Originally published December 2012 / Revised February 2016
A physician consultant for a workers' compensation board interprets the medical information received from the physician of an injured bricklayer. Based on this interpretation the case manager terminates the worker's benefits and determines that he is fit to return to work to perform modified duties. The bricklayer returns to work and, after several weeks, experiences a recurrence of back pain, along with numbness of the leg which he attributes to the earlier injury. Citing an increased risk for permanent disability, the bricklayer launches a lawsuit naming the board's physician consultant.
How can the CMPA help?
Physicians may apply their knowledge and expertise in many professional settings. For example, physicians may sit as members of committees, boards, and management groups for organizations such as hospitals, health authorities, learning institutions, governments, associations, or private companies. Although physicians in these roles do not have clinical contact with patients, they may still be vulnerable to medical-legal difficulties as a consequence of providing a medical perspective to decision making or as part of their overall responsibilities (e.g. executive director role). The CMPA recognizes that administrative medicine is a necessary and valuable part of the practice of medicine and the CMPA's assistance principles apply on this basis.
For physicians shifting from active clinical duties to administrative roles, volunteer duties, or other professional circumstances, CMPA membership remains valuable. Retaining CMPA membership provides access to all of the CMPA's services including medical-legal advice and assistance in civil litigation, medical regulatory authority (College) complaints, investigations and disciplinary hearings, and other medical-legal difficulties that may arise from a physician's professional medical perspective. Physicians who should consider retaining CMPA membership include:
- administrators and executives
- medical advisors, such as those reviewing disability claims for insurance companies
- reviewers of medical journal articles
- members of hospital committees and hospital review panels
- those involved in research activities
Lower risk means lower membership fee
The CMPA's membership fees reflect the relative risks of the type of work performed and the medical-legal experience in the region in which a member is working. The annual fee schedule lists the types of work in each of the CMPA's fee regions.
One of these types of work is administrative medicine (type of work 20), defined as someone who is a medical executive, medical advisor, or medical expert. To be a CMPA member, a physician must be licensed by a provincial or territorial College. The administrative medicine category is designated for physicians who do not have any clinical contact with patients, including by telephone or electronically, and who do not prescribe.
In the case of the injured construction worker described earlier, the physician consultant is eligible for CMPA assistance under the administrative medicine category, because his role is to use his specialized knowledge to interpret medical information pertaining to disability claims. If a physician's work includes assessing or examining patients, a different work category would apply. Given that the relative risk of administrative medicine is generally low, the CMPA fee for this type of work is less than that of most other types.
Medical-legal risk in administrative medicine
The CMPA's assistance principles are designed to offer flexibility by extending assistance to members in a wide range of situations, on a case-by-case basis. Such issues stem from the professional practice of medicine, including administrative medicine. It is the Association's experience that members whose type of work would fall into the administrative category may not fully understand the potential medical-legal risks associated with their work or recognize the benefits of CMPA membership. In addition to CMPA protection, physicians should ensure they have adequate professional liability protection from their employer in the event of medical-legal difficulties arising from the application of business or organizational policies or procedures. Members are advised to contact the CMPA if they have questions regarding the assistance extended to them.
Physicians who do not provide clinical care or patient advice but instead work in an administrative capacity related to healthcare should consider retaining their CMPA membership under the administrative medicine type of work category. By retaining CMPA membership, physicians may benefit from advice and assistance concerning medical-legal matters.
More information about CMPA's assistance principles is provided in the article "Providing medical input in an administrative role". Members are encouraged to call the CMPA at 1-800-267-6522, or use the Medical-legal assistance/web mail form for advice about their specific situation.