Jennifer Young is president of the Ontario College of Family Physicians
Over the past few months, I’ve been dealing with something I’ve never experienced as a family physician: patients are worried that coming in for a regular doctor’s appointment will put them at risk. I hate the thought of people getting sick or forgoing their medical needs because they’re afraid to leave their homes.
In-person visits are essential for things like immunizations, prenatal care and examinations for urgent problems. For the duration of the pandemic and likely long after it’s over, patients coming in for an appointment will have to bring their own mask and wait in their car or in the hall until the doctor can see them—no more crowded waiting rooms. Doctors’ offices will need to book extra time between appointments to clean all the surfaces patients might touch before they come into the room. Doctors will keep their distance more than before, and the examinations may be brief.
For most other issues, however, care will shift to the virtual realm. In the past few months, I’ve accelerated patient access through phone, video and email. In some ways, it’s a modern take on the old-fashioned house call. It can still be challenging for vulnerable and older patients, however, and we’ll need strategies to fix that. We’ll also need to improve access to cell connection and high-speed Internet in rural, remote and Indigenous communities. But it turns out that in many cases, it’s a much more equitable and effective way to deliver health care.
A lot of issues can be resolved via video, phone and photography. We can assess muscle or joint problems and look at skin rashes or spots. We can check on a patient’s diabetes or heart failure, help them stop smoking and provide care for mild to moderate mental health issues. We can even use encrypted, secure programs—such as the Ontario Telemedicine Network, Doxy.me and ThinkResearch VirtualCare—to ensure patient privacy.
The convenience of virtual visits makes primary care easier and more accessible for patients, especially those who rely on public transit or are working from home. This way, it’s easier to access your family doctor than it was before the pandemic. And I’ve noticed some unexpected benefits myself. Connecting with patients in their own environments has given me insights into who they are, which ultimately helps me provide better care.
We don’t know how long Covid-19 will be putting our communities at risk, and we don’t know when an effective treatment or vaccine will become available. We need to be ready for a new normal, and we need to be prepared to stick with it. After SARS, we learned some lessons, but when it was all over, we went back to our usual care. We cannot go back this time. Instead, we’ll look back at the Covid-19 pandemic as the driving force behind a fundamental change in medicine, one where the patient’s time is better valued and they are more actively engaged in their own health.