BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES
The current pandemic is deeply affecting many aspects of society. Accelerated usage of virtual healthcare is a good example. While frontline healthcare workers serve patients needing essential in-person care, some doctors and patients are meeting up over the phone or on video calls.
Virtual healthcare is well known to those living in remote communities. During the pandemic, it has become an option for everyone.
A debate has ensued about whether such care is good or bad. Proponents of either side are lining up evidence to prove the case. How can you argue with the fact that curable cancers in children have been missed in the absence of face-to-face consultations? How many lives have been saved by “seeing” the doctor virtually, when the alternative is no treatment at all?
The question should be, when is it okay to utilize virtual healthcare, and when not? And how should people approach the option?
Governments and regulators have been beefing up policies and billing structures for online medical consultations and treatments. In Canada’s public system, a plethora of new billing codes have been registered since the start of COVID-19. There hasn’t been as much attention given to educating the public about virtual care.
Until recently, there wasn’t much interest among healthcare consumers either. A survey of 4,530 American adults conducted by Deloitte in 2018 showed that 77% had never tried a virtual visit.
But as the ancient proverb notes, “Necessity is the mother of invention.” As COVID limited traditional doctor visits, the benefits of virtual care became apparent. Improved access and convenience, reduced travel, eliminated parking headaches. No transmission of infection.
A study published in the Canadian Medical Association Journal reported on virtual care use in the province of Ontario before and during the COVID-19 pandemic. The proportion of Ontarians who had a virtual visit increased from 1.3% in 2019 to 29.2% in 2020, with older people being the highest users. Data from the Massachusetts General Hospital psychiatry department switched from under 5% virtual visits in March 2019 to over 97% in March 2020.
Technology advances are also contributing to the trend. Diseases that may have required an in-person diagnosis in the past can now be detected using digital imagery tools, mobile health applications, and wearable medical devices.
Powerful medical groups are busy determining the support of clinicians’ need for effective integration of virtual visits in the practice of medicine.
Less evident are the support programs needed by consumers. How does a person know when is the right time to pick up the phone and when to make an in-person appointment?
In general, in-person care is always advisable for diagnostic and therapeutic procedures requiring physical contact (e.g., Pap smears and biopsies). The same for prenatal and newborn care. People dealing with multiple health issues or who struggle to communicate virtually should also present in person.
But virtual visits will likely be a significant part of the healthcare experience henceforth. So it is advisable to get good at making the most of them. Just because you are not leaving home doesn’t mean you don’t need to prepare. Preparation is more important than ever.
Make sure you know how to use whatever equipment is required – from the telephone to computers, mobile apps to specialized software. Be in a quiet space, with sufficient light to read and write, and so the provider can see and hear you well. Have patience and fortitude in case technology fails and to avoid misunderstandings.
If you haven’t seen your doctor in person since the start of the pandemic, make an in-person appointment.
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Dr. W. Gifford-Jones, MD is a graduate of the University of Toronto and the Harvard Medical School. He trained in general surgery at Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill University and in Gynecology at Harvard. His storied medical career began as a general practitioner, ship’s surgeon, and hotel doctor. For more than 40 years, he specialized in gynecology, devoting his practice to the formative issues of women’s health. In 1975, he launched his weekly medical column that has been published by national and local Canadian and U.S. newspapers. Today, the readership remains over seven million. His advice contains a solid dose of common sense and he never sits on the fence with controversial issues. He is the author of nine books including, “The Healthy Barmaid”, his autobiography “You’re Going To Do What?”, “What I Learned as a Medical Journalist”, and “90+ How I Got There!” Many years ago, he was successful in a fight to legalize heroin to help ease the pain of terminal cancer patients. His foundation at that time donated $500,000 to establish the Gifford-Jones Professorship in Pain Control and Palliative Care at the University of Toronto Medical School. At 93 years of age he rappelled from the top of Toronto’s City Hall (30 stories) to raise funds for children with a life-threatening disease through the Make-a-Wish Foundation. Diana Gifford-Jones, the daughter of W. Gifford-Jones, MD, Diana has extensive global experience in health and healthcare policy. Diana is Special Advisor with The Aga Khan University, which operates 2 quaternary care hospitals and numerous secondary hospitals, medical centres, pharmacies, and laboratories in South Asia and Africa. She worked for ten years in the Human Development sectors at the World Bank, including health policy and economics, nutrition, and population health. For over a decade at The Conference Board of Canada, she managed four health-related executive networks, including the Roundtable on Socio-Economic Determinants of Health, the Centre for Chronic Disease Prevention and Management, the Canadian Centre for Environmental Health, and the Centre for Health System Design and Management. Her master’s degree in public policy at Harvard University’s Kennedy School of Government included coursework at Harvard Medical School. She is also a graduate of Wellesley College. She has extensive experience with Canadian universities, including at Carleton University, where she was the Executive Director of the Global Academy. She lived and worked in Japan for four years and speaks Japanese fluently. Diana has the designation as a certified Chartered Director from The Directors College, a joint venture of The Conference Board of Canada and McMaster University. She has recently published a book on the natural health philosophy of W. Gifford-Jones, called No Nonsense Health – Naturally!
