Access to virtual care in jeopardy after fee structure changes

The province is set to cut fees it pays doctors for virtual care visits on Thursday, impacting millions of patients across Ontario who rely on the service.

Robyn Edwards turned to virtual care after losing her family doctor two years ago.

"The Rocket Doctor system has been a saving grace for me," Edwards said. "It has prevented me a few times from going to an emergency room."

Edwards needs annual biopsies and relies on virtual doctors for referrals.

"Thankfully last week I was able to get a referral from Rocket Doctor but if this was after December 1st I wouldn't be able to do that," she said "I don't know what I'm going to do next year. I'm on a waitlist, I've joined every list that I come across."

As of Dec. 1, the province is cutting fees it pays physicians for virtual care visits after reaching an agreement with the Ontario Medical Association (OMA).

"We're talking about 50 per cent reduction," said Dr. William Cherniak, a physician and founder and CEO of virtual care platform Rocket Doctor.

He also started an online petition calling for technology to be embraced to ensure access.

"The way that things are changing is it will become essentially impossible for physicians to provide the comprehensive coordinated care that they've been doing on Rocket Doctor for any patient that they haven't previously seen in person," he said. "And so millions of people are going to lose access to care tomorrow."

In a statement the OMA said "there was no publicly funded virtual care in Ontario before the pandemic, except for limited services through the Ontario Telemedicine Network."

"The OMA believes the best care is inside the patient-doctor relationship. Virtual care is fully funded by OHIP under this new agreement when there is this ongoing relationship."

For one-off visits when physicians don't have a relationship with a patient, OHIP will pay the doctor $20 for a video visit and $15 for a telephone visit, a dramatic drop from what is currently paid.

In a statement the ministry of health writes it "has taken a patient first approach to ensure that Ontarians will continue to have access to the care they need, when they need it" and that "virtual care is intended to complement in-person care, not replace it."

"It is frustrating but it's also devastating," said Edwards. "I'm grateful that I'm relatively healthy and can advocate for myself. This is taking away a very essential service from people that have accessibility issues, who just can't get out to see a doctor and we are now in a virtual world and it just made perfect sense that this was a service being offered virtually and to have it taken away I don't get it."

Edwards recently received her licence plate sticker refund in the mail and says she'd rather have greater access to healthcare.

"I'm scared for those who have no choice but to go to an emergency and I'm worried about the future of our healthcare," she said.