After patient visits plunge during COVID-19, N.S. doctors push for virtual sessions

At the beginning of the COVID-19 pandemic, Dr. Mike Wadden heard from an elderly patient who was bleeding significantly, but was too scared to go to the hospital for help.

"By talking to her on the phone, I was able to convince her that the danger of staying home far outweighed any risk that she would have in the hospital," Wadden said.

Wadden, a family physician in Kentville, N.S., said he's seen a noticeable change in his patients since the pandemic started. Many, he said, are hesitant to seek help even though they legitimately need it.

It's a sentiment echoed by emergency room physicians, who say there's been an alarming decrease in visits over the last two months.

Wadden is trying to reassure his patients that he can help the vast majority virtually, through a system that is being adopted by hundreds of doctors across Nova Scotia.

But he can't help them if they don't ask for an appointment first.

"It has done remarkable things," he said of the technology.

Wadden was one of the early adopters of virtual care. His patients span hundreds of kilometres from Halifax to Annapolis Royal, including many rural communities.

The system, which is attached to electronic medical records, allows him to securely message, call and video chat any of his patients, including those with spotty connections.

It also allows them to share photos, which Wadden said has proved useful for diagnosing things like rashes.

"The photos that we can take on our cellphones now are excellent," he said.

Why one patient chooses virtual care

In Gaspereau, N.S., Kaitlyn LeCouter said virtual care has been a huge help. LeCouter and her seven-month-old son, Finley, are two of Wadden's patients.

In order to see the doctor, she has to borrow her parents car and drive 30 minutes each way for an appointment.

"I worry about taking my son out in public at all," she said of the pandemic.

Now, LeCouter only goes out if Finley needs an immunization. Otherwise, she and Wadden use messaging and video chats to check in on the baby's growth and eating habits.

"It's super easy to get ahold of Dr. Wadden," she said. "If I message him on it, within a couple hours, I hear back."

While Wadden was ahead of the game, Doctors Nova Scotia says more than 400 physicians have been taking webinars to learn the technology and catch up. It says about 1,200 physicians are now using video conferencing.

Wadden said they're quickly learning the fine balance between virtual appointments and the need to physically see a patient.

In many cases, Wadden uses virtual meetings as a way to triage. If he has further concerns, he asks a patient to come to the office.

Benefits of virtual appointments

The video option was added just before the pandemic, and Wadden said that has a significant benefit, especially for psychological issues.

"On the phone, if there's a pause, you're not quite sure if a person is upset or thinking, but with video conferencing … I can kind of read those facial cues to try to determine what's going on and when I need to interject or when I can wait for the answer," he said.

Wadden spaces in-person appointments throughout the day and hosts virtual meetings in between.

That way, the waiting room is always empty, and there's time to clean in between each visit.

"The less we have travelling, the less we have people waiting in waiting rooms. The less chance there's going to be a spread of COVID," he said.

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