Virtual medical appointments, which allow doctors to deliver care and advice from a distance, without any risk of COVID-19 transmission, have become commonplace during the pandemic – but some British Columbia patients and physicians say the remote visits frequently aren’t ideal.
Claire Snyman, a Vancouver resident and health care advocate with multiple chronic conditions, said she often prefers to see her doctor in person.
“When it comes to a prescription renewal, I usually don’t need to go in and see my doctor for it. But sometimes I actually do need to, because the doctor needs to put a finger on the pulse to see if it’s still necessary to be on that medication,” she said.
“As a patient, when I talk to my doctor virtually, I find that it’s harder for me, because there’s always a perception of your doctor’s in a rushed space. I find that even harder and more cramped via virtual care.”
Virtual care can be delivered in a variety of ways, including by phone, e-mail, text message or video conference.
This type of health care is now widely available in Canada. A periodic survey of an average of 1,500 Canadians, conducted by Leger for Canada Health Infoway, found that 45 per cent of respondents were offered virtual care along with non-virtual options in December.
The survey found that 25 per cent of respondents were offered only virtual-care options during that period.
The College of Physicians and Surgeons of BC, the medical profession’s regulator in the province, said in a statement that doctors must see patients in person when necessary, but are expected to offer virtual care as a complement to in-office visits.
Leanne Currie, a professor at the University of British Columbia School of Nursing who studies biomedical and health informatics, said there has not been much research on how virtual health care compares to in-person meetings with doctors.
“Right now, since it’s so new, we do not have any good evidence yet on if virtual care methods are better than in-person or vice versa,” she said.
Remote consultations can occasionally cause doctors to miss important cues, she noted.
“Anecdotally, I’ve heard from some clinicians that they’ve been doing telephone or video visits with their patients during COVID. Most of the time, it has been fine for them. But I’ve heard things like, ‘Oh, I made a mistake, I probably should have had the person come in so I could have done an abdominal assessment.’”
She noted that many patients rely on their doctors to decide whether to deliver care virtually or in person.
“Sometimes, clinicians assume that patients do not want to have in-person … but that’s not necessarily the case,” Dr. Currie said.
Kathy Rush, a nursing professor at UBC who is researching ways of improving virtual-care options in rural communities, said phone-based consultations with doctors can be alienating for patients.
“Patients who are newly diagnosed with conditions, especially chronic, tend to prefer their first appointment to be either via video conference or to be in person, where they can actually start that relational piece with the doctor,” she said.
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