Tag: #cfpc

How to Make the CFPC More Accountable to Members

NB: My thanks to Dr. Greg Dubord and Dr. Paul Conte for co-authouring this blog.

Dr. Greg Dubord
head shot of Dr. Paul Conte
Dr. Paul Conte

Last June, Ontario physicians changed how the Ontario Medical Association (OMA) is governed. It wasn’t by writing angry letters. It was by registering for a virtual meeting, giving up some of their valuable time by showing up, and voting. The lesson was simple: members CAN change an organization that is supposed to advocate for and defend them, IF they are willing to get just a little bit involved.

The same opportunity is now in front of every practising member of the College of Family Physicians of Canada (CFPC), but the window is short.

WHAT’S ON THE BALLOT

In July, Dr. Greg Dubord, Dr. Paul Conte and I, each filed the same six proposals with the CFPC in accordance with the Canada Not-for-profit Corporations Act. On August 12 the College confirmed in writing that all six will go into the notice of meeting for the October 28 Annual Meeting of Members, exactly as we filed them.

Our motions are bylaw amendments, rather than ordinary resolutions. In 2023, members voted 95 per cent for access to Board minutes and 91 per cent for an independent review of the PGY3 process. Because they were not bylaw changes, the Board treated them as suggestions and declined to implement either. A by-law change means it is mandatory for the Board to follow it.

The full text of the motions (warning – there is a lot of legal jargon), can be found here. In plain English however, the six motions would:

1. Let members elect the President and the Board directly, with any member free to run and no committee screening the candidates.
2. Post Board and committee minutes to the member portal within 30 days.
3. Let members vote electronically in advance on member proposals, using the electronic voting system the College already runs.
4. Accept member proposals year-round instead of an easy-to-miss 60-day summer window.
5. Require the Board to respond formally, within 90 days, to any member proposal that passes: either an implementation plan or written reasons for declining, which members then vote on.
6. Publish five CFPC financial figures every year: travel and hospitality, sponsors over $10,000 by name, spending on the College’s own CPD products, consultant fees, and legal fees.

Number one is the big one. Right now the Board decides, in the by-law’s own words, “in its sole discretion,” who gets to be a candidate, and the President is acclaimed (i.e., installed without a vote) rather than elected. A small group choosing its own successors is the dictionary definition of an oligarchy. Motion 1 begins to democratize the CFPC.

WHAT ELSE IS COMING

The Board is bringing its own package of by-law amendments to the same meeting. At the September 9 member town hall (the recording is on YouTube) the President described it as corrective changes to bring the by-laws into line with federal law. She also said the Board will circulate its own commentary on our six motions alongside its package.

Fair enough. But not one clause of the Board’s package was shown at the town hall. Members will see the text for the first time when the notice of meeting arrives, which the College says will be by October 7. That leaves us just three weeks to read it before the vote.

We will be watching to see if the Board package touches the same sections our motions amend. We also want to see if the motion will be to approve the whole package in a single vote (i.e an omnibus vote) or each Board motion will require a separate vote. We prefer the latter.

One more thing to watch: the order of the votes. The Chair sets the agenda, and it would be natural for the Board’s package to come up before our motions. If their package rewrites the sections on elections, and then Motion 1 comes up, don’t be surprised to hear that the member motion “conflicts with the by-law as just amended.” It doesn’t. Our motions amend whatever by-law is in force at the moment they pass. But it’s the kind of thing that sounds convincing at 8:15 PM with a timer running, so it’s worth knowing before you log in.

HOW THE MEETING WORKS

The College has posted its meeting norms for October 28. If you read them you’ll see it allows only ninety seconds per speaker, with a visible timer. There’s no chat function, so you don’t have a clue what any of your colleagues are thinking. No amendments permitted from the floor.

In other words, nothing gets decided by debate on the night. Everything gets decided by who registers, and who shows up having already made up their mind. If physicians who simply favour the status quo, and the usual from the CFPC are the only ones that show up…….well…….

WHAT TO DO

The three of us recognize that family physicians are ridiculously busy. It has taken far too long for recognition of the unremitting nature of comprehensive family practice to be spoken about. Despite this, not nearly enough is being done to change things. This means that you all have precious little free time. However, the blunt reality is that we can’t change the CFPC for the better, unless members get involved.

We ask all CFPC members to do three things.

First, watch your inbox. The notice of meeting, with all six motions and the Board’s package, arrives by October 7. It will include registration and proxy instructions (yes, there does appear to be a proxy system for the CFPC, unlike for the OMA AGM).

Second, register the day it arrives. October 28, 7 PM Eastern, virtual. Put it in your calendar now.

Third, if you can’t attend, appoint a proxy. The notice will tell you how. A proxy vote counts exactly the same as one cast in the room.

And one question worth asking the College at amm@cfpc.ca: where on the agenda do the member motions sit, and will each be voted on separately? They’ve confirmed the motions are on the ballot. They haven’t said where, or how.

Regardless of what the leadership of member driven organizations may say, member engagement is always a good thing. The more members get involved and have their say, the stronger an organization will be. We encourage all family doctors to join us at the AGM.

We will post again with more information as the situation arises.

CFPC Fails to Learn its Lesson, Makes the Same Mistake Again

Here we go again. You know, after all the body blows the College of Family Physicians of Canada (CFPC) has taken over the years, you’d think they’d learn the most basic of lessons. A membership driven organization should not cheese off its members. Do that and bad things will happen. Yet somehow, they never seem to learn this basic principle.

First, you don’t insult your members, you support them. So when someone (anyone) writes an article that criticizes all your members, don’t publish it. Otherwise, you are basically telling people that you know better than them, and that they should do as you tell them. I actually had warned them when they allowed a miserable, hateful missive to be published that they should pull it and apologize to all their members or family physicians would lose confidence in the CFPC. Alas…….

Second, if you are truly concerned that trainees are not getting an adequate experience, you should first focus on improving the current training program instead of automatically extending it by one year. Do residents really need to go for all these “clinical day backs”, “forum days”, “research days” and “retreats”. Shouldn’t they be laying hands on a patient instead? Should they not be taught real life skills like how to run the business side of things? And so on.

And if you really, really believe that the training period needs to be extended, then communicate properly why it’s not possible to improve the program based the current times. Show every thing you’ve done to fix it. Then clearly explain how an extra year would help – don’t just force it down everyone’s throat.

Thirdly, if you need to raise dues, don’t just ram it down the members throats in a ridiculously convoluted manner. Otherwise people will smell a rat and will fight against it. Instead, clearly communicate why it’s necessary and how the membership will benefit from the increase. The fees we pay should be viewed as a value proposition. Yes we paid $X, but in return we get Y services. Prove Y services are worth it.

Alas, despite promising a “humbler and more transparent organization” just two years ago, the CFPC is at it again. They are once again attempting to get around the membership by baking in annual fee increases that do NOT require member approval.

Buried deep in the meeting package for the CFPC annual meeting, is a motion to amend section 10.5 of the bylaws (copied verbatim):

“THAT section 10.5 of the CFPC Bylaws be amended as follows: The Members shall pay the annual College membership fees applicable to their class of membership, as determined annually by a majority vote of the Board. If the Board intends to increase the existing membership fees for any class or category of membership by an amount that exceeds the annual Canada Consumer Price Index (as published by Statistics Canada for July of each year), and rounded up to the nearest dollar, such proposed increase must be ratified by an Ordinary Resolution of the Members at the Annual Meeting before it becomes effective. Any increase to the annual membership fees becomes effective on July 1 of the ensuing calendar year. Such membership fees shall subsequently be ratified by a simple majority of the membership eligible to vote at the Annual Meeting. Membership fees shall be directed towards the cost of College programs and activities, as determined by the Board.“

In essence, what the CFPC is asking, is to set in place a process where dues go up annually up to the CPI, without any rationale provided to the members. They are guaranteeing themselves annual increases in revenue. To quote a colleague: “It’s really an unprecedented consolidation of power, and removes member centredness from a member centric organization”.

Look, I actually get the need to raise fees (honest!). Contrary to what Ladouceur wrote in his offensive editorial, I actually run my office as a business. I know inflation has taken its toll. My expenses are up. Despite my best efforts at efficiencies, my overhead is higher than it was 5 years ago. I suspect this is the same for the CFPC.

But the solution is not to give the CFPC carte blanche to keep increasing dues. The CFPC needs to show real leadership and say to the members:

“This is what we’ve done with the money. This is the value we bring. These are the efficiencies we’ve implemented. But despite that, this is the increase we need to bring you the organization you deserve.”

And next year, it needs to do the same thing. And the year after. And so on. And that’s how you build an organization worthy of the trust of your members.

In the meantime, if you want to make your voice heard and vote against this nonsense, here’s how to stop it (shamelessly mostly copied from a colleague who gave me permission to do so):

  1. Live, at the Annual Meeting of Members (AMM). Wed Oct 29 from 7-8:30 PM. Details on how to join this were emailed to you by CFPC.
  2. If you cannot attend the AMM, assign a proxy by going here: https://reg.lumiengage.com/cfpc-2025. You will need your unique control number. See the email called “The CFPC’s AMM participation details“.

The bylaw in question is called “Bylaw Amendment Regarding Membership Fees”. Vote “Reject“.

By assigning a proxy, that person you assign does not know your vote, and must submit your ballot as is, so they can’t change your vote. You can assign your proxy to one of the CFPC leadership, or a specific individual with a backup option of CFPC leadership, or a specific individual alone. The danger of the last option is that if that person does not or cannot attend the AMM, your vote does not count. I personally would recommend you assign the CFPC President (who is pretty well guaranteed to attend the meeting) as your proxy.

Let’s stop the CFPC from getting out of hand on this issue. Then we can work on trying to figure out how come the organization never seems to learn its lessons.