President and CEO message

Photo: Michael Cohen
Michael T. Cohen, MD
CMPA President

Photo: Lisa Calder
Lisa Calder, MD, MSc, FRCPC
CMPA Chief Executive Officer

The ongoing COVID-19 pandemic – which gave rise to massive vaccination campaigns, threats against healthcare workers, and enormous demands on the healthcare system – made 2021 an incredibly challenging year.

We are proud to say that, against this difficult backdrop, the CMPA continued to assist physicians, contribute to safe medical care, and support the medical liability system. Here are a few highlights of what we accomplished last year.

We were there for you

As physicians entered the second year of the COVID-19 pandemic, we were there with compassionate and expert support. We responded to over 24,000 advice calls and provided essential medico-legal advice through our COVID-19 Hub – which was accessed by 77% of our 105,000 members.

We helped you respond to unprecedented levels of workload, stress, and fatigue by increasing our focus on physician wellness – creating a new Physician Support and Wellness department, providing online wellness resources to over 23,000 visitors, and participating in the Ontario Medical Association’s Physician Distress and Suicide Taskforce.

We provided you with peace of mind by continuing to prudently manage our investments so that we were able to provide timely compensation to patients proven to have been injured as a result of negligent care (fault in Québec). Closing 2020 in a strong financial position allowed us to reduce member fees for 2021. With an ongoing strong financial position in 2021, you will see further fee reductions for 2022.

Read more

CMPA Council, Leadership team and Strategic Plan


The CMPA is governed by an elected Council of 31 practising physicians who, working together and with CMPA management, foster the long-term success of the Association.

Meet Council >>

Leadership team

The CMPA's leadership team bring unique and diverse skills to advance our assistance to and support of members and our contributions to safe medical care across the healthcare system.

Meet the team >>

Strategic Plan

The CMPA’s commitment to its physician members and to the healthcare system at large is about empowering better healthcare.

Read now >>


Supporting physicians & patients

How the CMPA empowered better healthcare during a pandemic

The CMPA is committed to empowering better healthcare by delivering on it's strategic objectives: 

Assist physicians

“The CMPA has been so helpful to its members during the pandemic. I always feel better after calling [them].”

– CMPA member

Advice and assistance

Throughout 2021, the CMPA has supported our members with expert physician-to-physician advice and medico-legal assistance. Through these difficult times, we have continued to be there for Canadian physicians, answering their pandemic-related questions, supporting them in navigating the turbulent healthcare environment and helping them provide safe medical care.

How the CMPA’s advice and assistance made an impact in 2021:

Amid the uncertainty of a rapidly changing healthcare environment, impacted by emerging pandemic concerns, our members continue to trust us for timely advice and medico-legal assistance.

In 2021, we:

  • Responded to 24,000+ advice calls, providing compassionate support and expert guidance to help our members navigate medico-legal questions arising from their practice, along with pandemic-related challenges such as expanded scopes of practice, delayed and deferred care, staff shortages, and virtual care. 96% of CMPA members who spoke to one of our 45+ experienced physician advisors reported they were satisfied with the support provided. In fact, 70% of members with high stress levels reported a reduction in stress after speaking with a physician advisor.
  • Provided medico-legal support in 958 legal actions, as well as support around 4,844 College matters, 2,011 hospital matters, and 400+ additional issues (such as privacy investigations and inquests). Members reported high levels of satisfaction (>92%) with their legal counsel in these matters, reporting professional, prompt, supportive, and knowledgeable service.
  • Provided urgent COVID-19 medico-legal advice through our COVID-19 Hub (including timely FAQs directly informed by calls from our members), and targeted member communications in response to unique pandemic environments across Canada. Addressing topics such as critical care triage protocols, these communications provided timely guidance when and where it was needed most. In 2021, 77% of our 105,000 members accessed COVID-19 related information created by the CMPA.

“Practising medicine and the difficulties associated with it can be very isolating. I want members to know they are not alone.”

– Dr. Sharman Robertson, CMPA Physician Advisor

Physician wellness

We understand the unprecedented challenges our members are facing and the compounding effect these challenges have on workload, stress, and fatigue. These are demanding times, and we remain committed to supporting the wellbeing of our members dealing with medico-legal concerns.

How the CMPA supported physician wellness in 2021:

The CMPA provides confidential, non-judgmental, physician-to-physician support, guidance, and education to help members manage the stress and anxiety that often come with a medico-legal concern.

By helping physicians improve their wellness, we seek to improve their ability to provide safe medical care and reduce medical error.

We are committed to on-going collaboration with other organizations to support physician wellness at the individual, institutional, regulatory, and policy levels.

In 2021, we:

  • Created the Physician Support and Wellness department, which builds on the support we provide members on every call, formalizes our ongoing efforts, and focuses additional resources on supporting the wellness of our members.
  • Provided physician wellness articles, videos, and other resources to over 23,200 online visitors.
  • Commenced listening and learning activities to better understand the challenges our members face concerning equity, diversity, and inclusion.
  • Collaborated with the Ontario Medical Association Physician Distress and Suicide Taskforce to analyze Canadian Institute for Health Information (CIHI) data and interpret trends. The Taskforce aims to determine the demographics of physicians at highest risk of suicide and target those groups with proactive interventions.

Addressing EDI is directly tied to our mission of protecting physicians and supporting safe medical care and is why we are prioritizing this important work.

Equity, diversity, and inclusion

Equity, diversity, and inclusion (EDI) are vital to healthcare. We know members and patients experience racism and inequities and that this significantly affects physicians, threatens patient safety, and creates medico-legal risk.

The CMPA has a responsibility to address this risk and help mitigate bias and inequity in the services we provide and in our own workplace.

How the CMPA supported EDI in 2021:

We are committed to working with and learning from our members, our Council, and our employees to better understand their experiences and explore opportunities for positive change and improvement to support EDI.

In 2021 we:

  • Began the development of a long-term EDI strategy, which will focus on 5 elements: our members, our governance, our employees, learning, and advocacy.
  • Engaged in listening and learning with Black Physicians of Canada, Indigenous Physicians Association of Canada, and the BC First Nations Health Authority – helping us better understand and respond to challenges facing our members.
  • Provided our Council members and CMPA leaders with comprehensive EDI and bias training, positioning them to guide CMPA’s work and model effective governance practices to promote EDI and support members across the country.
  • Worked with renowned EDI experts, the Canadian Centre for Diversity and Inclusion (CCDI), to evaluate our internal policies and business processes, assess our own diversity, and explore ways to address gaps and remove barriers to a more equitable work environment.

We commit to building a workplace that supports equity, diversity, and inclusion (EDI) and encourages people to bring their best selves to work every day. 91% of employees (n=361) “strongly agree” or “agree” that CMPA’s senior leaders make employee health and well-being a top priority.

March 2021, COVID-19 Pulse Survey

Organizational resilience

We know that by investing in our people and infrastructures, we will have the talent, capacity, and resources needed to support our members.

To serve our members well, to innovate, and to positively impact the healthcare system, we provide employees with the support and resources they need to be resilient in a changing environment.

How the CMPA enhanced organizational resilience in 2021:

We strive to be an organization that explores opportunities for positive change and improvement while fostering equity, diversity, and inclusion (EDI), supporting employee wellness, and providing flexible work arrangements.

Our aim is to be a learning organization that provides employees with ongoing opportunities to learn new skills and competencies, while empowering employees to perform to their best potential.

In 2021, we:

  • Implemented a revitalized organizational structure, strengthening our ability to understand and respond to member needs, and increasing our focus on collaboration, stakeholder engagement, analytics, and learning.
  • Defined our new Flexible Work Model for implementation in 2022.
  • Implemented a COVID-19 vaccination policy, supporting staff safety and wellness.
  • Partnered with the Canadian Centre for Diversity and Inclusion (CCDI) to assist with the development of a long-term EDI Strategy which will focused on members, employees, governance, learning, and advocacy.
  • Received a snapshot report from CCDI focused on CMPA’s inclusivity status. Findings will be used to drive improvements to EDI across the organization.
  • Continued to enhance internal processes, systems, and technologies that support financial services, membership services, medico-legal assistance, and education delivery.

Contribute to Safe Medical Care

I loved the interactive nature of the virtual delivery (polls, breakout rooms, annotations). I've attended multiple virtual delivery workshops throughout my medical training (thanks to COVID), but this was by far the best organized and best run. Instructions were clear and easy to understand, and I think it flowed very seamlessly.

– University of Alberta resident, Prepped for practice: Medico-legal essentials for residents (2021)

Safe medical care learning

In response to ongoing pandemic restrictions, we’ve modernized and expanded our digital learning offerings to include virtual workshops, eLearning activities, podcasts, and timely resources—all tailored to suit the needs of our members.

How the CMPA’s learning offerings and support made an impact in 2021:

Using our vast collection of medico-legal data, CMPA researchers derive insights into how to improve the safety of medical care. These insights directly inform our safe medical care learning programs. Our programs aim to reduce the likelihood and impact of patient harm from care provided by healthcare professionals.

In 2021, we:

  • Deployed Prepped for Practice workshops to residents—in both official languages—comprising 38 virtual sessions at 17 Faculties of Medicine, with 2,698 participants.
  • Expanded our digital learning library, which includes 15 evidence-based eLearning activities that were completed over 20,000 times, helping members refine their skills and obtain CPD credits in 2021.

Our research supports patient safety and helps prevent harm from happening in the first place.

Research and insights

With the largest collection of physician medico-legal data in Canada, our team of researchers identify gaps that affect patient safety and opportunities for quality improvement.

How the CMPA leveraged insights and research to enhance safety in 2021:

We engage in innovative quantitative and qualitative analyses which help identify gaps in safe medical care. Using these insights, the CMPA publishes peer-reviewed research and articles, and develops accredited, practice improvement learning for our members.

Our research helps advance safety improvements throughout the healthcare system.

In 2021, we:

  • Modernized our research focus to provide timely medico-legal insights into sepsis, “never events,” and rural health.
  • Fulfilled 56 research project and data requests for members, giving members access to needed insights.
  • Published manuscripts in the Canadian Journal of Surgery, PRS—Global Open, and the CMAJ Open, with another manuscript accepted for publication and two in review.
  • Continued to build our collection of medico-legal data, adding almost 4,000 new closed cases to our database – allowing us to better understand and develop strategies to mitigate medico-legal risk.

Saegis Shield—a cybersecurity and privacy education program—equips healthcare teams with the skills and resources needed to respond to emerging threats and protect the privacy of patient health information.

Saegis, a CMPA subsidiary

As a member of the CMPA family, Saegis offers educational programs including coaching, and practice management solutions for physicians, institutions, healthcare professionals, and multidisciplinary teams–helping them perform at their absolute best. Through the delivery of high-impact programs and services, Saegis acts as a catalyst for lasting improvements to the Canadian healthcare system, supporting its sustainability.

How Saegis provided practice management solutions for teams and institutions in 2021:

Saegis expanded its online programming and enhanced its capacity for hands-on, facilitator-led group and individual learning.

In 2021, Saegis:

  • Provided 43 open enrollment programs and delivered specialized programs to 33 teams within healthcare institutions, helping medical professionals perform at their very best. 98% of participants surveyed indicated the training had a positive impact on their practice.
  • Expanded the reach of Saegis Shield—a cybersecurity and privacy education program—by entering into agreements with medical associations and large clinic chains that could provide up to 17,500 users and 1,150 clinics with access to the program. By helping clinics and institutions combat cybersecurity threats, Saegis continues to support a safe and sustainable healthcare system.

Support the medical liability system

On behalf of its members, the CMPA paid a total of $1.2 billion in patient compensation over the last 5 years.

Compensating patients

An important part of our role in the multifaceted Canadian healthcare system is to provide, on behalf of our members, timely and appropriate compensation to patients proven to have been injured as a result of negligent care as determined during the medico-legal process.

How the CMPA ensured appropriate compensation to patients in 2021:

The CMPA is a not-for-profit organization, not an insurance company. We collect membership fees from physicians each year so that we can:

  • Compensate patients injured as a result of negligent medical care (fault in Québec).
  • Support members facing medico-legal difficulties.
  • Advance safe medical care through education, advice, and advocacy.

We have a responsibility to invest prudently in order to maintain adequate funding, both for current needs and for projected compensation payments.

In 2021, we:

  • Provided $276 million in compensation to patients harmed by negligent medical care (fault in Québec), helping to support their short and long-term care needs. This is an increase of $70 million over the previous year.
  • Generated a 12.8 % return on investments – a significant increase to our planned 5% return. This return enabled us to further reduce member fees and positions us to continue to provide appropriate compensation to patients.
  • Closed 2021 in a strong financial position, allowing us to weather further challenges in the economy and financial markets and ensure members and patients that we are here for them when needed. This strong position will enable us to consider further fee reductions in the coming years.

Advocating on behalf of members, the CMPA sent 59 submissions to governments and regulatory bodies in 2021. These submissions provided the CMPA’s perspective on issues important to physicians and the healthcare system.

Advocacy and action

The CMPA regularly engages with medical regulatory authorities, healthcare leaders, and governments on matters related to legislation, regulation, and policy. We continue to advocate on matters that impact the lives of patients and physicians, and the Canadian medical liability system.

How the CMPA advocated and took action to support members in 2021:

Throughout the pandemic, we’ve continued to advocate for legislation that provides medico-legal protection to physicians delivering care during COVID-19, and for regulatory changes that remove barriers to practice and advance public health goals.

In 2021 the CMPA also:

  • Created the Strategic Engagement and Advocacy department, modernizing and strengthening our approach to advocacy and engagement.
  • Signed the Canadian Health Workforce’s Call to Action on the Healthcare Human Resource Crisis, followed by a letter to the Prime Minister and Minister of Health.
  • Advocated for virtual care and telemedicine standards in submissions to the College of Physicians and Surgeons of Alberta (CPSA), the College of Physicians and Surgeons of BC, the College of Physicians and Surgeons of Manitoba, and the College of Physicians and Surgeons of Ontario (CPSO).
  • Shared our insights and expertise with the CPSO, the College of Physicians and Surgeons of Nova Scotia (CPSNS), CPSA, the College of Physicians and Surgeons of Saskatchewan, and Health Canada’s Expert Panel on MAID and Mental Illness, helping to create clearer guidelines around MAID.

Our collaborative efforts and partnerships deliver value to Canadian healthcare by ensuring that medico-legal and patient safety matters are considered whenever new policies, laws, or programs are developed.

Engagement and collaboration

The CMPA engages with a diverse group of partner organizations to share our expertise in support of efforts to improve the healthcare system.

How the CMPA engaged with its stakeholders in 2021:

By working with partners, we support changes that help our members practice effectively during challenging times.

In 2021 we took the following actions in relation to:


  • Advocating on medico-legal risk-related issues in submissions to the Ontario Medical Association, Alberta Health Services, Health Canada, and the Public Health Agency of Canada addressing vaccination distribution, administration, and injury compensation matters.
  • Participated in a town hall with the College of Physicians and Surgeons of British Columbia, Doctors of BC, and the BC Provincial Health Program to address physician bullying and harassment.

Education and learning

  • Provided data and expertise to help create Continued Professional Development learning offerings, including: the Conseil québécois du développement professionnel continu des médecins; the Coalition for Physician Learning and Practice Improvement; and the Association of Faculties of Medicine of Canada’s (AFMC) Committee on CPD and Postgraduate medical Education.
  • Developed a series of e-learning activities on collaborative care in obstetrics with the Healthcare Insurance Reciprocal of Canada, increasing awareness of safe care practices.
  • Collaborated with the College of Family Physicians of Canada (CFPC) in providing support to CFPC’s Transition to Practice program, and participated in several CFPC educational events including two presentations at the 2021 Family Medicine Forum.
  • Collaborated with the Royal College of Physicians and Surgeons of Canada (RCPSC) by contributing to the CanMEDS Consortium, and exploring ways to promote CMPA learning offerings as quality improvement projects for RCPSC fellows.

Virtual care

  • Participated in the Canadian Medical Association’s Virtual Care Taskforce, helping to develop strategies for the use of virtual care.

Back to Supporting physicians & patients


A year in numbers

Our members

In 2021, the CMPA had 105,638 Canadian physician members

Type of work

37% Family medicine specialists
50% Royal College Specialists
13% Residents


26% BC/AB
13% SMAT*
41% ON
20% QC


38% 40 and under
41% 41-59
21% 60 and over

Our services



Advice calls provided to members

BC/AB 5,428
SMAT* 2,379
ON 11,820
QC 4,664


COVID-19 advice calls

BC/AB 416
SMAT* 191
ON 1,109
QC 234



Continuing professional development educational events and workshops

BC/AB 22
SMAT* 15
ON 130
QC 37


Continuing professional development attendees

BC/AB 1,570
SMAT* 655
ON 8,680
QC 3,802

Medico-legal services

New medico-legal cases

Legal actions - served1,2
Legal actions - not served1,3
College (medical regulatory authority) matters
Hospital matters
Paying agency matters


Resolved legal actions

Judgment for plaintiff
Judgment for physician
Settled with plaintiff

* Saskatchewan, Manitoba, Atlantic provinces and Territories


  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 threats (prior to 2021), human rights complaints, inquests, privacy investigations, and criminal matters.


Financial performance

How the CMPA maintains adequate funding to support physicians and compensate patients on behalf of members

The CMPA has a responsibility to maintain adequate funding so we can support physicians and compensate patients on behalf of members
now and up to 30-40 years in the future.

As a not-for-profit Association, the CMPA collects 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 (thereby preventing future patient harm).

The membership fees collected in any given year (e.g. 2021) fund patient compensation costs and medico-legal support costs in that year and, as claims unfold for the following 30-40 years. We strive to ensure the fees we collect are used efficiently and appropriately, and we are committed to containing growth in medical liability protection costs and striving for our goal of fee stability. As appropriate, we aim to reduce membership fees when in strong financial position and prudently increase them if we are in deficit.

Over the past ten years we have achieved exceptional returns on our investment portfolio earning a 9.1% compound annual return, which has contributed to the CMPA’s current net asset position. However, this has not always been the case. As recently as 2012-2015, the CMPA had a significant deficit due in part to increased patient compensation necessitating increases to membership fees.

A slowdown in the growth of medico-legal costs, and recent strong investment performance has significantly improved the CMPA’s financial position. In response, we have reduced membership fees for several years. In 2021 and 2022, we reduced fees by $99.5 million and $200.0 million respectively. 2023 fees will be reduced again by $362.5 million.

We will continue to invest prudently to be able to maintain a stable financial position that ensures timely and appropriate compensation to patients on behalf of our members, protection and support to physicians, and to help physicians provide safe medical care. Guided by Council, we will continue to work to provide membership fee reductions that lower the Association’s financial position to a reasonable level as appropriate – responding appropriately to the volatile market environment and financial impacts of the pandemic.

Compensation to patients

On behalf of our members, the CMPA provides timely and appropriate compensation for patients proven to have been injured as a result of negligent medical care (fault in Québec). Compensation to patients is the CMPA’s single largest expense each year.

While amounts vary from year to year, on behalf of its members, the CMPA paid a cumulative total of $1.2 billion in patient compensation over the last five years.

In 2021, on behalf of its members, the CMPA paid $276 million to patients harmed as a consequence of negligent medical care (fault in Québec) – $70 million more than in 2020.

Spending on learning

Leveraging our case data and through our research efforts, the CMPA develops evidence-informed education that enhances the safety, reliability, and quality of healthcare in Canada.

As one of Canada’s largest providers of continuing professional development in healthcare, the CMPA addresses the learning needs of physicians to help them improve their practices and provide safe medical care throughout their careers.

In 2021, the CMPA spent $22.5 million conducting safe medical care research, and developing and delivering safe medical care learning to Canadian physicians. This is consistent with the amount spent in 2020.

Investment returns

The CMPA invests to secure sufficient funds to compensate, on behalf of members, patients proven to have been harmed as a result of negligent medical care (fault in Québec).

In 2021, the portfolio produced a positive return of 12.8%.

Supporting physicians and compensating patients up to 30-40 years in the future

The membership fees collected in 2021 fund the medico-legal costs resulting from interactions between our members and their patients in 2021 and for the next 3-4 decades.

The reason for this large time window is the Association’s commitment to occurrence-based protection. Members are eligible for assistance (and patients are eligible for compensation if harmed by negligent medical care) any time in the future, as long as the physician was a CMPA member when the care occurred. A retired member could be eligible for assistance related to the care they provided early in their career.

We must hold appropriate funds to compensate patients and support physicians with medico-legal cases up to 30-40 years from the time the care was delivered.

Net asset position

Net assets are the difference between assets and estimated liabilities. They provide a point-in-time measurement that indicates whether the Association has the required resources to meet estimated liabilities over the next 3-4 decades.

The overall net asset position can fluctuate from one year to the next, depending on external driving factors such as investment returns and/or compensation to patients paid on behalf of members. The CMPA strives to maintain a reasonable net asset position. We use fee credits and debits to manage our financial position over time – reducing or increasing membership fees as needed.

Due in part to the strong performance of the markets in 2021, the Association’s net asset position as of December 31, 2021 was $1,664 million, an increase of $220 million from 2020.

The CMPA will continue to appropriately compensate patients that have been harmed as a result of negligent medical care (fault in Québec) and leverage this temporary surplus to lower membership fees.

Aggregate fees

Through prudent reductions or increases in member fees using fee credits or debits, the CMPA aims to optimize the stability and predictability of the membership fee structure over time.

CMPA members pay the expected cost of protection for the year in which the care was delivered.

If the actual costs of protection are different from the predicted values, future fees may be adjusted (increased or reduced) to address the difference.

On an annual basis, the CMPA uses fee credits to reduce membership fees when the Association is in a strong financial position.

Our exceptional return on our investments has allowed the CMPA to provide fee credits totaling $702 million between 2020 and 2023. Fee credit amounts were $99.5 million in 2021, $200 million in 2022, and $362.5 million in 2023.