians, recognizing that number must be adaptable over time as the size of Council changes.

The President summarized the recommendations and reminded members that following discussion of the motion projected on the screen, they would be asked to vote to approve or reject the entire governance review report, the approval of which would require the support of 50% +1 members of the assembly:

BE IT RESOLVED THAT the Modernizing CMPA Governance: Governance Review Report, dated July 12, 2024, is received and approved as the basis for implementing the governance model described in the report, recognizing that any changes to the current By-law will require approval by members as set out in the current By-law.

Dr. Debra Boyce, a family physician from Peterborough, Ontario, past CMPA President and mover of the member motion, reflected on the importance of careful governance. She appreciated the value of the work involved with the governance review, which impacts 111,000 physician members across Canada and the patients they serve. She highlighted the progress made in recognizing the strength diversity adds to Council, and in addressing the member motion of 2022, then described the proposed governance report as a good example of the CMPA’s usual careful, thoughtful and responsible approach, which is foundational to the work it sets out.

Dr. Brossard thanked Dr. Clover Hemans, a family physician from Burlington, Ontario and CMPA Councillor, for seconding the motion, then welcomed members to pose questions or share comments on the member motion regarding the governance review. Like-minded comments or questions were grouped thematically for efficiency of response following their having been put forward by the following members:

Dr. Charlotte J. Alabaster, a family physician from Calgary, Alberta

Dr. Thomas J. Barry, a family physician from New Maryland, New Brunswick

Dr. George D. Carson, an obstetrician from Regina, Saskatchewan

Dr. Saulo Castel, a psychiatrist from Toronto, Ontario

Dr. Susan M. J. Chafe (CMPA Councillor) an oncologist from Edmonton, Alberta

Dr. Michael T. Cohen, (CMPA Past President) a family physician from Grand Falls-Windsor, Newfoundland and Labrador

Dr. Deborah S. Danoff, an administrative physician from Ottawa, Ontario

Dr. Diane Francoeur, an obstetrician/gynaecologist from Montréal, Québec

Dr. Michael E. Green, a public health and family physician from Kingston, Ontario

Dr. Janice Wallace Journeau, a general surgeon from Salmon Arm, British Columbia

Dr. Pravinsagar G. Mehta, a family physician from Winnipeg, Manitoba

Dr. Paul C. Missiuna, a surgical consultant from Ancaster, Ontario

Dr. Philippa (Pippa) A. Moss, a rural child and adolescent psychiatrist from East Amherst, Nova Scotia

Dr. Lynn C. Murphy-Kaulbeck, an obstetrician/gynaecologist from Dartmouth, Nova Scotia

Dr. Maged Shokry Nashed, an oncologist from Winnipeg, Manitoba

Dr. Saul Pytka, an anesthesiologist from Calgary, Alberta

Dr. Fredrykka D. Rinaldi, a family physician from Medicine Hat, Alberta

Dr. Norman S. Schachar, a surgical assistant from Calgary, Alberta

Dr. Patrick Trudeau, (CMPA Councillor) a general surgeon from Chicoutimi, Québec

Of the discussion that ensued, the following points were salient:

A member in support of the motion raised concerns about the proposed Council size combined with the appointment of members and lack of term limits for senior governors limiting the number of independently elected members. It was suggested that, upon amending the By-law, the Association consider aiming for the higher end of the proposed range. The President clarified that the senior governors are elected to Council before taking on those roles and the decision to exempt them from term limits while in the senior governor roles was not aimed at limiting the number of directly elected Councillors, but about maintaining governance stability.
To a question, the President explained the term “other physicians” in the Council membership list is meant to include all practicing physicians eligible for Association membership and who may not be family physicians or specialists (e.g. residents).
A few members argued that, given Councillors represent all members and not solely those from particular regions, a smaller, more nimble Board than that proposed, one comprised of individuals selected as a result of their specific skillsets rather than their regional representation, would be more impactful, effective and fiscally responsible. They also suggested the exclusion of non-physician members eliminates broader expertise and the voice of the public. They emphasized the need for an agile and modern governance model that moves quickly and inclusively, and highlighted the challenges and benefits of change, including increased engagement from younger and more diverse members.
Having recalled the decision to move to provincial representation stemmed from a need to follow different billing guidelines across the country and to be aware of the different perspectives that arise, a past CMPA President highlighted the need to build flexibility into the By-law to enable ease of future potential changes.
To concerns raised about maintaining engagement and regional representation across our large country with a smaller Council, the President reminded meeting participants that the Association’s more than 500 employees are responsible for the day-to-day operations of the Association, including engagement with the various provinces, Colleges, stakeholder organizations and members. He indicated the role of the Council is to govern and in doing so, to attract a balance between diversity, skills and regional representation to better equip its governors to focus on decision-making and risk management.
The President confirmed, with the singular nomination stream proposed, any CMPA member may put their name forth for Nominating Committee consideration, following which the Nominating Committee will prepare a slate of candidates for the election. Physician member appointments will only occur in a limited number and only if required to address any gaps in skillsets or diversity. Currently, the CMPA By-law restricts the Nominating Committee from putting forth more than one candidate per position, following which the membership may elect another candidate, which in turn may lead to limited diversity or an imbalance of skillsets or medical specialities on Council.
Term limits of twelve years are being proposed to allow Councillors to gain the necessary experience and knowledge to effectively govern and potentially move into senior governor roles.
The President indicated the fact that the CMPA exists through a Special Act of Parliament means that any proposed By-law amendment requires the approval of the membership during an annual meeting before it can be presented to the federal government for approval. With Cabinet approval, the updated By-law would only take effect once it is published in the Canada Gazette, a final step that could take up to two years to achieve following the membership approval.
The President explained the motion is being presented on the governance report as a whole rather than piece by piece because the governance proposal should be viewed holistically given the inter-connectedness of its elements. A reduction in Council size requires attention to composition, diversity, and skills, which in turn affects the nominating process, turnover, and term limits. General Counsel added a holistic approach simplifies the drafting of the By-law and ensures comprehensive changes.

The following motion was moved by CMPA member Dr. Debra Boyce of Peterborough, Ontario and seconded by CMPA member, Dr. Clover Hemans of Burlington, Ontario:

BE IT RESOLVED THAT the Modernizing CMPA Governance: Governance Review Report, dated July 12, 2024, is received and approved as the basis for implementing the governance model described in the report, recognizing that any changes to the current By-law will require approval by members as set out in the current By-law.

Motion carried.

The Associate CEO announced a comment had been received from a 52-year member of the CMPA after the membership was called upon to vote. The member congratulated the Association for all it does for physicians and expressed appreciation for the knowledge that a well organized team stands behind him.

The President expressed the CMPA’s appreciation for its members’ guidance and approval of the Governance Review Report, which directs the Association to begin adjusting its By-law and bring associated amendments for a vote during the 2025 annual meeting, the approval for which will require the support of two thirds of the members of next year’s assembly.

Looking to the future

The CEO thanked meeting participants for their feedback and support of the governance model. She noted the CMPA is continuously working to improve and become more agile. Modernizing the Association’s governance is a key step in the journey, and allows the CMPA to continue to focus on executing its Strategic Plan and to look for better ways to:

support members and employees,
strengthen its foundations through collaboration, and
adapt to the changing healthcare environment through modernization.

Dr. Calder encouraged all to read the CMPA’s Annual Report and Strategic Plan to learn about its plans for 2024 and beyond. She reiterated that, no matter what changes occur within healthcare, the Association will be there to protect members’ professional integrity and to support safe medical care throughout Canada.

Remarks from the CEO

Given it was his last annual meeting as President of the CMPA, the CEO thanked Dr. Brossard for his wisdom, guidance and expert leadership, all of which have helped the Association develop a targeted and practical Strategic Plan. He supported the execution of the CMPA’s EDI Strategy and helped drive efforts to better understand members’ experience with inequities, racism, and discrimination. Under his guidance, the Association continued to explore new ways to support physician wellness, strengthened its learning and research offerings, and made huge strides in modernizing governance. Noting his leadership has helped the CMPA empower better healthcare across Canada, Dr. Calder thanked Dr. Brossard for his many years of service to the Association and most particularly, for these last two years of his Presidency.

Dr. Brossard indicated it had been a privilege working with the CEO and her dedicated, competent and professional management team. He was also honoured to have chaired the CMPA Council and collaborate with his Council colleagues to guide the Association.

Remarks from the incoming President

The President introduced Dr. Birinder Singh, a talented physician and lawyer with a wealth of leadership experience. Dr. Singh is a medical director of Toronto’s Eglinton Station Medical Centre, where he practices family medicine. Having been on the CMPA Council for ten years, he understands the intricacies of the Association and the importance of representing the interests of the members. In addition, he has served as a medical inspector for the College of Physicians and Surgeons of Ontario, a judicial clerk at the Supreme Court of Canada and an adjunct professor at the University of Toronto. This diverse experience has deepened his understanding of the medico-legal issues facing physicians. Given his strong leadership, knowledge of governance and experience within the healthcare system, Dr. Brossard expressed every confidence the incoming President would ensure the CMPA’s continued success in the years to come.

Dr. Singh echoed the CEO’s gratitude for Dr. Brossard’s guidance and leadership during his past two years as President and during his past 20 years on Council. He offered thanks for his mentorship and tremendous leadership, and as he stepped into the role of President, committed to striving to emulate Dr. Brossard’s passion, dedication and ability to guide and inspire.

The incoming President remarked that his main objective will be to focus on CMPA members and ensure the Association remains a strong organization that exists for years to come. As he begins his tenure as President, he committed to continuing to modernize the governance of the CMPA, to support the execution of its Strategic Plan and to move forward with its EDI Strategy, all while holding fast to its values, supporting the evolving needs of its members and maintaining its sustainability. Having described it as an honour to lead such an exceptional organization, Dr. Singh looked forward to working with Council colleagues and the CMPA staff to continue to protect the professional integrity of over 111,000 members in an effort to help them provide safe medical care.

Closing remarks and adjournment

There being no further business, at 4:19 p.m. AT, the President declared the meeting adjourned, and indicated he looked forward to meeting again during the 2025 annual meeting in Toronto, Ontario.