Medical clinic shutting down after province cuts payments for virtual care

Jennifer Peirson says the Good Doctors clinic in Mallorytown is essential for her and others without a family doctor. The site is set to close on Jan. 20, and it blames changes in the amount doctors can bill for virtual visits. (Dan Taekema/CBC - image credit)
Jennifer Peirson says the Good Doctors clinic in Mallorytown is essential for her and others without a family doctor. The site is set to close on Jan. 20, and it blames changes in the amount doctors can bill for virtual visits. (Dan Taekema/CBC - image credit)

Jennifer Peirson has been searching for a family doctor for more than four years, and in that time she's come to rely on a walk-in clinic in Mallorytown, Ont., for primary care.

Now she's preparing to lose it too.

The Good Doctors virtual care clinic in the rural eastern Ontario town, part of Front of Yonge Township along Highway 401, is one of 17 across the province. It's set to shut down Friday.

The CEO of the company says all of its sites including those in Barrie, Kingston, Peterborough, London and Windsor will close unless the province reverses a reduction in fees for virtual visits or communities help cover the cost.

Residents fighting to keep the Mallorytown clinic open point to the situation as an example of the province failing rural Ontarians.

"It frustrates me and I'm sickened, not just for myself, but for all of the people around here that do not have a family physician," said Peirson during a recent visit.

"It's very essential. Mentally and physically, this clinic is needed."

Good Doctors was launched in 2016 and provides virtual appointments with physicians. There's one key difference between the service and other online options, according to founder Leo Liao — a nurse is on site to carry out examinations and collect samples.

Peirson said the registered practical nurse at the Mallorytown Pharmacy and Health Centre is more than a familiar face: she provides a connection with a health-care worker whom patients have come to know personally during visits for both routine and serious health issues.

Dan Taekema/CBC
Dan Taekema/CBC

People across the province turned to online care during the COVID-19 pandemic and doctors were permitted to bill OHIP a $37 fee.

As of Dec. 1, 2022, the company has been told it can only bill $20, which is too little for the clinics to survive, said Liao. The change has seen many doctors leave virtual care.

He argues the presence of a nurse sets Good Doctors apart and has written to Health Minister Sylvia Jones, which he hopes could help keep the company's locations open.

"It's a little definition thing, a tiny little thing, but the impact of it is there will be tens of thousands of people who will not have access to this care," Liao said.

Ontario's Ministry of Health did not respond to a request for comment.

Roughly 1,800 patients have used the clinic in Mallorytown, according to a post the company shared on Facebook to announce the closure. The province is widening "health inequality" between rural areas and urban centres with walk-in clinics, it added.

While people get better care during in-person visits, that's not an option for many who live in areas without family doctors. If the clinic closes, rural residents can't walk down the street to another, said Liao.

Front of Yonge Township Mayor Roger Hayley said the clinic doesn't just serve Mallorytown but the entire region.

"It's an emergency situation," he said. "Jan. 20 it shuts down, and where are they going to go next?"

Hayley also said the thousands of patient visits at the clinic helps lessen the load at the emergency department at Brockville General Hospital, which is a 20-minute drive away.

"Rural areas have been forgotten," he said. "The system is broken [and] the government's not helping it. They're contributing to the problem."

Hundreds sign petition to save site

People in Mallorytown and the surrounding area have spent the past few weeks signing a petition to save the clinic.

Angie Cowan is one of the petition creators. She said copies left at popular stops including the library, post office and Royal Canadian Legion have collected hundreds of signatures.

Dan Taekema/CBC
Dan Taekema/CBC

"It's hard to get in and out of the dump unless you sign the petition," she said with a laugh.

"This is relieving the pressure off the emergency room and that is very important. [The hospital is] clogged, congested, understaffed. It's terrible," Cowan said.

Feeling let down by government

Bryan McPherson moved back to the Mallorytown area more than two years ago, but he hasn't found a family physician.

That's a far cry from when he was growing up in the small town and a doctor rented rooms from his family's big stone house.

McPherson said he and four other family members have come to rely on the walk-in clinic.

His daughter-in-law has a thyroid condition that requires checkups and tests every six months. The doctor he meets with virtually also helped spot an issue with his heartbeat and arranged a visit with specialists.

Dan Taekema/CBC
Dan Taekema/CBC

McPherson said he feels let down by the provincial government and worries about what will happen to people without someone to see them regularly.

"It could cost people their health, their life, to the point where maybe they end up in some sort of long-term care, because they didn't have the opportunity to have the ability to diagnose your condition early," he said.