The New Brunswick Medical Society (NBMS) is calling for the cancellation of a virtual care pilot project at two rural emergency departments in the province.
Patients visiting the Sussex Health Centre and the Charlotte County Hospital have the option of seeing a doctor virtually through Teladoc for non-life-threatening issues.
Dr. Lise Babin, president of the society, said in an emailed statement that the use of virtual care solutions can be appropriate “in the right clinical context.”
However, Babin said they do not understand why these services are being contracted out to a private-sector human resource agency at a premium to taxpayers.
“Of particular concern to us is the apparent hiring of our own physicians by the third party, to then be sold back to us at a premium,” wrote Babin.
“The NBMS is very worried about the precedent the Horizon Health Network is setting by providing equal or more generous incentives for virtual care than in-person alternatives in our rural community emergency departments.”
The society president worries that this approach could lead to more closures of small emergency rooms across the province as clinicians choose “the less onerous option.”
Babin also noted that the pilot project requires a nurse to always be present when the service is being provided, meaning resources are being pulled from other duties.
“The use of highly specialized emergency department physicians and nurses to provide what is essentially a virtual primary care service seems like a misutilization of resources at a time when our system is in crisis,” she added.
The society said the province should immediately cancel the pilot project and direct the funds toward collaborative care clinics or incentivizing emergency department physicians to work in rural hospitals.
Horizon Health responds to concerns
Meanwhile, the president of Horizon Health, which operates both hospitals, said the pilot project is improving access to emergency and urgent care in those communities.
Margaret Melanson said in a statement that the trial has produced “impressive” results in a short period of time since it launched in November.
Around 650 patients have received virtual care to date, accounting for one in five overall patient visits. Patient satisfaction has also been overwhelmingly positive, she said, with an average rating of 9.5 out of 10.
“We know face-to-face care provided by an emergency physician is the gold standard for emergency and urgent care,” Melanson said in her statement.
“However, face-to-face care is not always possible, and we must consider other ways to provide New Brunswickers quality care when they need it.”
Melanson noted this type of service has successfully been implemented in other provinces which are experiencing similar recruitment challenges as New Brunswick.
The Department of Health has fully funded to the pilot with Teladoc to the tune of more than $865,000, which covers the cost of establishing and operating the pilot over the 2024-25 fiscal year.
“We have a limited pool of emergency physicians in the Saint John area. This service will help reduce workload while still ensuring emergency services are available for patients if physician coverage is not available,” said Melanson.
Further, Horizon is committed to keeping the Sussex Health Centre Emergency Department open under its existing hours, and this tool brings us closer to returning to 24/7 emergency department service.”
