‘The system is still in crisis’: CMA president looks back on 2024 and opportunities for the new year

With the end of 2024 on the horizon, the president of the Canadian Medical Association (CMA) says this past year saw several positive developments on addressing the physician shortage and easing the administrative burden—but there’s more work to do.“The system is still in crisis. There are over six million Canadians who don't have access to a family doctor, so there's no question that Canadians are suffering and they're not getting the care they need,” CMA president Dr. Joss Reimer said in an interview looking back on the year that was with the Medical Post. “But I do see that there've been positive steps and there are a lot of things in different provinces, territories and at the federal level that do give me hope that we're moving in a good direction.” For example, Ontario, Quebec and Nova Scotia have all passed legislation banning or restricting employers from requiring sick notes. Last summer, the federal government introduced the Connected Care for Canadians Act, which would open the door to more interoperability in healthcare. British Columbia also made changes to how family physicians are compensated, as did Manitoba and Nova Scotia the year prior.Read: Three-quarters of Canadians support legislation to curb sick notes: surveyHowever, it hasn’t been all good news. Dr. Reimer pointed to recent numbers from the Canadian Institute for Health Information (CIHI), which found that the number of family doctors per capita in Canada dropped for the first time in decades. “Over the last year and when we have a growing population, any decrease is hugely problematic, so there's no question that we have a supply problem,” she said.“I think we're moving things in the right direction, but it's too slow and right now the system remains in crisis.”A federal election is also set to take place sometime next year, polling currently favours the Conservatives to form the next government. Dr. Reimer says the CMA is looking forward to working with whatever party comes into power next year.“We've had great discussions with [the Conservative Party], for example, about national licensure and making sure that we have better mobility of physicians across the country and so we look forward to these ongoing conversations and we're having productive conversations with all political parties,” Dr. Reimer said.Balancing public and private healthcareThis past year also saw the CMA release its official policy recommendations on balancing private healthcare in the public system, which took a stance against user fees or private insurance to cover care that would be otherwise covered by the public system.These recommendations came under criticism from some doctors, such as Maple CEO Dr. Brett Belchetz, who said the CMA’s recommendation “disparages the role that employer-funded care has played in reducing strain on our public health system.”However, Dr. Reimer said the CMA “heard loud and clear” from more than 10,000 Canadians, including from physicians and other healthcare providers, that access to healthcare shouldn’t be “impacted by someone's ability to pay.”“In general, privately delivered services, whether they're publicly funded or privately funded, tend to be lower quality, more expensive and have worse outcomes,” she said. “We're not saying that private doesn't have a role in the system . . .. But what we are saying is that it shouldn't be seen as the solution when we're having problems in the public system.”Achieving reconciliation in medicineBack in September, the CMA also issued its apology towards Indigenous peoples for the role that it and the medical profession had played in perpetuating harms towards First Nations, Inuit and Metis communities.Dr. Reimer called the apology “an important first step” and said the work to stamp out anti-Indigenous racism in healthcare continues.“We were also clearly told that our apology without action, it can be more harmful than saying nothing in the first place, so we've now started down the road of a reconciliation plan, which means we need to be committing to many things, and we need to be willing to change our action plan as Indigenous people guide us through that work,” she said.Read: ‘Not much has changed’: Indigenous physicians reflect on healthcare in CanadaSome of the next steps for the CMA include revising the Code of Ethics and Professionalism to strengthen the parts relating to anti-Indigenous racism and supporting Indigenous health goals, such as advocating for legislation to protect clean drinking water for First Nations.“We're also going to be working with other healthcare organizations, with physicians, with students at trying to help them in their reconciliation plans as well. So, these are just the first steps, but important first steps, and we intend to continue to develop this plan guided by Indigenous people going forward,” she said.

‘The system is still in crisis’: CMA president looks back on 2024 and opportunities for the new year

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