In-person or in trouble? B.C. docs told to bring routine visits back to the clinic

Senior health officials in British Columbia have told doctors they expect them to start seeing patients in-person and that the province is now “actively reviewing” the fee codes for virtual visits, which had been approved only for temporary use. ” provincial health officer Dr. Bonnie Henry, assistant deputy health minister Ted Patterson and College of Physicians and Surgeons of B.C registrar and CEO Heidi Oetter said in a joint statement sent to doctors on September 3. “You may recall that a series of adjustments to the payment schedule were approved by the Medical Services Commission on the basis that they were temporary and could be cancelled on the advice of the provincial health officer,” read the second page of the statement, according to a CTV News report. “The ministry is actively reviewing the current temporary fee codes and considering the appropriate path forward for virtual care compensation.” The document’s authors cited reasons for pulling back on virtual care, including unnecessary emergency room visits, specialist referrals that lack sufficient or pertinent clinical information for accurate triaging and care, and lack of access to important preventive and screening health services. Read: OMA fails family practice with virtual care agreement Dr. Manya Sadouski, a family doctor on Salt Spring Island, expressed disappointment in the statement. “It was quite a coercive tone – ‘though shalt return to routine in-person care’ – and lacked some of the subtlety that I was hoping for and so the letter landed to me as if those telehealth appointments are no longer appropriate and the comment about defunding them left me a lot of concerns,” she said. “There needs to be an element of trust in our professionalism and our good faith towards our patients.” The statement comes at a time when most doctors and surgeons in the province have already resumed seeing patients in person, while continuing to provide virtual care. Dr. Matthew Chow, president of the Doctors of B.C., said the statement may be aimed primarily at certain doctors. “We’ve become aware of a small number of physicians who’ve only been seeing people virtually and have not provided any in-person care over the course of the pandemic,” he said. “This has raised concerns from patients as well as other doctors.” The gig is up: Why more doctors are moonlighting today Dr. Chow said mandating virtual care in March 2020 made sense at the time for patients and practitioners. But with effective vaccines now administered to majority of the population—including 97% of doctors—doctors have an obligation to provide in-person care where appropriate. Some doctors, however, expressed concerns about the push to go back to in-person appointments. Speaking with CTV News on condition of anonymity, a number of these doctors said virtual care has been especially important for patients who are elderly, disabled or living in remote communities. Some doctors also told CTV News they were aware of growing resentment among physicians who have continued to provide in-person care while others opted for virtual visits only. Vancouver physician, Dr. Eric Cadesky said it’s important for doctors to be able to provide the “right care at the right time at the right place ... sometimes that's in the office, sometimes that's by phone and sometimes that's by video.” Dr. Chow said virtual care is unlikely to go away. “I want to emphasize that virtual care is here to stay, we’ve seen how important it is in the past 18 months and how it saved the medical system from collapse in the first wave,” he said. The province may have other plans. “We are now at a different stage in the COVID-19 pandemic in BC,” read the health officials’ statement. “COVID-19 is now a vaccine preventable virus that we will be living with into the future.” Read: Doctors frustrated with 'selfishness' of unvaccinated people, protesters

In-person or in trouble? B.C. docs told to bring routine visits back to the clinic

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