Medical Legal Coverage Raises Flags – Winnipeg Free Press

Millions of Manitoba taxpayer dollars subsidize doctors' membership in an organization that pays legal expenses — mostly for lawsuits, hospital claims and professional discipline — but also for certain criminal cases.

However, the organization is refusing to say whether it will pay for the legal defense of a former Manitoba doctor recently convicted of sexual assault.

The Canadian Medical Protective Association describes itself as a “mutual medical defense organization” for Canadian doctors that protects their “professional integrity” and “improves patient safety and compensates patients who have suffered negligence.”

According to CMPA's 2022 annual report, its assets are $5.4 billion. The organization clarifies that it is not an insurance company – it does not require doctors to pay deductibles and does not raise premiums.

In Manitoba, physicians pay thousands of dollars in annual dues to the CMPA, which are then partially reimbursed through the province's rebate program. In turn, they have access to legal help and advice, including information about litigation or the threat of litigation, regulatory complaints or criminal matters related to their work, as well as information about improving patient safety and a range of other services.

According to the province, a total of $108.5 million from taxpayer dollars has been sent to doctors through Manitoba's CMPA rebate program over the past 10 years, including $12 million in 2022-23.

As for funding criminal cases, CMPA policy “uses its discretion to provide assistance” by paying for a member's legal defense in cases where a criminal charge arises out of a physician's medical practice.

CMPA does not say whether it has paid legal costs associated with the defense of Arcel Bissonnette, the former Ste. Anna's family doctor was convicted of sexual assault. A spokeswoman said the organization “cannot comment on individual members or on litigation matters.” His lawyer, Martin Minook, said the same.

Bissonnette was convicted of sexually abusing five patients last fall. Earlier this month, he pleaded guilty to two more sex crimes, avoiding a third trial. He remains on bail and will be sentenced in June. He is also responsible for the civil case of five women whose charges were dismissed in the first court. His medical license was revoked after his conviction.

Arthur Schafer, an ethics expert, called the CMPA's refusal to say whether it would fund Bissonnette's legal defense “outrageous ethics.”

“The public has a right to know,” said Shafer, founding director of the Center for Professional and Applied Ethics at the University of Manitoba. He said CMPA receives “substantial public dollars” and has a “moral obligation” to be transparent.

Two of the alleged victims in the Bissonnette case were shocked to learn that taxpayer dollars were supporting his legal defense.

“I understand that doctors have malpractice insurance, which makes sense because accidents happen, but not in criminal sexual assault cases because it's not an accident,” said one victim, who could not be named. His charges were among the rest.

Another woman whose charges were dropped said she was “disgusted” to learn that the CMPA would cover legal fees in similar cases.

“It's hard to deal with,” he said. “It's really gross.”

The Canadian Taxpayers Federation also raises the issue of the use of public funds in criminal cases.

“It's certainly very upsetting,” said Gage Haubrich, the organization's field director.

According to Haubrich, doctors convicted of criminal offenses should be required to pay court costs.

CMPA declined to provide a representative for an interview. CMPA CEO Dr. Lisa Calder said in a statement that the association works with doctors to prevent harm and improve patient safety and does not condone sexual assault.

“We understand that sex-related allegations can be devastating for everyone involved; but like all Canadians, doctors should be presumed innocent until proven guilty,” he said. “Thus, where the CMPA provides assistance, it does so on the basis of the presumption of innocence; and we will continue to provide fair and ethical protections for physicians.”

Calder said the CMPA “does not provide additional assistance when convicted of sexual assault.” It also will not pay settlements or costs in cases where a member is accused or found to have “engaged in sexual harassment.”

Paul Harte, a Toronto-based medical malpractice lawyer, disagrees with the CMPA's position.

“You find that they are willing to fund legal defenses against doctors who have been sexually assaulted, but they don't use their discretion to compensate those victims,” ​​he said. “As a publicly funded organisation, their priorities have changed.”

It is unclear how many criminal cases CMPA has assisted in Manitoba. Statistics from its annual report show that in 2022 there were 18 medico-legal cases classified as “other,” which includes criminal cases as well as human rights complaints, investigations and privacy reviews, in the “SMAT” region — Saskatchewan, Manitoba, Atlantic Provinces and Territories.

In his statement, Calder emphasized that CMPA is not a taxpayer-funded organization.

“Membership fees are paid entirely by members,” he said.

However, this description is rejected by critics.

“The perception that it's not public money is wrong,” Harte said. “Just as hospitals and doctors are funded by the state, the reimbursement program is funded entirely by taxpayer dollars.”

“The notion that this is not public money is wrong.”– Medical malpractice attorney Paul Harte

According to Hart, the CMPA's main interest is protecting the reputation of physicians, which it takes great pains to accomplish. His deep pockets allow him to take a “scorched earth” approach to litigating, dragging out cases and collecting fees, he said.

“It is not in the public interest,” he said. “I don't understand why doctors are given this protection when other professions are not.”

Hart said it can be difficult for injured patients to find an attorney willing to take their case. Going against CMPA-funded lawyers means the costs are high, he said, and if the injury isn't catastrophic, it may not make financial sense to sue.

In response, Calder said the CMPA would assess each case and try to resolve it “as soon as possible, if necessary.”

Chris Woollum, a medical malpractice lawyer in Winnipeg, is less critical of CMPA practices.

“The (CMPA) places the burden on the plaintiff to prove their claim, regardless of the minor injury or catastrophic event,” Woollum said. “I don't blame the CMPA for playing by these rules and protecting the reputation of doctors.”

“The problem with the system is the disparity in the cost of litigation relative to the amount of damages that can still be recovered for negligent wrongs.”– Medical malpractice attorney Chris Woollum

However, Woollum said it was the existing legal system that presented a potential “access to justice” problem.

“The problem with the system is the disparity in the cost of litigation versus the amount of compensation that could be recovered if the wrongs were negligent but the injuries were less severe,” he said. “In such cases, even though negligence may still have occurred, litigation is usually not pursued.”

Doctors of Manitoba, which facilitates the benefits program on behalf of Manitoba Health, said doctors are “disgusted and appalled” by the Bissonnette case.

As for the rebate, spokeswoman Keir Johnson said it “covers part of the annual liability indemnity payment that all doctors are required to practice medicine”.

“Our rebates never cover the direct costs a doctor would incur in criminal court,” Johnson said, adding that the rebate helps Manitoba remain “competitive” in recruiting and retaining much-needed doctors.

Liability insurance rates can run into the tens of thousands of dollars, depending on the specialty, he said.

The funding model is similar in other provinces and is not unique to Manitoba.

“The need for doctors to work in Manitoba with reasonable protections must be balanced with the needs of patients to be safe and seek justice when they have been wronged,” said Manitoba Health Minister Uzoma Asagwara. CMPA.

— With files from Dean Pritchard

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