In this article, you will get all information regarding Why Rocket Doctor and Other Ontario Virtual Care Sites Are Facing a Crash
During the pandemic, Rocket Doctor seemed to be on an upward trajectory.
About 250 physicians in Ontario were using the company’s cloud-based system to offer virtual appointments. On weekends, doctors were seeing 600 to 1,000 patients, and virtual seats were reserved on Friday afternoons.
Georgian Bay General Hospital’s emergency department was using the system to see patients virtually, which caught the attention of the Ontario Medical Association magazine, which intended to write an article.
And, most recently, the company’s founder, Dr. Bill Cherniak, equipped two London pharmacies with virtual stations allowing a doctor anywhere in the province to view a patient’s inner ear.
But on December 1, when the new fee codes for virtual dating go into effect, Rocket Doctor will fall to earth.
The business’ virtual model will not be economically viable after Nov. 30, when OHIP decreases the amount doctors are paid to see patients by phone or video for one-time virtual appointments.
OHIP will pay $20 for a video appointment and $15 if it’s over the phone, when a patient sees a doctor through a virtual-only website — less than a third of what a doctor might typically charge for a date during the pandemic, when virtual and in-person payments were tied.
“We surveyed doctors who provide emergency and primary care services on our platform and most said they intended to stop seeing (virtual) patients after December 1 if the codes fees remain unchanged,” Cherniak said in an email.
“It remains the same for pediatricians seeing patients on our walk-in platform, which is a real shame, given the current flu season we’re in.”
Rocket Doctor might be just one of many online sites collapsing in the wake of the pandemic. Either that or the sites could start billing patients instead of OHIP.
Appletree Medical Group, for example, has physical clinics and will continue to offer virtual appointments to its patients, but will no longer offer virtual-only appointments to anyone as it has done during the pandemic. .
Another site, VirtualDr.ca, no longer takes OHIP-covered patients.
And companies such as Maple Corp. continue to bill patients for medical care largely based on chat, a technology not covered by OHIP.
Why Change Happens
Many experts agree with the government’s position that virtual care is best when it’s part of the comprehensive medical care a patient receives from a family doctor they continue to see over time. And that the new low fees for virtual-only medical care reflect what they are worth.
The new fees are part of a medical services agreement between the government and the Ontario Medical Association, which was ratified by doctors in March. It is the first PSA to include specific fee codes for virtual care.
Family physicians who have seen a patient in the past 24 months will be able to bill the full price for a video appointment, and 85% of the full price (which varies by appointment type) if it is of a telephone appointment. The same applies to patients who are registered or registered with a doctor or clinic.
“What it seems to me they’re trying to do is they’re trying to prioritize, to encourage comprehensive care,” says Ibukun Abejirinde, a scientist at the Women’s College Hospital Institute for Health System Solutions and Virtual Care.
“We know that comprehensive health care, wraparound care with that therapeutic alliance between your primary care provider, is actually more beneficial,” says Abejirinde, who is also an assistant professor at the Dalla Lana School of Public Health in the US. University of Toronto.
Critics of virtual sites also say doctors working there, like those at walk-in clinics, typically don’t have access to a patient’s medical record, which could lead to problems with prescriptions, like duplication. .
“When a patient sees, for example, several specialists who can prescribe different things, you want to make sure you get reports from the specialist,” says Dr. Rashaad Bhyat, a chief clinician for Canada Health Infoway, a non-organization for-profit with federal funding to improve the use of digital solutions in healthcare. “And right now it’s very difficult in our current environment because of the silos of (electronic medical records).”
Different systems are used by family doctors, specialists and hospitals, says Bhyat, who is also a family doctor in Brampton, among others.
“You can sort of extrapolate that if there’s a proliferation of these virtual walk-in clinics, it’s not necessarily contributing to good continuity of care,” Bhyat says, a concern he says has been raised. by many medical associations and organizations across the country during the pandemic.
The question of the family doctor
However, the “elephant in the room,” as Abejirinde put it, are the approximately 1.8 million people in Ontario who do not have a family doctor.
And for these patients and many others, the impact of price changes could be significant.
A London hospital clinic, where doctors provide services to homeless people with HIV and hepatitis C over the phone and very rarely see patients in person, will now receive $15 per appointment. This amount is less than a quarter of what they could charge even before the pandemic, when they used a different fee code because virtual codes did not exist.
Connect-Clinic, a virtual-only clinic that helps people across the province get hormones and gender-affirming surgery, says low fees will make it impossible to add patients to its waitlist, or even assistance to the 2,000 patients already registered. The clinic, which was founded in 2019 and has always been virtual, could eventually close.
Specialists and other physicians are also concerned that the prioritization of video over the phone will force elderly patients or other patients without computers or reliable internet to travel long distances for in-person appointments, as telephone appointments do not are not allowed in some cases, or they are paid at a reduced rate.
Meanwhile, patients without a family doctor who turn to emergency departments will face record wait times.
With the December 1 deadline looming, Cherniak is looking for a way to salvage his business, which he and others say was so promising to begin with.
“We interviewed patients after each appointment,” asking “what would you have done if Rocket Doctor hadn’t been there?” said Cherniak.
“And consistently, 33% say they would have gone to the emergency department,” he said. “Another 50% would have gone to walk-in clinics. So very few of the people who use us would have had a family doctor or expected one anyway.
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Why Rocket Doctor and Other Ontario Virtual Care Sites Are Facing a Crash
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