Doctors' association, nurses' union point to red flags in N.L.'s rush to embrace virtual care
Teladoc awarded $22M contract to provide virtual care for 2 years
Details of the Teladoc Health contract to provide virtual emergency rooms and primary care for Newfoundland and Labrador have been revealed, and health-care leaders have concerns about its cost, suitability and how it's being deployed.
Newfoundland and Labrador Medical Association president Dr. Gerard Farrell says there's still plenty they don't know.
On Monday, Health Minister Tom Osborne unveiled more details about its $22-million contract with Teladoc Health, including the company's plans to open five virtual emergency rooms and offer virtual primary-care physicians in the coming months.
Farrell said he was glad to see Teladoc doctors will have to register with the College of Physicians and Surgeons of Newfoundland and Labrador and the medical association, as well as be paid in line with local doctors — as they were items the NLMA had recommended to the government.
"It's just unfortunate that we find ourselves in a situation where we've got to look at virtual care to fill the gaps that have been created … over the decades that have gone into the present crisis in primary care," Farrell said.
Farrell said he's concerned about the contract's cost, pointing out that one unsuccessful bidder said he could do the work for $3.5 million a year, one-third of the Teladoc $11 million-a-year contract.
Farrell wondered why there was such a discrepancy in those costs and exactly what that money was going toward.
"I think what worries us most is the fact that … we're in this place where we have to look at virtual care being provided instead of … holistic primary care," said Farrell.
He said a better model for primary care is when someone has a family doctor who they can develop a relationship with over time, as opposed to a doctor the patient has never met before.
"That's a dicey situation and it's not good long term," he said.
Virtual care's future
Farrell said he isn't completely against virtual care, saying sometimes a phone call can make a difference.
"But there's an awful lot of situations where you really just have to get that person in. You really just have to lay hands on them. You have to see them."
If a hypothetical patient with a lump in their armpit is told to go to their doctor but doesn't have one, the only option left may be an emergency room, he pointed out.
Pat Parfrey, deputy minister of health transformation, said he believes virtual care is the future and people have to embrace it.
Farrell, in contrast, sees virtual care as a way to augment the work being done by community-based doctors on the ground.
"The idea that we're going to set up, you know, hotlines where people can just phone up and get their prescription for their sore throat or … get an anxiolytic because they're having an anxiety attack. This is not the way to deliver primary care," he said.
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Yvette Coffey, president of the Registered Nurses' Union Newfoundland and Labrador, says virtual care is little more than a "stopgap measure" for the more than 100,000 people in the province without a doctor.
"This is just another example of privatizing health care, just like the use of agency nurses," Coffey told CBC News.
"And it erodes our publicly funded health-care system, which is a concern for not only the registered nurses and nurse practitioners in this province, but for every single person in Newfoundland and Labrador."
Virtual care isn't fiscally sustainable and it isn't for everyone, she said, calling a hands-on assessment the "gold standard."
Coffey, who was part of the Health Accord, wasn't happy to hear Parfrey suggest virtual care is here to stay.
"At the end of the day the best care, the gold standard of care, that people can get is from people under the publicly funded health-care system. Not people or companies who report to their shareholders," she said.
Coffey says there are situations where virtual care can work, citing rural Labrador as an example. However, she's worried standards of care are declining and people are accepting it because of a shorage of health-care professionals.
Instead, she called for more investment into the recruitment and retention of health-care professionals to "stabilize" the system.
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ABOUT THE AUTHOR
With files from The St. John’s Morning Show and Mark Quinn
