2021 ANNUAL REPORT

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.

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.

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 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.

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.

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 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.

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.

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.

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:

COVID-19

• 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.