Esquimalt’s Sandi Plewes wasn’t sure what to expect when she met her new family doctor over a computer screen, but she was happy to give it a try.
Plewes, 60, has been looking for a doctor since coming to Victoria in 2013.
Plewes has signed up as a patient with MedviewMD in the Cridge Family Pharmacy, 641 Fort St. It’s the first of the company’s telemedicine offices on Vancouver Island.
“I’ve been seeing ads on Facebook saying they were taking new patients and it’s really hard to find a family doctor in Victoria,” said Plewes, 60.
“I didn’t know it was teleconferencing … but why not?”
During the visit on Wednesday, Plewes was assessed by a licensed practical nurse, had her vital signs taken and recorded, and then met online with the company’s chief medical director, Dr. Chad Burkhart, based in Southampton, Ont.
“I really liked it,” Plewes said. “I think it’s more time efficient. I like that the LPN does all that preliminary work, like taking blood pressure and my temperature and oxygen levels.”
Plewes’ prescription was sent electronically to Cridge pharmacist Jason Cridge. For her regular Pap test, Plewes was told she’ll be referred to a gynecologist.
Critics caution that some telehealth services run the risk of patients not getting attached to one physician, excessive visits, or doubling of medications if several services are used by one person.
Cridge said the “phone has been ringing off the hook” since the telemedicine clinic in his pharmacy started taking patients last month.
“Because it’s a new concept, there’s some hesitancy on the patient side,” he said, “but people are willing to try because they’ve been looking for a doctor for so long.”
Cridge often comes across elderly patients without family doctors refilling the same old prescriptions through clinics because they haven’t been reassessed in years.
“I’m really happy about this concept because there are so many patients who need physicians and there’s no one to refer them to,” he said.
There are 245 telehealth public facilities providing access to approximately 790 video-conferencing locations, said the Health Ministry.
There are also a handful of private companies offering telemedicine in B.C. It can be delivered over smartphones or home computers or in consultation rooms equipped for such a purpose.
Appointments are paid for by the Medical Services Plan and the doctor is paid on the traditional fee-for-service model.
Dan Nead, CEO of MedviewMD, a former bond trader, said what’s unique to his telemedicine clinics is that they are located in pharmacies and offer the patient a hands-on and online assessment and the latest diagnostic equipment.
Key is that patients can schedule follow-up appointments with the same doctor, he said.
“It’s not a walk-in clinic, not even close.”
In just over a year the company, which started in Chatham, Ont., has about 30 locations in Ontario, B.C. and Alberta.
The doctors and nurse practitioners are mostly from Ontario, but B.C. professionals are being recruited, Nead said.
Diagnostic equipment includes an electronic stethoscope that can amplify the thump of the patient’s beating heart and breathing, another machine reads blood pressure and oxygen in the blood, and a dermatosope to photograph skin lesions which onscreen can be measured and magnified for examination.
David Ling, an LPN who is training his Victoria counterpart, said “it’s quite advanced and allows me to use more of my nursing skills.”
In examining the ear with an audioscope, the physician, patient and LPN can together look deep into the ear canal onscreen to see infection or abnormalities and discuss what they see.
“That collaboration piece really is a game-changer for that patient,” Nead said.
“We’re not there to compete with existing doctors … or any health facilities,” he said.
“We are there for the orphan patient or those that need to see a doctor short notice.”
Burkhart, in family practice for 15 years, joined MedviewMD about five months ago. He said telemedicine is especially useful for patients in rural communities.
“The benefit is access to care,” Burkhart said. Through telemedicine, patients can also access specialists on the referral of the doctor, he said.
Some new physician graduates are going directly into telemedicine because of the low overhead, he said.
Utilizing digital communication tools such as text, email, web, smartphone and video has great potential to improve access to health care, said Health Ministry spokesman Stephen May.
But the province must consider patient privacy, confidentiality, data security, legislative and regulatory requirements and the costs associated with supporting the technology.
As well, telemedicine needs to ensure a single patient record, and a regular team of doctors and other health professionals providing care, said May.
Plewes, one of many affected by a doctor shortage across Canada, is ready to give it a shot.
