Billed as remedy for doctor shortage, virtual medicine in N.S. hits bottleneck
Early in the COVID-19 pandemic, virtual medicine offered a novel way for patients to see doctors during a lockdown and hope that technology could alleviate chronic pressure on a strained health system.
For many in Nova Scotia, though, the early promise has proven illusory.
Tim Neufeld, 28, from Dartmouth, N.S., has been on Nova Scotia's wait-list for a family doctor for five years. He said in a recent interview that he was left frustrated after several unsuccessful attempts at securing a virtual appointment.
"The biggest hurdle is just accessing the system, having to log on between 8:59 a.m. and 9:09 a.m.," he said, noting that when he tried to sign up for virtual care after 9:10 a.m., all the day's appointments were already booked.
"Obviously the demand far exceeds the supply, so there's some pain around that and whether or not you're able to even get the care you need."
Sara Wallace, 48, from Dartmouth, compared the experience to "trying to buy concert tickets." She said she tried unsuccessfully to schedule a medical appointment four times over two weeks before finally succeeding.
Nova Scotia launched its virtual health platform in May 2021, and it now has 67 health professionals -- physicians and nurse practitioners -- who provide virtual consultations on top of existing general practice commitments.
Brendan Elliot, a spokesman for Nova Scotia Health, said in an email that there are between 150 and 200 virtual visits available on a typical weekday, available to the 120,400 people in the province without a family doctor.
Elliot acknowledged that demand is high and said the province is trying to recruit more doctors and nurses to take part.
Zen Tharani, founder and CEO of Victoria-based digital consulting firm Xenex Consulting Inc., said in an interview that challenges are expected in the early stage of virtual care implementation, but a bottleneck at the booking stage is a problem.
"It really defeats the purpose" of virtual care, which should be increasing access to medical care and improving the patient experience, he said.
Tharani, who has worked in digital health for 22 years, said a process like Nova Scotia's that requires logging in quickly during a short time frame is likely going to be a barrier to those who have poor internet connection or are less comfortable using digital tools.
"We don't want people to feel left behind," he said.
Because provinces are implementing different methods of virtual care, access looks a bit different in New Brunswick, where virtual appointments are funded for everyone -- not just those without a family doctor.
Kelly Stokes of Saint John N.B. uses virtual health care for herself and her young daughter through the province's eVisitNB application.
The 27-year-old said in an interview the experience was "hit or miss" when she first tried it a year ago -- but she said it has improved as some referrals were outsourced to nurse practitioners and doctors in other provinces. She said a nurse practitioner based out of Ontario provided care for her daughter last month.
New Brunswick's eVisitNB, which is operated by virtual health company Maple, is staffed mostly by nurse practitioners and a few physicians who may be working remotely from other parts of the country.
Like Nova Scotia, Prince Edward Island reserves provincially funded virtual appointments for residents without a family doctor or primary care provider. In Nova Scotia that represents about 12 per cent of the population, and in P.E.I. it's more than 15 per cent.
In Newfoundland and Labrador, where the medical association reported in June that about 24 per cent of residents were without primary care, virtual appointments are covered for everyone. The appointments are provided by Springdale, N.L.-based telemedicine company Medicuro, which employs 16 local physicians.
Last month, the medical director of a Medicuro virtual clinic called on the province to raise the cap on the number of daily appointments funded by the province. Dr. Todd Young said in a statement that the province's limit of 40 virtual appointments a day is far too low given the number of residents without a family doctor and the circulation of influenza, COVID-19 and respiratory syncytial virus.
"The time is now to remove any restrictions to available reliable and professional health care," Young said. The province's health department has not said if it is considering funding more appointments.
Tharani said it's very positive to see that provinces are using virtual care to fill in some of the gaps caused by a shortage of primary care providers, and agrees that limits should be removed from virtual care whenever possible.
"Why would you want to put limitations on innovation and accessibility in that way?" he asked.
Tharani said that while virtual care does not work for everything, there's potential to use it strategically to increase efficiency in pre- and post-operative care, emergency medicine and mental health care.
Part of the challenge, Tharani said, is that advances in telehealth have happened in a rush as the pandemic dramatically increased the need for virtual medical care.
"It's difficult because a lot of this is happening in panic, it's reactive," he said, adding that there is a need to step back and look critically at the system.
Neufeld and Wallace both said that once their appointments were booked, they enjoyed the experience of using virtual care.
Wallace, who lost her longtime family doctor when he closed the practice in June, said that the virtual appointment she secured on her fifth attempt led to an in-person followup six weeks later.
She said that appointment, in a Halifax clinic reserved for virtual patients, was "the most thorough medical appointment of my adult life."
It was a complete change from the "packed and overcrowded walk-ins" in the Halifax area she's had to visit since losing her doctor.
"I think there's real potential here for this to positively change the way things are done," Wallace said.
This report by The Canadian Press was first published Dec. 7, 2022.
This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.
This is a corrected story. A previous version misspelled the last name of Zen Tharani.
CTVNews.ca Top Stories
The Department of National Defence says Canada is working with the United States to protect sensitive information from foreign intelligence threats after a high-altitude surveillance balloon was detected.
Magic mushroom dispensaries are popping up in cities across Canada, with customers ranging from those looking for treatment for depression or PTSD to people wanting to 'micro-dose' a small amount of psilocybin, the hallucinogenic compound in magic mushrooms. But while the situation is in some ways reminiscent of when cannabis retailers set up shop before marijuana was legalized in 2018, Health Canada says there are no plans to legalize or decriminalize psilocybin products.
Hundreds of customers who scan QR codes for restaurant menus across Canada are being surprised by secret menus instead, revealing the hidden costs behind the food they eat.
With the anniversary of Ukraine's invasion by Russia around the corner, CTV News sat down with a Russian warfare expert to discuss how he sees the conflict playing out and what happens next.
According to Environment and Climate Change Canada, as of Thursday morning there were extreme cold or winter storm warnings active from coast to coast, with the harshest extreme cold warnings stretching from northern Alberta all the way to Nova Scotia.
One of Saskatchewan’s oldest hockey rinks has garnered national attention for its unique features and unusual design.
A paramedic signing off for duty for the last time got choked up and teary-eyed during his final radio call to colleagues.
Quebec is changing its vaccine strategy: public health officials are now recommending booster shots only for vulnerable people who have never had COVID-19.
Would you pay $300 a year for quick access to a nurse? Dealing with demand, Ontario doctors get creative
Paid subscriptions to on-demand care are among the many strategies primary health-care providers in Ontario are adopting in order to meet increased demand for access to doctors in the past year, while also managing staffing shortages.
'We win or it’s free' paralegal bribed court clerk in traffic ticket fixing scheme: testimony alleges
A paralegal firm whose tagline is “we win or it’s free” bribed a Toronto traffic court clerk to change legal records to make it look like they had won, said the clerk in the first time he has testified publicly about the case.
Toronto and most of Ontario are in for a frigid bout of winter weather, according to Environment Canada.
A group of Ontario Greens have put together a counteroffer for Liberals trying to poach their leader.
After years of decline, demand for Calgary's downtown commercial real estate is showing signs of returning to life.
Artur Pawlowski is charged with breaching a release order and mischief for inciting people at the border crossing, where truckers gathered to block a highway.
Curling Canada says it is opening up its pregnancy exemption eligibility to all teams competing at next year's Canadian women's and men's championships, with the announcement coming a day after the organization came under fire for limiting the exemption to just the top five teams in the rankings.
After an extremely mild month of January, the province is bracing for a blast of arctic air that will move in tonight and last until Saturday. Environment and Climate Change Canada has issued extreme cold warnings that covers most of the province with wind chills expected to be between -38 and -42 across the South and -50 across Northern Quebec.
A beloved man who was a fixture on the streets of Montreal's Notre-Dame-de-Grace neighbourhood died last year from a combination of street drugs in his system, including fentanyl, a coroner has ruled.
Medicago's parent company has announced that the Quebec City-based biopharmaceutical company, which developed a vaccine against COVID-19, will cease operations.
If EPS, sheriffs try a hard crackdown on inner-city Edmonton it could make things worse: criminologist
A former Edmonton Police Service officer believes bringing Alberta Sheriffs into downtown Edmonton is a risky plan that has the potential to backfire if not done properly.
The Operation Friendship Seniors Society (OFSS) announced Wednesday that it would be shutting down services at the McCauley Seniors drop-in facility.
A new public art installation has blossomed in a downtown Edmonton neighbourhood.
An argument between two young children playing outside together escalated to violence when a parent got involved, a North Bay mom says.
The Ontario Lottery and Gaming Corp. is holding a big reveal Friday morning: the winner of a $48 million Lotto 6/49 Gold Ball draw.
The past few weeks have been a bit of a roller coaster for 16-year-old Ra'Jah Mohamed, a student at Lo-Ellen Park Secondary School.
One person has died and four others were sent to hospital after a two-vehicle crash in south London Wednesday night. She has since ben identified by her former cheerleading coach as 19-year-old Chloe Mackenzie.
Two-year-old Ella Crosset loved to dance and celebrate Halloween. Her smile lit up a room, and brought joy to so many people. But Ella passed away after a pool accident, and the pain of that loss was incomprehensible — through tragedy however, comes hope.
Environment Canada has lifted a snow squall warning for the London region Thursday evening, but a cold weather alert from the Middlesex-London Health Unit remains in effect. In addition, Grey-Bruce and Huron-Perth remain under snow squall and extreme cold warnings.
New documents show what led to a couple handing out cannabis-infused gummies to children in Winnipeg - and what happened in the hours directly after.
Ducks Unlimited Canada is celebrating World Wetlands Day by highlighting a success story in Niverville, Man.
A mobile home owner could potentially be out thousands of dollars after learning her home might not be insurable.
EXTREME COLD WARNING
EXTREME COLD WARNING | Temperatures to drop to -30 C the next two nights in Ottawa
Environment Canada has issued an extreme cold warning with Ottawa expected to see its coldest temperatures in years.
Two parents are facing charges of criminal negligence causing bodily harm after a toddler suffered an opioid overdose at a home in Kingston, Ont. last week.
As March Break approaches, travel agents are experiencing a surge in bookings, with many families choosing to travel to Disney World in Florida despite the rising cost.
Aaron Benneweis, 46, has been charged by Saskatoon Police with sexual assault and sexual exploitation of a minor while in a position of trust or authority.
Brian Hodgkinson always knew there was benzene in natural gas — after all, he spent 40 years working with it for SaskPower, then SaskEnergy.
A report written and reviewed by Saskatoon Water is calling on the city to create a warning system, in particular for drivers, when roadways become “dangerously flooded” due to heavy rain.
CTV News has learned that four of five RCMP officers facing charges in the death of an Indigenous man during an arrest in Prince George are still on active duty.
A man who was gunned down outside of his business in South Vancouver never got the chance to meet his daughter, a court heard as his killer was sentenced.
A nationwide billboard campaign that appears to promote grunge-chic clothing for street youth is causing confusion and igniting debate.
One of Saskatchewan’s oldest hockey rinks has garnered national attention for its unique features and unusual design.
The final details are being chiselled into place at the REAL District in preparation for the second annual Frost Festival taking place Feb. 3 to 12.
The Farmer and Rancher Mental Health (FARMh) Initiative has launched a mental wellness network along with a virtual toolbox full of mental health resources for the agriculture community.
A teenager from Nanaimo is being hailed as a hero by his family after a suspect wielding a knife entered their business and the boy scared them off using a baseball bat.
Hazmat teams were called to the BC Cancer Agency building in Victoria on Thursday due to reports of a "noxious odour" in the building.
A furry mascot endemic only to Vancouver Island is predicting six more weeks of winter on Groundhog Day.