2023Annual
Report

President, CEO & Leadership

Message from CMPA Leadership

CMPA Council, Leadership team and Strategic Plan

Council

Council

The CMPA is governed by an elected Council of 30 practising physicians who, together with CMPA management, foster the long-term success of the Association.

Meet Council >>

Leadership team

Leadership team

Our leadership team brings unique and diverse skills to the Association that help us support members and contribute to safe medical care across the healthcare system.

Meet the team >>

2023-2025
Strategic Plan

2023-2025
Strategic Plan

The Strategic Plan lays out CMPA’s proactive approach to meet the changing needs of physicians and the Canadian healthcare system.

Read now >>

CMPA's mission and vision




Mission

To protect the professional integrity of physicians and promote safe medical care in Canada.

Vision

The CMPA is valued as an essential component of the Canadian healthcare system.

Empowering Better Healthcare

As an essential component of the Canadian healthcare system, we empower better healthcare by supporting our members and employees, strengthening our foundation through collaboration, and adapting to a changing healthcare environment.

Supporting our members

Strengthening our foundation through collaboration

Adapting to the changing healthcare environment through modernization

Supporting our members

93% of members who completed our post-call survey expressed satisfaction with the service provided.

Advice and assistance

We continued to provide empathetic, physician-to-physician advice and guidance to members in a timely manner.

Advice and assistance highlights in 2023:

  • Engaged with members over 49,000 times on the phone and online, providing expert peer-to-peer support and guidance.
  • Responded to 29,000 unique requests for medico-legal assistance (20,592 requests for advice and 8,538 new medico-legal case requests).
  • Provided medico-legal support in 979 legal cases, 5,135 College matters, and 2,064 hospital matters.
  • Supported our members with proactive information and advice in an extremely challenging healthcare environment, including information on medical assistance in dying (MAID), providing care to non-Canadian residents, and more.
  • Conducted 174 face-to-face, virtual and hybrid learning activities, sharing safe medical care strategies and resources with over 11,000 members.

Members who reported high stress levels experienced a 74% reduction in stress levels after speaking with a Physician Advisor about a medico-legal concern.

Physician wellness

Amidst a physician wellness crisis, we provided compassionate support to members, fostering their wellness and helping to preserve careers.

Physician wellness highlights in 2023:

  • Continued to conduct one-on-one member interviews to understand how experiences of racism, inequity, and discrimination impact their wellness and practice. By listening and learning, we continue to embed safety and inclusion into our own services and support members dealing with these issues.
  • Conducted a successful peer support pilot program, which will be rolled out more broadly in 2024. The program will provide enhanced wellness support to members experiencing significant emotional distress from a medico-legal event.
  • Actively engaged with organizations at the national and provincial levels to strengthen relationships, collaborate with stakeholders, and support physician wellness across Canada.

The ‘6 Things you should know about the CMPA’ video shared our value and clarified the concept of mutuality in easy-to-understand language.

Member experience

We adapted to the needs of our members by continuing to modernize our online services and information to provide resources that are intuitive, timely, and flexible.

Member experience key activities in 2023:

  • Expanded our advice and information on key medical issues in Canada, such as medical and birth tourism, scarcity of resources, and delays in care.
  • Launched the 2023-2025 CMPA Strategic Plan, positioning us to respond to the changing needs of members and the healthcare system.

Over the past 10 years, we paid a total of $2.4 billion in patient compensation on behalf of our members.

Patient compensation

An important part of our role as a not-for-profit mutual defense organization is to provide, on behalf of our members, timely and appropriate compensation to patients if the care provided is found to be negligent (fault in Quebec).

Highlights of patient compensation in 2023:

  • We paid close to $308 million in compensation, on behalf of members, to patients proven harmed by negligent medical care, helping to support patients’ short and long-term care needs. This is the highest amount ever paid in patient compensation in one year.
  • With favourable overall market performance, our investment portfolio earned 8.5% in returns, helping us close 2023 in a strong financial position. Our steadfast commitment to the careful management of our financial resources should assure members and patients that we are here for them when needed, now and in the future.

Strengthening our foundation through collaboration

In 2023, we held over 340 meetings with stakeholders and sent 34 submissions to medical regulatory authorities and governments.

Advocacy and collaboration

We helped build a stronger healthcare system by collaborating with stakeholders—shaping policy on key issues that impact patients, physicians, and the medical liability system.

Advocacy and collaboration highlights in 2023:

  • Continued to meet with and advise stakeholders and governments—including the governments of Ontario and Québec and the Office of the Chief Justice—on issues related to medico-legal risk, including virtual care, healthcare human resources, and ethics and responsibilities. For example, we made a submission to the Ministère de la Santé et des Services sociaux on Bill 15, where we advocated for fair processes for physicians.
  • With the College of Physicians and Surgeons of Alberta (CPSA) co-hosted Innovation, Safety and Artificial Intelligence (AI): Developing regulatory & medico-legal approaches to AI in Canadian healthcare. This symposium brought together experts from many fields and advanced the conversation on key opportunities, risks, and barriers to the safe adoption of innovative AI technologies. In addition, we provided guidance to members on using AI and automated scribes.
  • To help address human resource shortages in healthcare, provided advice and guidance to the College of Physicians and Surgeons of BC and the College of Physicians and Surgeons of Ontario on the use of physician assistants and collaborative care models.

96% of members who responded to our survey felt that Physician Advisors provided a safe and non-judgmental environment on one-to-one calls.

Equity, diversity, and inclusion (EDI)

As Canada’s largest medical organization, we acted on our responsibility to address EDI issues, mitigate bias and inequity in the services we provide, and make physicians feel valued for their diverse experiences and perspectives.

EDI highlights in 2023:

  • Expanded our collection of member demographic information to gain a more representative profile of Canadian physicians. This will help enhance the services we provide to members through evidence-based decision making.
  • Participated on the panel of the Restorative Leadership Symposium with the British Columbia Restorative Circle, where barriers and challenges to implementing restorative approaches after healthcare harm were discussed.
  • Developed a plan for an EDI Office and hired CMPA’s first EDI Strategic Lead, who is providing strategic oversight and support for EDI initiatives and offers consultation to CMPA leadership and various groups.
  • Continuing to embed inclusivity into our member services and deepen our understanding of member needs through listening and learning.

The CMPA is a workplace community where employees are valued, supported, continually learn, and have opportunities to grow their careers.

Talent development and organizational resilience

We took a purposeful and proactive approach to developing our talent, ensuring we had the capacity to deliver the highest quality service to our members now and well into the future.

Talent development and organizational resilience highlights in 2023:

  • Successfully implemented a hybrid flexible work model, including policies, processes, technology, and facility needs.
  • To manage future talent needs, we launched the 2023-2025 People Strategy with a focus on inclusion, belonging, well-being, and learning and development.
  • As a learning organization focused on continuous improvement, we engaged CMPA Provincial Counsel in an education series aimed at giving them the tools needed to navigate challenging encounters with members struggling with medico-legal issues.

Adapting to the changing healthcare environment through modernization

Over 11,000 members participated in CMPA continuing professional development (e.g. webinars and workshops) in 2023, gaining skills and strategies to provide safe medical care.

Safe medical care learning

We strive to develop and deliver inclusive, data driven learning products that are responsive to the needs of our members and advance safety in medical care.

Learning and safe medical care highlights in 2023:

  • Our teaching resources received over 19,000 web visits, helping physician-educators teach trainees key medico-legal and patient safety principles. All activities are mapped to CanMEDS roles.
  • Delivered the revamped CMPA Patient Safety Primer workshop to over 1,550 resident physicians and shared Good Practices online resources over 227,000 times, helping members stay informed.
  • 35,347 self-guided eLearning activities were completed by members, providing engaging and interactive learning experiences.

We are committed to a modern governance model that prepares us for opportunities and challenges now and in the future.

Governance review

Recognizing the need to modernize our governance structure and in response to a member motion passed in 2022, we began a thorough review of our governance model in 2022, and continued our efforts throughout 2023.

Governance review highlights in 2023:

  • Worked with an expert governance consulting firm to help us identify how to strengthen the function of CMPA Council and modernize our governance practices.
  • Launched a member-wide engagement survey, seeking feedback on our current governance practices and input on what should change.
  • All active members will have the opportunity to vote on elements of the governance model at the 2024 Annual Meeting.

CMPA data and insights support evidence-informed decision-making that contribute to the safety of medical care.

Data, research, and knowledge sharing

We continued to be a leading organization in data, research, and analytics. Our research and insights support patient safety and help prevent patient harm from happening in the first place.

Data, research, and knowledge sharing highlights in 2023:

  • In support of patient safety research and knowledge sharing, created 47 free analytical reports in response to member requests for medico-legal information—a benefit of membership.
  • Published 7 "Know your risk" reports, providing specific medico-legal data by clinical specialty. These reports highlighted the key risks of each specialty and provided guidance and learning resources to reduce risk.
  • Published 9 peer-reviewed articles on timely and relevant medico-legal topics, including sepsis and never events.

A year in numbers


  • 2023 TOTAL
    ON
    BC/AB
    QC
    SMAT**
    New medico-legal cases





    Legal actions - served1
    674
    329
    157
    107
    81
    Legal actions - not served2
    305
    82
    72
    128
    23
    College (medical regulatory authority) matters
    5,135
    1,658
    1,591
    930
    956
    Hospital matters
    2,064
    597
    442
    862
    163
    Paying agency matters
    187
    34
    22
    107
    24
    Other3
    173
    87
    41
    18
    27
    Total
    8,538




    Resolved legal actions





    Judgment for plaintiff
    13
    7
    3
    1
    2
    Judgment for physician
    33
    7
    3
    20
    3
    Settled with plaintiff
    322
    138
    61
    97
    26
    Dismissed/discontinued/abandoned
    623
    310
    128
    121
    64
    Total
    991




    Notes:

    1. Legal actions – served: means legal action was commenced against a member.
    2. Legal actions – not served: means legal action was threatened. Note: threats may result in a settlement or progress to Legal action – served.
    3. Other: includes human rights complaints, inquests, privacy investigations, and criminal matters.

  • 2019
    2020
    2021
    2022
    2023
    New advice contacts





    Advice to members
    22,967
    23,702
    24,291
    21,149
    20,592
    New medico-legal cases





    Legal actions1
    854
    732
    -
    -
    -
    Legal actions - served2
    -
    -
    632
    670
    674
    Legal actions - not served3
    -
    -
    326
    272
    305
    Threats1
    958
    791
    9
    -
    -
    College (medical regulatory authority) matters
    4,827
    4,183
    4,844
    5,069
    5,135
    Hospital matters
    2,129
    1,773
    2,011
    1,859
    2,064
    Paying agency matters
    598
    293
    206
    176
    187
    Other4
    144
    176
    178
    148
    173
    Total new medico-legal cases
    9,510
    7,948
    8,206
    8,194
    8,538
    Resolved legal actions





    Judgment for plaintiff
    5
    8
    11
    8
    13
    Judgment for physician
    47
    29
    30
    26
    33
    Settled with plaintiff
    285
    259
    343
    313
    322
    Dismissed/discontinued/abandoned
    438
    349
    574
    638
    623
    Total resolved legal actions5
    775
    645
    958
    985
    991

    Notes:

    1. The CMPA migrated to a new client management system in 2021, which classifies medico-legal cases differently. Reclassification of medico-legal cases will be observed, such as legal actions now classified as served and not served.
    2. Legal actions – served: means legal action was commenced against a member.
    3. Legal actions – not served: means legal action was threatened. Note: threats may result in a settlement or progress to Legal action – served.
    4. Other: includes human rights complaints, inquests, privacy investigations, and criminal matters.
    5. Total resolved legal actions: the majority of resolved legal actions includes cases commenced before 2023

** Saskatchewan, Manitoba, Atlantic provinces and Territories

Our members

Type of work


55,955 (50%)
Royal College Specialists


14,457 (13%)
Residents

111,186

Canadian physician members of the CMPA in 2023


40,733 (37%)
Family Medicine Specialists


41 (0.04%)
*Other

*Other: This category consists of two types of members: those who are currently working in another country (providing humanitarian aid or learning/teaching outside the US) and those who have renewed their membership to support COVID care activities.

Age

42,860 40 and under

38%

45,233 41 to 59

41%

23,093 60 and over

21%

By region


  		•  CMPA Members Percentage of membership
    BC/AB 29,440 26%
    SMAT** 14,540 13%
    ON 44,834 40%
    QC 22,372 20%
    ** Saskatchewan, Manitoba, Atlantic provinces, and Territories

    Regional distribution of CMPA membership


  		•  Advice calls provided to members
    BC/AB 4,969
    SMAT** 1,963
    ON 9,510
    QC 4,150
    ** Saskatchewan, Manitoba, Atlantic provinces, and Territories

    Advice calls provided to members by region


  		•  Legal cases (such as civil-legal matters) College matters Hospital matters
    BC/AB 229 1,591 442
    SMAT** 104 956 163
    ON 411 1,658 597
    QC 235 930 862
    Total 979 5,135 2,064
    ** Saskatchewan, Manitoba, Atlantic provinces, and Territories

    Regional distribution of CMPA medico-legal support

Our services

In 2023, the CMPA engaged with members 49,468 times on the phone and online in English and in French, providing peer support and expert guidance to help physicians navigate medico-legal challenges.

49,468

Call and Portal Interactions

Medico-legal assistance

29,000

unique requests for medico-legal assistance from members

20,592

requests for advice

8,538

new medico-legal cases






























Medico-legal support

979

legal cases (such as civil-legal matters)

5,135

College matters

2,064

hospital matters

CMPA Member Portal

205,025

membership-related transactions were supported in 2023 by CMPA’s convenient, online member portal



55,223

agent transactions were expertly managed by our dedicated teams who offer personalized assistance to support more complex inquiries


149,802

self-service transactions allowed members to access services (e.g. change your type of work) and documents (e.g. CMPA Statement of Protection) at their convenience

Learning


330

learning events across canada


174

CMPA Continuing Professional Development

Our face-to-face, virtual and hybrid learning activities, were conducted sharing safe medical care strategies and resources with over 11,000 members.

330

learning events in 2023, which includes CMPA continuing professional development, CMPA presentations at outside conferences, booths, webinars, and more.

14,634

Canadian physicians, allied healthcare professionals and stakeholders who attended these learning events.

Did you know?

Financial performance

2023 Audited Financial Statements [PDF] Opens in new window

Our financial responsibility

The CMPA has a responsibility to maintain adequate funding to support member physicians and compensate patients on behalf of members when negligence (fault in Québec) has been proven – now and beyond the member’s retirement.

Accordingly, our financial planning horizon is long.

As a not-for-profit mutual medical defense organization, we collect membership fees from physicians each year. On behalf of members, we use our funds to compensate patients proven to be harmed by negligent medical care (fault in Québec), to support members facing medico-legal difficulties, and to advance safe medical care.

Members pay the full cost of their protection through their fees. In 2023, we collected fees necessary to protect our members and compensate patients today, tomorrow, and well into the future for all occurrences taking place in 2023.

We are committed to limiting the growth of medical liability protection costs as much as possible and strive to use the fees we collect efficiently and appropriately.

2023 membership fee reductions

One of our goals is to maintain relative fee stability, which is determined in part by the performance of our carefully managed investments and market fluctuations. As appropriate, we may lower membership fees when we are in a strong financial position and prudently raise fees when needed.

Membership fees can also fluctuate if the actual costs of protection for any given year are different than the predicted values. Future fees may be adjusted (increased or decreased) to address the difference.

From 2019 to 2021, we experienced exceptional returns on our investment portfolio. This allowed us to temporarily reduce membership fees by a significant amount in an effort to draw down our net asset position.

Our recent strong returns on investments have allowed us to further reduce membership fees in 2023.

Fee reductions over the past 3 years:

  • $99.5 million in 2021
  • $200 million in 2022
  • $362.5 million in 2023

This is a $662 million reduction in membership fees since 2021, largely due to our prudent management and investment of membership fees.

If our financial position normalizes (i.e., decreases from the highs we have seen in recent years), we will likely see a return to pre-pandemic levels in 2024 fees.

For more information, read our consolidated financial statements and Independent Auditors’ Report.

Compensating patients

On behalf of our members, we provide timely and appropriate compensation to patients proven to have been injured as a result of negligent medical care (fault in Québec). Compensation to patients and the cost of legal services are our largest expenses each year.

We paid a total of $2.4 billion in patient compensation on behalf of our members over the last ten years, or an average of $241 million per year.

The following graph highlights patient compensation by region–Consumer price index (CPI) adjusted

Compensation to patients by fee region - CPI Adjusted

2014 - British Columbia/Alberta: 57,373,237.91; Ontario: 205,118,693.56; Québec: 33,266,847.95; Saskatchewan/Manitoba/Atlantic and Territories: 5,452,977.38; Total: 301,211,756.80; |
2015 - British Columbia/Alberta: 43,106,192.71; Ontario: 153,497,309.73; Québec: 22,803,392.14; Saskatchewan/Manitoba/Atlantic and Territories: 24,377,688.37; Total: 243,784,582.95; |
2016 - British Columbia/Alberta: 62,107,969.77; Ontario: 103,356,972.73; Québec: 24,056,999.61; Saskatchewan/Manitoba/Atlantic and Territories: 22,148,482.40; Total: 211,670,424.50; |
2017 - British Columbia/Alberta: 42,206,589.86; Ontario: 196,525,693.23; Québec: 40,229,080.17; Saskatchewan/Manitoba/Atlantic and Territories: 24,170,853.74; Total: 303,132,216.99; |
2018 - British Columbia/Alberta: 77,090,853.31; Ontario: 171,862,485.75; Québec: 23,489,517.42; Saskatchewan/Manitoba/Atlantic and Territories: 36,239,129.02; Total: 308,681,985.49; |
2019 - British Columbia/Alberta: 41,848,148.91; Ontario: 181,467,609.56; Québec: 19,506,146.66; Saskatchewan/Manitoba/Atlantic and Territories: 16,453,331.83; Total: 259,275,236.95; |
2020 - British Columbia/Alberta: 61,063,893.49; Ontario: 128,910,953.55; Québec: 22,886,340.74; Saskatchewan/Manitoba/Atlantic and Territories: 26,367,353.17; Total: 237,330,633.42; |
2021 - British Columbia/Alberta: 85,012,392.70; Ontario: 174,410,468.16; Québec: 22,175,916.89; Saskatchewan/Manitoba/Atlantic and Territories: 22,073,515.79; Total: 303,672,293.54; |
2022 - British Columbia/Alberta: 82,253,097.23; Ontario: 167,15,593.55; Québec: 23,518,741.14; Saskatchewan/Manitoba/Atlantic and Territories: 15,568,774.35; Total: 288,846,206.27; |
2023 - British Columbia/Alberta: 82,458,049.72; Ontario: 176,213,494.76; Québec: 24,530,870.20; Saskatchewan/Manitoba/Atlantic and Territories: 24,618,196.07; Total: 307,820,610.75;
  •   British Columbia/Alberta
  •   Ontario
  •   Québec
  •   Saskatchewan/Manitoba/Atlantic and Territories
  •   Total
2014
British Columbia/Alberta 57,373,237.91
Ontario 205,118,693.56
Québec 33,266,847.95
Saskatchewan/Manitoba/Atlantic and Territories 5,452,977.38
Total 301,211,756.80
2015
British Columbia/Alberta 43,106,192.71
Ontario 153,497,309.73
Québec 22,803,392.14
Saskatchewan/Manitoba/Atlantic and Territories 24,377,688.37
Total 243,784,582.95
2016
British Columbia/Alberta 62,107,969.77
Ontario 103,356,972.73
Québec 24,056,999.61
Saskatchewan/Manitoba/Atlantic and Territories 22,148,482.40
Total 211,670,424.50
2017
British Columbia/Alberta 42,206,589.86
Ontario 196,525,693.23
Québec 40,229,080.17
Saskatchewan/Manitoba/Atlantic and Territories 24,170,853.74
Total 303,132,216.99
2018
British Columbia/Alberta 77,090,853.31
Ontario 171,862,485.75
Québec 23,489,517.42
Saskatchewan/Manitoba/Atlantic and Territories 36,239,129.02
Total 308,681,985.49
2019
British Columbia/Alberta 41,848,148.91
Ontario 181,467,609.56
Québec 19,506,146.66
Saskatchewan/Manitoba/Atlantic and Territories 16,453,331.83
Total 259,275,236.95
2020
British Columbia/Alberta 61,063,893.49
Ontario 128,910,953.55
Québec 26,367,353.17
Saskatchewan/Manitoba/Atlantic and Territories 20,988,433.21
Total 237,330,633.42
2021
British Columbia/Alberta 85,012,392.70
Ontario 174,410,468.16
Québec 22,175,916.89
Saskatchewan/Manitoba/Atlantic and Territories 22,073,515.79
Total 303,672,293.54
2022
British Columbia/Alberta 82,253,097.23
Ontario 167,415,593.55
Québec 23,518,741.14
Saskatchewan/Manitoba/Atlantic and Territories 15,658,774.35
Total 288,846,206.27
2023
British Columbia/Alberta 82,458,049.72
Ontario 176,213,494.76
Québec 24,530,870.20
Saskatchewan/Manitoba/Atlantic and Territories 24,618,196.07
Total 307,820,610.75

In 2023, on behalf of our members, we paid close to $308 million in compensation to patients proven harmed as a result of negligent medical care (fault in Québec). This amount is $67 million more than our ten-year average (2014-2023).

Read more about compensating patients

Patient compensation costs on behalf of members vary greatly from year to year. Contributing factors include the number of cases settled, the medico-legal outcomes of these cases, and their duration.

In 2023, the almost $308 million in patient compensation was $28 million more than in 2022. This increase was driven by more cases settled at higher values. As compared to the ten-year average, the 2023 average payment per case was higher by 41%.

Insurance protection against unexpected costs

Since there is volatility in outstanding claims and compensation to patients, we have insurance to help protect us from unexpected costs for medico-legal occurrences prior to December 31, 2023. These policies will help us continue to compensate patients and support members even if there is an unexpected increase in medico-legal expenses.

Legal costs

When appropriate, we provide ethical defense to eligible members experiencing medico-legal issues. The legal costs we incur fall into two categories:

  1. Costs related to civil actions and threats (i.e., those that might lead to compensation to patients).
  2. Costs related to non-civil matters (e.g., College complaints, hospital matters, advice, and other forms of medico-legal assistance).

In 2023, we paid $224.7 million in legal expenses, which was a $9.2 million increase over 2022.

The rise in legal spending is primarily attributed to a steady increase in non-civil legal cases, as a result of the shifting landscape of regulatory environments across most regions. To a lesser extent, inflation has also led to a growth in legal fees.

In examining civil legal cases, while the number of cases has decreased year-over-year, the overall hours per case has increased, also resulting in higher costs. This trend indicates growing complexity within the legal environment, influenced by factors such as the number of trials, trial delays, and the intricacies of medical cases.

Our investment portfolio

We have a diversified investment portfolio that earns income to ensure we can appropriately compensate patients on behalf of members and fund future medico-legal expenses to support our members.

In 2023, the investment portfolio had a net value of $5.6 billion.

This is an increase of $169 million from 2022. This increase can be attributed to a $468 million investment gain due to an overall increase in financial markets. This strong position allowed us to temporarily reduce member fees in 2023.

Read more about our investment portfolio

The performance objectives of our investment portfolio are to:

  • Match or exceed an investment return of 6% over the long-term to assist physicians, support the medical liability system in Canada, and contribute to safe medical care.
  • Achieve positive value-added returns (over a passive benchmark return) after deducting management fees.

Our investment portfolio consists of both public and private assets. We value our private assets at the lower of original cost or market value. At the end of 2023, we estimated that the fair value of our private assets exceeded their original cost by $866 million. At fair value, our investment portfolio value was $6.5 billion in 2023.

Supporting physicians and patients long-term

The membership fees collected in 2023 will help fund patient compensation and the medico-legal costs of our members well into the future for care provided in 2023.

This long-term horizon demonstrates our commitment to protecting members and their patients long after members retire. This is known as occurrence-based protection. Members are eligible for assistance (and patients are eligible for compensation if proven harmed by negligent medical care) any time in the future if the physician was a CMPA member at the time the care occurred. For example, a retired member could be eligible for assistance related to the care they provided early in their career, provided they were a member at the time.

We must hold adequate funds to compensate patients and support physicians with medico-legal cases for up to 4 decades from the time care was provided.

Our net asset position

Our net asset position is the difference between our assets (things that bring money to the CMPA) and estimated liabilities (things that cost the CMPA money). It provides a point-in-time measurement that indicates whether we have the required resources to meet our financial obligations, including compensating patients over the next 4 decades.

This amount fluctuates from one year to the next, depending on factors such as investment returns and compensation to patients. We strive to maintain a reasonable net asset position and take a measured approach to temporary shortages or excesses. To manage our financial position over time, we increase or decrease membership fees as needed.

From 2019 to 2021, we experienced unexpectedly strong market performance. This allowed us to temporarily reduce member fees in 2023 to draw down our net asset position.

The Association’s net asset position as of December 31, 2023, was $983 million, a decrease of $121 million from 2022. This decline was mainly the result of membership fee reductions in 2023, and therefore by design.

Planning for future compensation and physician support

We plan ahead to ensure we have adequate finances to appropriately compensate patients proven to have been harmed by negligent care (fault in Quebec) and manage legal and administrative expenses well into the future.

As of December 31, 2023, the estimate for all accumulated outstanding claims was $4.2 billion, an increase of $127 million from December 31, 2022.


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