Provinces are relying on virtual doctors to keep smaller ERs open. Here’s how it works

Virtual doctors for real ERs

Dr. Michael Ertel begins his evening shift in the emergency department at around 8 p.m. After grabbing a cup of coffee and bidding his golden retriever, Norman, goodnight, he heads down to the basement of his home in Kelowna, B.C. But he’s not going to the hospital.

The “bunker” is where he virtually covers shifts for an emergency department in Mackenzie, B.C., a small community located hundreds of kilometers away with a population of about 3,300 people. Ertel works through a program called Virtual Emergency Room Rural assistance (VERRa), which deploys emergency physicians to work overnight shifts virtually for smaller emergency departments in B.C.

The use of virtual physicians is a response to the challenge of staffing rural ERs, where health authorities are struggling to find and retain healthcare professionals. In some communities, emergency centers have to close for hours or even days due to staffing shortages.

Several provinces, including B.C., Nova Scotia, Newfoundland, and Saskatchewan, have adopted virtual emergency care models to address this issue. In Newfoundland, the virtual physician coverage is managed by a private company called Teladoc Health.

While some see the value in virtual coverage for both patients and local physicians, there are concerns about the quality of patient care and the costs associated with using private providers in the public healthcare system. Physicians emphasize that virtual care should complement in-person services rather than replace them entirely.

Despite the mixed opinions on virtual emergency coverage, it has proven to be a valuable resource in keeping rural ERs open and accessible to patients. The program in B.C. has prevented over 5,000 hours of emergency department closure or diversion since its inception in 2021.

At the Mackenzie and District Hospital and Health Centre, nurses like Amber Pasichnyk play a crucial role in connecting patients with virtual doctors. Pasichnyk believes that virtual care is particularly useful for non-urgent cases, although it can increase the workload for nurses.

In Nova Scotia, Wendy Martin experienced virtual care firsthand when she sought treatment at Twin Oaks Memorial Hospital. While she was initially hesitant about receiving a diagnosis remotely, she acknowledged the value of being able to consult with a physician.

In addition to providing essential coverage for rural communities, virtual physician programs offer local doctors like Dr. Lindsey Dobson much-needed rest and relief. This allows them to maintain a healthy work-life balance while ensuring that emergency departments remain operational.

The Canadian Association of Emergency Physicians (CAEP) sees potential long-term benefits in virtual care, including addressing service gaps and enhancing recruitment and retention efforts in rural areas. While virtual doctors can help bridge the gap in the short term, addressing larger healthcare issues such as staffing shortages will require a multifaceted approach.

Ultimately, virtual physician coverage is just one of the many strategies being employed to address the challenges faced by rural ERs across Canada. By combining innovative solutions with long-term recruitment and training initiatives, healthcare providers hope to ensure that all communities have access to quality emergency care.