Following is the fifth installment of our series on the Canadian Medical Protection Association. 

The last article hit a nerve.  A lawyer posted the following comment: “I am a plaintiff medical malpractice lawyer from a small town (Cambridge, Ont.) who acts for only patients as against the behemoth Law firms which the CMPA hires. I completely agree with your assessment of how the Defense acts. I am also a member of The Holland group, a think tank for medical malpractice cases, and have been since it’s inception and only now after over a hundred meetings, have we come up with ”best practices”. The members of the Group are both from the Defense side and the Plaintiff side. These “best practices” are a typed up version of what I have been doing for 35 years. The CMPA lawyers on instructions from the CMPA (I assume) may talk the talk in the group but on the street, it is the same old shit of delay delay and scorched earth. Earlier resolution of obvious cases of merit would save all money and compensate the Plaintiffs so they can try and lead a better life earlier than is now and probably forever a broken system of compensation. Good article right on the nuts. PMM”

The latest CMPA financial statement figures from 2016 show membership revenues of $566.3 million.  You paid most of that.  When you add in another $203.8 million from investment income, that makes the total revenue $770.1 million for that year alone.  That’s just the revenue; that doesn’t count their assets in land and buildings.  Not bad for a non-profit corporation.  I might start one myself if the province will subsidize it and let me set my own rates, as noted in the 2016 CMPA financial statement:

“The 2016 Membership fees in Quebec were arrived at as per the Memorandum of Understanding between the Association, the Fédération des médecins spécialistes du Québec, the Fédération des médecins omnipraticiens du Québec, and the Government of Quebec. The 2016 membership fees in Ontario and the Rest of Canada were determined by the Association.”

At the CMPA’s inception in 1901, the flat fee for membership was $2.50 annually.  By 1976, it was $200 a year. Provincial subsidization in Ontario began at the rate of 50% in 1978 and by 1981 the fees had increased to $350.  In 1984, the CMPA began charging differential fees as determined by specialty and 1986 saw another significant jump to an average fee of $1,238.  Five years later, it had doubled.  By the year 2000, the average fee was $3,929.  And it gets worse.  This year, the unweighted average fee is triple that of 2000 at $11,338.  The general rate of inflation for the period 1979 through 2017 was 235%.  Shocking?  Not compared to the CMPA rate increase of 6,156.5% for the same period.  Had the CMPA fees kept pace with inflation, the 2017 fee would have been $670.  But then, why limit your increases if you can enjoy a feeding frenzy at the public trough?

Let’s put the fee impact into perspective, shall we?  The 2016 Canadian Institute for Health Information reports that a doctor’s earnings vary based on doctors’ specialties.  Family physicians make about $271,000 while medical specialists make about $338,000 and surgical specialists earn $446,000.  So the average gross pay for a doctor sits at $339,000.  That makes the current average CMPA fee 3.3% of the average gross pay.

Why do we have to subsidize this?  Hands up — how many of you mere mortals make as much money as a doctor?  What percentage of your income goes to mandatory insurance?  How many of you get subsidized from the province for the insurance that you are required to get for your car or your house?  How many businesses are subsidized for their liability insurance premiums?  How many employers are getting subsidized for the crippling WSIB fees?  That’s what I thought.

CMPA does pay out claims in cases so blatant and so egregious that there’s just no hope of even their ruthless lawyers winning the case. But they don’t pay out as much in claims as they do on fees for lawyers and expert witnesses, which is entirely consistent with their strategy of seeking to crush anyone bringing suit against a doctor.  They even brag about it.

The last article in the series “Your Doctor Probably Isn’t Insured” will be published next Tuesday.

This is the last in our series of six stories about the Canadian Medical Protection Society.

It is a common misconception that the CMPA provides doctors with insurance.  They don’t.  The CMPA has repeatedly insisted that it is not an insurance provider, and at least one court agrees.

A New Brunswick woman sued her psychiatrist who over drugged and sexually abused her and then threatened her with the nightmare of involuntary incarceration in a psychiatric facility if she told anyone what he was doing.  Was she harmed?  Of course, she was.  She was driven to a suicide attempt which caused her serious physical damage and which very nearly cost the poor woman her life.  She won her case and was awarded roughly $600,000 that she was then unable to recover from the psychiatrist because the sniveling coward fled the country leaving no assets behind.  The woman looked to the CMPA for these damages, arguing that the CMPA was this doctor’s insurer.  The CMPA asserted that it is not an insurer and that furthermore, it is entirely within their discretion as to whether any claims are paid.  The CMPA’s position was upheld in The Court of Queen’s Bench of New Brunswick and the victim of this predatory psychiatrist remains unable to collect the damages awarded by the Court.

Now here is an interesting fact.  In Ontario, the College of Physicians and Surgeons carefully words one of the requirements for registration, saying the doctor “must hold professional liability protection”.  Most people would think that it means that the doctor has to be insured.  The College names membership in the CMPA as fulfilling that requirement even though the CMPA does not provide insurance, as they’ve said over and over.   Paying compensation to injured patients is entirely at the CMPA’s discretion.  Furthermore, unlike real insurance companies, the CMPA does not raise the fee for doctors who have been found at fault (which is just as well since you and I are footing the bill anyway).

A huge percentage of Canadian doctors are members of the CMPA so the chances are that the doctor you’ve just been to see is not insured.

Membership in the CMPA doesn’t count as insurance, as the CMPA is decidedly not an insurance provider.  They are a defense organization for screw-up doctors whose lawyers savagely attack those with the temerity to suggest that the doctor was fallible.

Perhaps we should have a Canadian Patient Protective Association with a huge government-funded war chest for the benefit of those who have been harmed by negligent doctors.

Failing that, there are a few things that must happen:

1.    The Colleges must stop naming CMPA membership as providing adequate liability protection for doctors.  CMPA certainly protects the doctors with high-priced lawyers, but it sure does not protect the patient who has been damaged nor does it protect the family of the patient who has been killed outright by a doctor’s error.

2.    Doctors must be obliged to carry real medical malpractice insurance from a real insurance company, just like anyone else who is required to carry professional liability insurance.  There are obvious advantages to this:

(i)            Doctors, and therefore their patients, would have actual liability insurance coverage.  Compensation to patients would be on the basis of the merit of their case, not on the “if we feel like it” discretionary basis of the CMPA.

(ii)          Those doctors who repeatedly commit errors would be treated as any other insured against whom repeated claims are made.  The first time the insurance company had to pay out, they’d up the premiums.  The second time the insurance company had to pay out, they’d decline further coverage.  And wouldn’t that help to weed out the doctors who really ought not to be allowed anywhere near a patient.

3.    The government must stop liberally bestowing our hard-earned dollars upon this cash-bloated protectionist organization.  If the doctors want to pool their money for lawyers, let them.  It’s probably a good idea.  But let them bear the expense themselves.  Why do we have to pay for the insult-added-to-injury scenario that presents so often when a patient has been harmed?

Let’s level the playing field here for injured patients seeking rightful recompense.