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The Canadian Medical Association (CMA; french: Association médicale canadienne, AMC) is a national, voluntary association of
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s and medical learners that advocates on national health matters. Its primary mandate is to drive positive change in health care by advocating on key health issues facing doctors and their patients. The '' Canadian Medical Association Journal'' (often abbreviated as ''CMAJ'') is a
peer-reviewed Peer review is the evaluation of work by one or more people with similar competencies as the producers of the work ( peers). It functions as a form of self-regulation by qualified members of a profession within the relevant field. Peer revie ...
general medical journal that publishes original clinical research, commentaries, analyses and reviews of clinical topics, health news, and clinical-practice updates.


Membership

The CMA has over 75,000 members and is the largest association of medical doctors in
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tota ...
. Its membership includes physicians and medical learners. The CMA represents Canadian physicians from medical school through to residency, medical practice and retirement.


History

The CMA's origins may rest with Dr. Joseph Painchaud and other Quebec physicians who in 1844 hoped to find ways to help physicians and, after their deaths, their widows and orphans. There were false starts in attempts to form an association, but soon after confederation, practicing physicians were successful in developing a national body. The CMA's first president was Sir Charles Tupper, the Nova Scotia Premier who led that province into confederation and later became
Prime Minister of Canada The prime minister of Canada (french: premier ministre du Canada, link=no) is the head of government of Canada. Under the Westminster system, the prime minister governs with the confidence of a majority the elected House of Commons; as suc ...
. The foundation of the CMA was strongly rooted in its
Scottish Scottish usually refers to something of, from, or related to Scotland, including: *Scottish Gaelic, a Celtic Goidelic language of the Indo-European language family native to Scotland *Scottish English *Scottish national identity, the Scottish ide ...
origins as the first three presidents of the CMA graduated from the Edinburgh Medical School. Among the CMA's founding principles in 1867 was to "improve public health and prevent disease and disability," a purpose which remains today. The CMA Code of Ethics has been around in one form or another since 1868. As recently as 2015 this document was considered by the CMA to be "arguably the most important document produced by the CMA. It has a long and distinguished history of providing ethical guidance to Canada’s physicians. Focus areas include decision-making, consent, privacy, confidentiality, research and physician responsibilities. The code is updated every 5-6 years and has a major revision approximately every 20 years. Changes must be approved by CMA General Council." The fledgling association faced a lot of growing pains in its first 25 years as meeting attendance was small. There was even a notice of motion in 1894 to disband it. The ''Montreal Medical Journal'' was taken over in 1911 to become the ''CMA Journal''. In 1921, the CMA re-organized with the appointment of its first permanent general-secretary, Dr. T.C. Routley. The association also became more financially stable by raising funds with a bond issue. Over the years, the CMA and its physician members have advocated on behalf of patients and educated the public to limit the effects of outbreaks, such as the 1918 Spanish flu,
SARS Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), the first identified strain of the SARS coronavirus species, '' s ...
in 2002 and the H1N1 influenza pandemic in 2009–2010. In an effort to raise awareness and research treatment of
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bl ...
, the organisation formed the Canadian Cancer Society (CCS). The association provided most of the funds for the early years of the CCS based on interest generated from public donations made to a fund honoring
King George V George V (George Frederick Ernest Albert; 3 June 1865 – 20 January 1936) was King of the United Kingdom and the British Dominions, and Emperor of India, from 6 May 1910 until his death in 1936. Born during the reign of his grandmother Q ...
's silver jubilee. Since the 1950s, the CMA has advised against
tobacco Tobacco is the common name of several plants in the genus '' Nicotiana'' of the family Solanaceae, and the general term for any product prepared from the cured leaves of these plants. More than 70 species of tobacco are known, but the ch ...
use. It has fought against promotional tobacco marketing and for new laws that curbed smoking and other tobacco consumption among Canadians. The CMA played an important role i
medical assistance in dying (MAID)
legislation, calling it one of the most complex and ethically challenging issues facing Canadian physicians. The CMA supports its members in exercising their freedom of conscience - both for those who chose to provide or participate in physician assisted suicide and those who do not. The CMA also played a central role in the creation of the Registered Retirement Savings Plan in 1957 as a tool to provide its members financial security in retirement
MD Financial Management
MD Financial Management was developed in 1969 to provide financial services to physicians and their families. It was sold in 2018 to Scotiabank, the sale including a 10-year collaboration agreement. In 2018, the CMA ended its membership in the World Medical Association (WMA) to protest the plagiarism found in the speech of the WMA's incoming president.


Advocacy

As a national association of physicians and medical learners, the CMA often advocates on key health issues that matter to Canadians and its members. In developing its positions, it seeks input through town hall meetings, surveys its members and reviews relevant scientific research. It also seeks input from provincial and territorial medical associations and from its more than 60 affiliate, associate and stakeholder organizations.


Medically assisted death

In 2015, the
Supreme Court of Canada The Supreme Court of Canada (SCC; french: Cour suprême du Canada, CSC) is the highest court in the judicial system of Canada. It comprises nine justices, whose decisions are the ultimate application of Canadian law, and grants permission to ...
, in a unanimous decision, struck down the
Criminal Code A criminal code (or penal code) is a document that compiles all, or a significant amount of a particular jurisdiction's criminal law. Typically a criminal code will contain offences that are recognised in the jurisdiction, penalties that migh ...
's absolute prohibition on physician-assisted death. As a result, the CMA developed foundational principles for medical aid in dying to guide discussions with its members and with the federal government on ensuring patient dignity and upholding the rights of both patients and physicians. Consultations included submissions and presentations to the federal ''External Panel on Options for a Legislative Response to
Carter v. Canada ''Carter v Canada (AG)'', 2015 SCC 5 is a landmark Supreme Court of Canada decision where the prohibition of assisted suicide was challenged as contrary to the ''Canadian Charter of Rights and Freedoms'' ("''Charter''") by several parties, includi ...
'', the House of Commons Standing Committee on Justice and Human Rights and Health Canada. The CMA continues to work with government to address outstanding issues including medically assisted dying for mature minors and those who have mental illness as the sole underlying medical condition.


Public mobilization campaign

In 2015 the CMA embarked on its first major public mobilization efforts. With a federal election happening that year, the CMA saw an opportunity to align with the public on an issue that mattered to both the public and physicians. Hence, Demand a Plan was born. Demand a Plan is a public campaign spearheaded by the CMA with the aim of having all levels of government work together to develop a comprehensive national seniors strategy. Over 74,000 people have signed up in support of the campaign. The Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities, in a report in March 2018, adopted many of the recommendations made the previous year by the CMA on ways to better serve seniors with improvements to housing, income security and quality of life. The success of Demand a Plan brought on a new era of public mobilization at the CMA. Recognizing that there are many more issues that need to be rallied around, the CMA launched a second public mobilization platform called CMA Health Advocates. This platform is designed to bring Canadians together around a shared goal: improving health care. It enables them to engage and connect with their local politicians to share their health and health care stories. During the 2019 federal election, the CMA Health Advocates platform will be tracking each party's platform promises and creating opportunities for the public and its members to show their support.


Choosing Wisely Canada

Choosing Wisely Canada was launched by Dr. Wendy Levinson in 2014 in partnership with the CMA to help physicians and patients reduce unnecessary tests, treatments and procedures, and ensure high-quality care. Central to the campaign are lists developed by more than 45 specialty societies to encourage critical thinking that will avoid unnecessary and potentially harmful tests and procedures. The federal government's Advisory Panel on Healthcare Innovation urged governments in all jurisdictions to support the initiative.


Drugs: Pharmacare, opioids and cannabis

The CMA continues to advocate that Canadians should have access to medically necessary pharmaceuticals that are safe, effective, available when and where needed and reasonably priced. The CMA is an active member of the Pan-Canadian Collaborative on Education for Improved Opioid Prescribing, which is chaired by the College of Family Physicians of Canada. The CMA's position is that ''opioids'' are important for managing pain, but prescribing them must be based on evidence and include careful assessment and monitoring. The CMA endorsed the collaborative's clinical guideline for opioids, initially published by CMAJ and updated in 2017 by the Michael G. DeGroote National Pain Centre. The CMA identified potential risks of ''cannabis'' use and has addressed them in submissions to
House of Commons The House of Commons is the name for the elected lower house of the bicameral parliaments of the United Kingdom and Canada. In both of these countries, the Commons holds much more legislative power than the nominally upper house of parliament. ...
standing committees. Following the introduction of the Cannabis Act, the association provided guidance to the federal government on a regulatory framework to protect children and youth.


Health and technology

Advances in technology could bridge the physical divide between doctors and patients, thereby reducing wait times and health care costs. Technologies such as virtual reality, artificial intelligence and robotics hold significant promise for patients and physicians, particularly for a country like Canada with its large land base and numerous remote communities. In early 2019, the CMA launched a Virtual Care Task Force alongside the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada to explore the barriers affecting the effective implementation of virtual care in the Canadian health system. Recommendations are expected in early 2020.


Physician health and wellness

Physician health and wellness has become a key priority of the CMA. In 2018, a national snapshot report released by the CMA showed that while physicians report high resiliency, they also experience high levels of burnout and depression, particularly residents and women. To help respond to this growing issue, the CMA has implemented a physician health and wellness department led by Dr. Caroline Gérin-Lajoie. An environmental scan is underway to further identify key issues and possible solutions.


Controversy

In 2009, the CMA was criticized for partnering with
Pfizer Pfizer Inc. ( ) is an American multinational pharmaceutical and biotechnology corporation headquartered on 42nd Street in Manhattan, New York City. The company was established in 1849 in New York by two German entrepreneurs, Charles Pfize ...
to launch a continuing medical education program.


Provincial and territorial medical associations

*
Doctors of BC Doctors of BC, formally known as the British Columbia Medical Association (BCMA), is a professional organization that represents 14,000 physicians, medical residents and medical students in the province of British Columbia. Its goals are to prom ...
*Alberta Medical Association *Saskatchewan Medical Association *Doctors Manitoba * Ontario Medical Association *Quebec Medical Association (''French: Association médicale du Québec'') *New Brunswick Medical Society *Doctors Nova Scotia *Medical Society of PEI *Newfoundland and Labrador Medical Association *Northwest Territories Medical Association *Yukon Medical Association


Corporate structure

The size of the elected board of directors is transitioning to 19. The board includes physician, resident and student representatives. It is the executive authority of the CMA, meets four times a year and is responsible for policy direction. In 2018, the association launched the CMA Patient Voice, a group of 12 individuals that provide a patient's perspective to the CMA's work. A health summit attended by a wide spectrum of medical and health professionals as well as patient representatives is held annually to disseminate new research, information and innovations, and to debate issues facing the medical community and users of medical services. A public annual general meeting is held to review financial statements and other CMA business matters. As well, the association holds an annual General Council meeting of its members to discuss policy matters.


Companies

The CMA's subsidiary company Joule was created on Sept. 1, 2014. It delivers continuing education to doctors, resources for accessing medical information online, clinical information resources and summaries of the latest clinical evidence. CMAJ is published by Joule. Joule's grant program funds CMA member innovations that potentially may assist in healthcare advancements.


See also

* '' Canadian Medical Association Journal'' * Canadian Medical Protective Association * James Thorburn: President, CMA, 1895 * List of Canadian organizations with royal patronage


References


External links

* * {{authority control 1867 establishments in Ontario Medical associations based in Canada Organizations based in Canada with royal patronage 1867 establishments in Canada