Letter – Doctor states her case regarding patient care

Editor’s note: Dr. Heather Shonoski, of Peace River, sent the following letter to CBC and CTV March 10 and also posted to Facebook. South Peace News obtained permission to publish her letter.

My name is Heather Shonoski and I am a physician in Peace River, AB. I am writing you about the recent tweets from @Shandro, @Kenny and @GoAHealth endorsing the Telus Babylon app.

I am beyond frustrated at this. Family physicians have been begging the health minister to allow us to provide virtual care to our patients so that we can keep our vulnerable patients at home and promote social distancing. We want to be able to provide high quality care even if our patients or ourselves are in self-isolation.

Physicians from my clinic have called Telus and were told they cannot see their own patients through this platform, rather they would have to provide virtual walk-in. We want to be able to see our own patients in our own critically underserved rural community where we know our local resources. We want to provide continuity of care, which has been proven to save lives and minimize resource use.

For example: a patient receiving virtual care has a concern that necessitates a physical exam or follow up. Through Babylon they would be directed to go to a walk-in or ED. If we could see our own patients we could do our own follow-up or arrange cross-coverage with proper handover to a colleague in our own community. This would minimize the risk of medical error.

We are all preparing for increased health system demands with COVID. Each clinic and hospital is rapidly developing new policies and procedures to keep patients safe. A physician elsewhere in the province seeing patients in my community would have no way of knowing what these are and would not know how to advise patients seeking care appropriately other than ‘just go to the ED’.

The billing code for virtual care and phone advice available to physicians in this pandemic is set at the same rate as it was during the H1N1 pandemic – $20 per patient. Providing adequate care can sometimes take up to 40 minutes of direct counselling, reviewing labs, sending prescriptions, etc. per patient. At this rate, physicians providing virtual care will not be able to afford to pay their overhead.

We are faced with yet another difficult choice during this crisis – do we have patients physically come in to the clinic and increase their risk or do we shut down our clinics / go bankrupt / lay off our staff and keep patients safe? I guess the question is whether we as a society want family doctor offices to exist after the pandemic.

I am very concerned that the government is using this pandemic to further their own push for privatization. CMPA and the CPSA have endorsed many apps other apps [medeo, doxy.me, etc] as well as using regular phone, e-mail, Skype or Facetime calls to provide virtual care. Why is it that none of these are being supported?

Thank you for taking the time to read through my concerns,

Dr. Heather Shonoski, MD, MSc, CCFP,
Peace River, AB

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