Canadian Medical Protective Association

The Canadian Medical Protective Association (CMPA) is a legal defense organization for Canadian medical doctors. It was incorporated by Act of Parliament on Feb 27, 1913, and given Royal Assent on May 16, 1913.

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Doctors pay fees that contribute to the association's reserve fund of nearly $3 billion, and Canadian Provincial governments refund up to 100% of these fees back to the doctors. These refunds were agreed to in contracts negotiated between the Provincial Medical Associations (individually by province) and the Provincial Departments of Health. The CMPA also acts like an insurance company and as such some of its reserve of funds is used to pay claims.

For a significant period of time, the provinces, as paymasters, had refused to increase physicians fees in spite of long and difficult negotiations. In addition to increased frustration on the part of physicians as their expenses continued to increase, there was the added factor that malpractice insurance as provided by the CMPA was increasing rapidly and all out of proportion to increases (or not) in provincial physicians fees. A compromise was arrived at where a baseline CMPA fee was set based on the fee in a certain year according to the specialty. In subsequent years, physicians would continue to personally pay the base fee and in lieu of a fee increase, the provincial departments of health agreed to pay the increased malpractice fee, recognizing that without insurance, physicians could not and would not practice.

The CMPA is known to contest almost all cases. The CMPA states that many suits are brought for frivolous reasons or bad outcomes and these are not considered malpractice. Rather than settle these cases, the CMPA defends what is considered to be non-valid suits. In cases where there is obvious indefensible malpractice the CMPA frequently settles.

In almost any type of lawsuit settlement, the defendant will often require the plaintiff to sign a non-disclosure agreement prior to settlement. As such, settlements agreed to by the CMPA are not publicized.

There have been allegations that the CMPA has at times been overzealous in their defense of medical malpractice cases where the doctor seemed clearly at fault.^[1] Some of this perception may be based on plaintiff misunderstanding of the difference between a bad outcome and actual malpractice.