Patients did not use emergency departments in Ontario as a substitute for in-person visits with their family doctor during the pandemic, according to new data from the Ontario Medical Association (OMA).
While only 4 per cent of family physicians in Canada offered video visits in 2018, virtual care now accounts for more than one-quarter of physician visits in Ontario. Family doctors are reportedly seeing about 60 per cent of patients in person and 40 percent virtually.
A study done by the OMA looked at the number of virtual visits patients had with family doctors in the first year of the pandemic and the number of times those same patients visited the emergency department.
“We did not find evidence that enrolled patients substituted emergency department visits because of less availability of in-person care,” Dr. Jasmin Kantarevic, the OMA’s chief economist, wrote in the paper published in the Canadian Medical Association Journal.
“This finding is important given concerns about virtual care adversely affecting quality of care, leading to calls to substantially reduce care delivered virtually,” wrote Dr. Kantarevic, who holds a PhD in economics.
Doctors across Ontario had to move rapidly to virtual care at the start of the pandemic when the government paused most non-emergency services to avoid the spread of COVID-19 and many patients were reluctant to engage with the health-care system.
“These findings are important because virtual care, when medically appropriate, allows patients to connect with their doctor from the privacy and comfort of their own home,” said OMA President Dr. Rose Zacharias.
“Research shows that virtual care is particularly well-suited for mental health consultations, refilling prescriptions and discussing lab and other test results,” she added.
“This study shows that the unprecedented strain on emergency departments is not associated with patients being unable to see their family doctors in person,” the OMA president noted.
Dr. Zacharias said the pressure on emergency departments is probably due to a mix of things including a shortage of primary care doctors.
Patients who did not seek health care during the pandemic are re-engaging in large numbers, many showing up sicker and in need of more treatment at all points in the health-care system, from their family doctor to the ED. At the same time, many urgent care settings are suffering from staff shortages. Health-care workers who have been on the front lines of the pandemic keeping their patients and their communities safe are suffering from record levels of burnout. About 1 million Ontarians do not have a primary care doctor and may have no where to turn but the emergency department.
Also, patients who did not seek health care during the pandemic are re-engaging in large numbers, many showing up sicker and in need of more treatment at all points in the health-care system, from their family doctor to the ED. At the same time, many urgent care settings are suffering from staff shortages. As a result health-care workers who have been on the front lines of the pandemic keeping their patients and their communities safe are suffering from record levels of burnout.
The OMA study looked at records of 7,936 physicians in family health groups and family health organizations from April 1, 2020, to March 31, 2021. It found no statistically significant relationship between emergency department visits and the proportion of virtual visits.