Virtual care is here to stay, but not always the right option

·3 min read

“Virtual care can’t be an absolute,” said Dr. Jeff Steeves, president of the New Brunswick Medical Society, a year into the pandemic.

Dr. Ann Collins, president of the Canadian Medical Association and until recently, a family physician in Fredericton, agrees.

“Virtual care was never intended to replace in-person care,” she said.

But at the beginning of the pandemic in particular, it was something that allowed many health-care providers to keep serving patients.

Work had already started on the virtual care front before the pandemic, Collins said. Research conducted by the CMA during the pandemic indicated that it is working well for many patients in many situations, but it is clear a lot still needs to happen, she said.

While the tool has played an important role in some areas, there is very little for virtual care in some specialities, said Steeves, an ophthalmologist.

Disciplines that require physical exams, from much of the world of dermatology to obstetrics-gynaecology, are generally not a good match for virtual care, said Collins.

At the onset of the pandemic, almost all disciplines were going virtual, Steeves said, but as restrictions loosened, many disciplines had to play catch-up. Breast and bowel exams and MRIs, for example, are among those now catching up, he said, and there is an elective surgery backlog.

Even in disciplines that have more potential to work virtually, it can be complicated in other ways, one being privacy.

Patients are now often speaking to a doctor from their home, said Collins, but not all patients have a “safe, quiet and confidential space.”

Tasha Walton of Sackville, has faced this challenge and agrees it’s a major problem when accessing virtual care.

“If I had the choice, I’d definitely go in person again. I live with my fiancé and a roommate, so I struggle finding somewhere private to go,” she said.

Collins noted that mental health care can occur over the phone, as can other specialities that don’t require a physical exam.

However, just because something can happen virtually, doesn’t always mean it should, Collins said; a patient’s desire to see a doctor in-person should also be considered.

Walton said that would be her preference. “My [therapy] sessions lately, I’ve been sitting in our car because that’s the only alone space I can get during those times,” she said.

Walton, 26, said she is also now a year and a half late waiting to get a Pap test, and people close to her are booking the same procedure well into the summer.

Assumptions that virtual health care is always preferred by young people is a problem, she said. “We have kinda been labelled as the technology generation but when it comes to mental or physical health, virtual care isn’t always helpful.”

But virtual care can offer a degree of privacy considered an advantage to some, said Steeves. For example, some people like that they aren’t seen by members of the community in a waiting room or parking at a clinic; virtual care eliminates these concerns.

Those who live far from their doctors or find it difficult to travel may also benefit, said Collins.

As a demographic, virtual care involving video can be difficult for seniors, said Steeves. While the back-up strategy of the phone continues to be a dominant method in the province, it may not be able to capture everything going on, he said.

Virtual care isn’t going away when the pandemic is over, said Collins, but when to do an appointment virtually and when to do it in-person will be important discussion topics going forward.

“Most New Brunswickers understand and agree that our health-care system requires change to better serve the needs of our population,” said Bruce Macfarlane, communications director for the province’s Department of Health. The province realizes that although there are benefits to opening up virtual care options, it can’t replace in-person care and not all patients can benefit from it, he said.

Clara Pasieka, Local Journalism Initiative Reporter, Telegraph-Journal