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‘We’re not going back’: Doctors give high marks to virtual appointments

TORONTO — If you had a doctor’s appointment during the pandemic, there’s a good chance it was over the phone, or on a video call–and that practice is expected to continue in the future.

Canada has been slowly transitioning towards virtual health care for a number of years, but the lockdowns and states of emergency that came with the onset of the pandemic about 1.5 years ago accelerated the process.

“Virtual care sort of catapulted into our practices,” Dr. Ann Collins, president of the Canadian Medical Association (CMA), said in a telephone interview on Wednesday.

And about 70 per cent of doctors doing virtual appointments are satisfied with them, according to a survey by the CMA and Canada Health Infoway (CHI), which was released on Wednesday.

In the early days of the pandemic, Fredericton-based Collins said, virtual care was crucial because of the extreme situation of dealing with a dangerous and deadly virus about which very little was known.

Collins, who had a family practice for 34 years before taking over as the head of the CMA in July, said doctors and patients were very grateful to be able to connect by phone, email or video when in-person visits were impossible.

“What’s become evident is that there’s a great deal of benefit to virtual appointments,” Dr. Collins said. “We’re not going back to where we were in March 2020.”

About 94 per cent of doctors currently provide care through virtual means, according to the survey, which was completed by 2,071 of the roughly 80,000 CMA physicians, between April 29 and May 25 this year and has a margin of error of 2.12 per cent, 19 times out of 20.

Canada worked hard to move very quickly on virtual care during the pandemic, Michael Green, president and chief executive officer of CHI, an independent not-for-profit organization funded by the federal government to promote digital health, said in an interview Thursday.

“I’m hopeful we will continue to increase virtual care,” Toronto-based Green said, adding that he’d like to see half of all health visits done virtually within three to five years.

Nearly all of the doctors in the survey, which included 1,000 general practitioners, 973 specialists and 98 residents, offer telephone consultations, 51 per cent offer video and 36 per cent secure email/messaging.  

“We all know there is more demand for health services than supply, so if you can make the system more efficient … it will free up doctors’ time,” Green said.

And that’s important when you consider that about five million Canadians don’t have a family doctor.

The virtual approach is also good for routine appointments, saving patients and doctors time and making services more accessible.

However, not everything can be done virtually. Face-to-face appointments are still necessary for things such as physical examinations and vaccinations.

And more investment is needed to expand and develop services across the country, Collins and Green said.

But virtual health care can really help Canada, Julia Zarb, a professor with the University of Toronto’s Dalla Lana School of Public Health, said by email on Thursday.

“Our broad geographies and sparsely populated areas mean that many people cannot get the care they need without travelling, and cannot access specialty care locally,” Zarb said. “For some patients the hardship is in incurring costs, time away from work and home, while for others access issues could cause delays in diagnosis. The more access we can help people have to care, the more we can reach our value-driven goals of health equity.”

She thinks virtual tools may help to personalize care.

“It will take ongoing change management on the part of patients and providers to ensure the positive aspects of the ‘virtual surge’ are carried forward,” Zarb said. “There is interesting work being done in the idea of ‘digital compassion’ meaning that we are building increasing skills to build respectful patient relationships virtually.”​

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