Our health-care leaders wilfully ignored the benefits of virtual walk-in medical care

Posted on January 22, 2023 in Health Delivery System

Source: — Authors:

TheStar.com – Opinion/Contributors
Jan. 22, 2023.   By Aviva Lowe, Contributor

Virtual walk-in care is being held to an impossible standard that is not applied to any other aspect of health-care delivery, writes Aviva Lowe.

A recent Toronto Star headline reads: “Patients who use virtual walk-in clinics more likely to go to ER later: study.”

This was the conclusion of a recent study comparing ER visits of patients using a virtual walk-in clinic to patients seeing their own family doctor for virtual care.

Is it any surprise?

We don’t need a study to tell us that patients who have a family doctor tend to visit the ER less often than those who don’t have a doctor or those who don’t have timely access to their doctor. There’s a selection bias at play.

Such a headline misleadingly implies that virtual walk-ins lead to more ER visits.

Sadly, this is perpetuated by one of the study’s authors who stated that virtual walk-in visits “can add to an already overwhelming strain on the emergency departments.”

Conflating an association between virtual walk-in clinic visits and added ER visits with causation perpetuates the thinking of our health-care leaders’ that virtual walk-in clinics are subpar. It is being used to justify the recent defunding of such care.

Moreover, virtual walk-in care is being held to an impossible standard that is not being applied to any other aspect of health-care delivery in our province.

Through statements such as “Virtual care is best when it’s with one’s own physician” and “Virtual care is only worthwhile if the same doctor providing it can also guarantee an in-person visit,” the Ministry of Health and Ontario Medical Association further justify their disdain for — and defunding of — any other type of virtual care, notably “walk-in” virtual care, that doesn’t fall into these “ideal” scenarios.

If Ontario only funded health-care services that took place under ideal circumstances, then by the same logic, funding for myriad other health-care services would be similarly slashed.

Ontarians, on average, wait a suboptimal 111 days for priority two hip replacement surgeries, instead of the target 42-day wait.

Should OHIP cut funding for all surgeries that take place outside of the target 42 days?

Only 21 per cent of patients awaiting admission to the hospital from the ER are admitted within the target of eight hours. The average wait time in the province is actually 22.9 hours. Should we stop funding hospital admissions from the emergency department for the 79 per cent of patients who are forced to wait longer than the ideal time frame?

Of course not.

Yet as preposterous as these “better never than late” scenarios sound, this is exactly what befell virtual walk-in services in Ontario.

Ironically, while Ontario is finding every excuse to limit people’s access to virtual-care services, Quebec recently announced it is maintaining full funding for virtual care, citing the inherent value in and need for its continuation.

It really would have behooved our leaders to study the data from one pediatric virtual urgent care clinic. The clinic I am referring to, Kixcare, saw approximately 2,000 children each month, with 92 per cent of families reporting that such care saved them a visit to the ER. So, approximately 1,800 pediatric ER visits were diverted on a monthly basis — until these services were shuttered on Dec. 1, 2022.

But alas, none of this fits the narrative that scapegoats virtual care.

Not only did our health-care leaders hold virtual walk-in care to an impossible standard of perfection, but they wilfully ignored its benefits, and wildly misconstrued its impact. All of which contributed to and was used to justify its untimely and tragic demise.

How will our leaders explain all this to the 1.8 million Ontarians without a doctor, and to the millions more who cannot access their doctor in a timely fashion, who have had virtual care — their health care lifeline — mercilessly taken away from them?

Regrettably, the next headline will likely read: “Patients who can no longer access virtual walk-in clinics are more likely to go to ER as they face a further barrier to health care: common sense.”


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