Tell the CMA to make the right choice

It is time to tell the CMA that their equity goal is right but silencing democracy is off-target. So say a group including former CMA presidents and provincial medical association presidents. They make this case as we approach the CMA's virtual AGM on Aug 22 where key issues are being decided.

How much trust do you have in the Canadian Medical Association? As our national body, it has represented doctors at the federal level since 1867, but membership is declining and dissatisfaction is growing. And, if proposed changes to the CMA board are accepted, things will undoubtedly get a great deal worse.

All readers should be concerned that the CMA is planning to eliminate the democratic election of board members. Ostensibly a scheme to improve Equity, Diversity and Inclusion (EDI), this is the wrong move with many unintended consequences. Eliminating member voting will further decrease member engagement and erode the legitimacy that the CMA has as the voice of Canada’s doctors. We have already heard from doctors who feel that this move would distance them even more from an organization that is statedly membership-based.

Churchill may have said that democracy is “the worst form of government except for all those others that have been tried from time to time;” our experience shows that democracy is not a barrier to EDI and good governance, but rather the foundation. Democratic elections of the board at the Canadian Federation of Medical Students have yielded exemplary results.

The CMA’s own democratic process for choosing the president-elect has also shown the wisdom of the crowd with successful candidates representing an increasing diversity of gender, sexuality, geography, and culture. The process is not perfect—as demonstrated by the absence of any women candidates from Alberta in the latest contest—but those issues are further upstream: for candidates to better represent the general membership intentional and genuine systemic changes must take place that include greater focus on mentorship, coaching, nominations processes, and term limits. 

We wholeheartedly agree that EDI is the correct destination; what we oppose is the CMA’s suggested path. We support approaches such as Doctors of BC’s ongoing efforts to address inequity; this method has already led to several working groups and a thorough report on the barriers doctors face. Rather than divide our profession, we have learned more about each other and each other’s experiences. This approach has led to improved representation and democracy within Doctors of BC.

The CMA is similarly capable of such change. It has the financial resources to hire staff and consultants to advise on best practices. The presidential chain of Drs. Ann Collins, Katharine Smart, Sandy Buchman, Gigi Osler and newly-elected Alika Lafontaine are progressive thinkers with track records of strong advocacy. Moreover, the current proposal to eliminate democratic CMA board elections comes in the context of the otherwise forward-thinking Impact 2040 strategy that demonstrates that the CMA recognizes the importance of equity, diversity, inclusion, anti-racism and reconciliation. Developed in consultation with doctors from across the country—including several of our authors—Impact 2040 builds towards greater engagement with other health-focused organizations such as provincial and territorial medical associations, universities, governments, and patient groups, especially those that have been traditionally disadvantaged in our healthcare system.

Simply put, we do not need to sacrifice democracy to achieve diversity.  We have proven that when diverse candidates are mentored, encouraged to run and prepared for their campaigns then informed, intelligent members are capable of directly electing leaders that represent Canadian doctors. 

We hope readers of this article will amplify this message and show up at the virtual AGM on August 22nd in order to support the aim of equity while rejecting the proposed elimination of democratic board elections. Without member participation and improved engagement Canadian physicians will irrevocably lose control of the CMA.

If we don’t speak up for ourselves now, who will?


Dr. Eric Cadesky is a Family Physician in Vancouver and was the 2018-19 president of Doctors of BC. Dr. Kathleen Ross is a past-president of Doctors of BC and Family Physician with a focused practice in obstetrics and current President of the Royal Columbia Hospital Medical Staff Association. Dr. Granger Avery is a past-president of the CMA. Dr. Arun Garg is a past-president of the British Columbia Medical Association (BCMA, the earlier name for Doctors of BC) and was previously a CMA board director. Dr. Derryck Smith is a Vancouver-based psychiatrist and a past-president of the BCMA and a past CMA board member. Dr. Ian Gillespie was president of the BCMA in 2010-11. Dr William (Bill) Cavers was president of Doctors of BC in 2014-15. Dr. Charles Webb is a GP-anesthetist, a past-president at Doctors of BC,  current president of the Vancouver Medical Association and recently completed three years as a democratically-elected director at CMA. Dr. Alan Ruddiman was president of Doctors of BC in 2016-17. Dr. Ramneek Dosanjh is the president-elect of Doctors of BC. Dr. Jeff Dresselhuis is family physician and the immediate past-chair of Doctors of BC. Dr. Richard Merchant is an anesthesiologist and the president of the Westminster Medical Association. Dr. Robin Saunders is a past-chair of Doctors of BC and served on the CMA board. Dr. Michael Putland is the current President of the Victoria Medical Society.