‘Apologies are an opportunity’: Supporting reconciliation in health care across Canada

Press Release

June 5, 2025

Counselled by an Indigenous Guiding Circle of Elders, Knowledge Keepers and health experts, the Canadian Medical Association (CMA) issued a public apology last fall for past and present harms to First Nations, Métis and Inuit Peoples in the health system.

It was a necessary first step toward meaningful reconciliation in health care, says Dr. Alika Lafontaine, the CMA’s first Indigenous president and now its Indigenous advisor in residence.

“You can’t always make whole people who have been harmed, but you can choose to start toward something different, and to a great degree, ask people to trust again, even though that trust has been broken,” he says.

But rebuilding that trust can’t happen in isolation. The CMA’s path has been informed by the work of many others, including provincial and territorial medical associations who bore witness to the apology at a ceremony in Victoria. And the apology was meant as a spark for a larger movement of change across the health sector.

Change is urgently needed. Since the Truth and Reconciliation Commission of Canada released its 94 calls to action Opens in a new window in June 2015, including seven related to health care, First Nations, Métis and Inuit Peoples continue to suffer from structural and direct racism — with disproportionately poor access to care and negative health outcomes.

In a 2024 survey by Statistics Canada Opens in a new window, more than one quarter of Indigenous Peoples reported unmet health care needs in the previous 12 months. One in five reported unfair treatment, racism or discrimination from a health care professional, often involving health concerns being minimized or dismissed. And these numbers offer a limited reflection of the challenges faced by Indigenous Peoples seeking care.

The importance of the CMA’s apology was recognizing these truths, says Dr. Lafontaine, as well as following words with action, showing “that there’s a space to have impact. Apologies are opportunities,” he says.

The CMA’s Reconciliation Action Plan outlines the opportunities it’s taking to advance reconciliation. Here’s a snapshot of some of the other work underway across the sector and the country to recognize and respect Indigenous experiences and expertise in health care.

Alberta Medical Association

Like many provinces and territories, the Alberta Medical Association (AMA)’s policy direction is determined by physicians who represent the full spectrum of the profession – from family doctors to rural and remote practitioners to specialists. This spring, the AMA voted to establish a new section on Indigenous health Opens in a new window to ensure clinicians working with Indigenous Peoples have a strong voice in decisions that impact patients.

Although work on the new section was already underway when the CMA made its apology, Dr. Cassandra Felske-Durksen, an Otipemisiwak family physician in Edmonton and chair of the AMA’s Indigenous Health Committee, says it helped support changes at the association by “amplifying the goals and principles” behind reconciliation efforts.

“The apology socialized the idea that we really do have an opportunity to effectively action reconciliation.”

Doctors Manitoba

With the highest percentage of Indigenous people of any province, Doctors Manitoba is especially attuned to the need for equitable care. The organization’s president Dr. Randy Guzman and president-elect Dr. Nichelle Desilets participated in the CMA’s apology and were struck by the “energy for change Opens in a new window.”

Last year, their association formally added equity, diversity, inclusion and decolonization (EDID) as a new foundation to its strategic plan Opens in a new window, with the goal of improving access to care for Indigenous patients.

While the organization acknowledges “there is much more work to do,” it has learned from Indigenous members, as well as the CMA and the College of Physicians and Surgeons of Manitoba. Their “strong work in this sphere is only helping to improve our own,” says a Doctors Manitoba spokesperson.

College of Physicians and Surgeons of Manitoba

In 2023, the College of Physicians and Surgeons of Manitoba (CPSM) apologized Opens in a new window to First Nations groups for racism in medical practice — something that meant a lot to Dr. Lisa Monkman, a family physician and Ojibway member of Lake Manitoba First Nation.

“My own family members continue to suffer from the harms of racism and are continually hurt by systems that seek to oppress us,” says Dr. Monkman, who leads the CPSM Indigenous Advisory Circle and is a CPSM council member. “So, the apology, for me, personally, was a starting point.”

Dr. Monkman was also present for the CMA’s apology and valued their work with Indigenous staff to connect and consult with different groups. The CMA “managed to gather some really amazing voices,” she says.

Following the CMA’s apology and its own work and consultations with Indigenous groups, the CPSM approved a standard of practice Opens in a new window to eliminate anti-Indigenous racism in medicine last December. They aim to launch the standard and mandatory training this June.

It will also present a restorative practices program that helps practitioners challenge their biases “in a way that is more restorative than our traditional blame, shame and punish, colonial approach for complaints,” says Dr. Ainslie Mihalchuk, CPSM registrar and CEO.

“This work is not performative, it is transformative,” she says. “This is about making changes that will impact the health and well-being of residents of this province, hopefully forever.”

New Brunswick Medical Society

The New Brunswick Medical Society (NBMS) is at the start of its journey toward reconciliation. In January 2025, its board affirmed its commitment to meaningful engagement with Indigenous communities. Important discussions to determine a path forward grounded in respect, collaboration and cultural safety followed.

“Inspired by the leadership of the CMA,” says Dr. Lise Babin, NBMS president, “we are committed to listening to Indigenous voices and supporting culturally safe practices.”

The NBMS has begun to build relationships with First Nations communities and remains dedicated to moving forward in a manner that reflects the direction and pace set through ongoing dialogue with its Indigenous partners.

Canadian Medical Forum

In December 2024, members of the Canadian Medical Forum — which include the College of Family Physicians of Canada, the Royal College of Physicians and Surgeons of Canada, the Indigenous Physicians Association of Canada and Black Physicians of Canada, among others — issued a statement on their commitment to truth and reconciliation and anti-racism in Canadian health care.

On an annual basis, the CMF will review progress as well as barriers to respect for Indigenous worldviews of health and support for more Indigenous leadership within their organizations.

Says, Dr. Lafontaine, “Most doctors are looking for where they can make the biggest difference. Immediately after apologies, the opportunity to make a difference is significant.”

“We’re past the point where we’re debating whether harm happened. The CMA has said the words that needed to be said, including ‘I’m sorry.’ We’re now in the action stage. We get to work together to make things better. We can have a new beginning.”

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