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Comment: Telehealth is here to stay, and opting out makes sense

A commentary by a family ­doctor who came to Victoria from a rural area.
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Dr. Maria Dibb writes that opting out of the Medical Services Plan is often a necessary financial decision for family doctors, particularly those saddled with debt from medical school. HANNAH McKAY VIA THE ASSOCIATED PRESS

I object to the castigating of the two “opting out” physicians and the telehealth physicians in the Sept. 29 editorial “Authorities must act to preserve health care.”

Firstly, telehealth grew exponentially as a result of the COVID pandemic when family doctors were limited initially to only treating patients over the phone.

Telehealth accessed changes in the medical system opened by MSP initially increasing the payment for a phone visit from $7 to $20 and then further increasing the payment to equal to an office-visit payment.

Clearly this comes with a fraction of the overhead costs when there is little or no office maintained. The average family doctor made the calls from their now-empty offices while telehealth companies essentially offered remote work without the usual overhead.

Patients are just now coming back to the office. However, phone visits are here to stay and should remain well-compensated as patients have benefited by not having to leave their place of work, school or home to travel to a doctor’s office, saving them money and time and perhaps even reducing greenhouse gases.

The province remains so short of family physicians that they can hardly punish telehealth companies and shut down their “operation” as patients often have no other options to receive care.

I am not endorsing a phone visit as equivalent to an office visit, but I do see it as part of health-care access.

Secondly, the two physicians who have been singled out for opting out of MSP likely have also reached the breaking point financially.

I am unfamiliar with their stories but, with the cost of a medical education, obtained locally or abroad, family physicians are entering the profession with crippling debt.

With so many British Columbians without a family doctor, I suspect many will be willing to pay for this service rather than suffer the consequences of not having a GP.

You may call this a two-tiered system, but that is effectively what we have right now: those with a family doctor and those without.

Patients are waiting often eight hours to access hospital emergency rooms in Victoria. Access is limited to the new Urgent Primary Care Clinics and walk-in clinics have largely closed for financial reasons around the city.

Opting to be an office family physician is not a glossy choice, coming out of medical school. There is no fast-paced work in emergency, bustling hospital medical specialties credited with the saving lives, high-paying positions.

Individuals choose general practice to have the autonomy to choose their hours, be there for their families, and not have to work weekends and nights.

Their patients benefit from the accessible, personalized care provided over life’s continuum.

The provincial government has tried to bring on Urgent Primary Care Clinics with salaried positions and with set hours, seven days a week, evenings and weekends. So far this model is not working.

Until the powers that be recognize why gentle, caring individuals choose a city-office family-medicine career and compensate them fairly without punishing them for their choices, the province, and the country, will continue to have a severe shortage of family doctors in city-office practice and a two-tiered health system.

While it is not fair that some patients may choose to pay for a spot with a family doctor or access limited services such as telehealth, with the above issues, it is also wrong to leave individuals with no options for a family doctor.

>>> To comment on this article, write a letter to the editor: letters@timescolonist.com

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