The Canadian Medical Association has represented doctors at the federal level since 1867, but membership has declined and dissatisfaction is growing. And if proposed changes to the CMA Board are accepted, things are about to get a lot worse. 

All doctors should be concerned that the CMA is planning to eliminate the democratic election of Board members. The change is being presented as a scheme to improve equity, diversity, and inclusion, but it will lead to many unintended consequences. Eliminating member voting will decrease member engagement and cause further erosion of the CMA as the united voice of Canada’s doctors.

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 [2]”; our experience shows that democracy is not a barrier to inclusion and good governance, but rather its foundation. The CMA’s existing democratic process for choosing the president-elect has resulted in successful candidates representing a diversity of genders, sexualities, geography, and cultures. 

Doctors of BC’s ongoing efforts to address inequity [3] are the preferred and successful approaches that have already 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 (the first Indigenous CMA president in the its 154-year history) are progressive thinkers with track records of strong advocacy. They were all elected based on merit under the current electoral system. The current proposal to eliminate democratic CMA Board elections comes in the context of the otherwise forward-thinking Impact 2040 strategy [4] that builds toward 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 health care system. 

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

We ask all physicians to support us by registering for the virtual AGM being held on 22 August 2021 [5] in order to reject 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?

—Granger Avery, MD
—Arun Garg, MD
—Derryck Smith, MD
—Ian Gillespie, MD
—William Cavers, MD
—Charles Webb, MBChB
—Alan Ruddiman, MBBCh
—Eric Cadesky, MDCM
—Kathleen Ross, MD
—Ramneek Dosanjh, MD 
—Jeff Dresselhuis, MD
—Richard Merchant, MD 

Directors from BC to the CMA over the past 5 years: four men and two women, and one BIPOC individual since the start of an open vote in BC: Drs Nasir Jetha, Shelley Ross, Carol Williams, Robin Saunders, Charles Webb, and Nigel Walton.  Recent Doctors of BC presidents/presidents-elect: four men and three women, including two BIPOC candidates: Drs Charles Webb, Alan Ruddiman, Trina Larson Soles, Eric Cadesky, Kathleen Ross, Matthew Chow, and Ramneek Dosanjh (president-elect). Recent presidents/presidents-elect at the CMA: five women and six men (two identifying as LGBTQIA2S+), two BIPOC individuals, and two past-presidents from the Royal College or CCFP rather than PTMAs: Drs Anna Reid, Hugo Francescutti, Chris Simpson, Cindy Forbes, Laurent Marcoux, Granger Avery, Gigi Osler, Sandy Buchman, Ann Collins, Katharine Smart, and Alika Lafontaine.

 

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