23 March 2020

The doctor is out... of the province #nlpoli

Health minister John Haggie announced on Friday that doctors in the province could now start seeing patients remotely either by telephone or using video conferencing.

Kinda bizarre, though, given that some doctors in the province have already been doing this.

In any event, using technology to see patients remotely is a good idea not only now but in the future.

It allows doctors to treat patients in remote areas where there is a constant turn-over of resident doctors.  Last year, SRBP wrote about the potential for technology to help with the supply of family doctors

Meanwhile, last week Shoppers Drug Mart also quietly rolled out a service in conjunction with a cash-for-service doctor company called MAPLE. 

This is “virtual care”  - a truly hideous term - as well but it comes with a big twist people need to watch out for besides the cat MAPLE isn;t covered by MCP. The same twist will affect any local patients who are in Newfoundland and Labrador but wind up being treated by doctors living and working outside the province using remote communication technology.

Under a new policy established in March 2017,  the College of Physicians and Surgeons of Newfoundland and Labrador has decided that care takes place where the doctor is, not where the patient is.  Under the old policy, CPSNL held that care took place where the patient was.

Under the new policy,  a patient in Comfort Cove who sees a doctor via Skype while the doctor is in British Columbia will have to complain to the BC College and deal directly with the BC College about it.  CPSNL will pass the complaint along but after that the patient is must find their own comfort.

The policy doesn’t just cover Canadian doctors, whose licences incidentally, the local College doesn’t recognize as valid anyway.  Same thing applies for a doctor living anywhere in the world.  You see, the CPSNL policy states that the “College considers the practice of medicine to take place in the jurisdiction in which the physician resides and holds a licence.”

So if the local patient winds up dealing with a doctor in the United States,  Mexico, Sri Lanka, or India, the complaint will have to go to whatever country the doctor is in.

These days, technology allows doctors from anywhere in the world to treat patients anywhere else.  It’s a common practice in commercial shipping where doctors work for international contractors.  Got a problem on a rig offshore or a ship at sea and you could find the captain calling a doctor in Europe whose company has the contract to supply health care to the ship owner’s crews. 

But people living in Arnold’s Cove are not used to that.

Patients need to look closely at the contracts they sign for medical service under virtual care by doctors not living in Newfoundland and Labrador.

And, of course, no one from the provincial government or the College of Physicians and Surgeons has told the public about this let alone warned them of the implications should something go wrong.  

After all,  there really isn't anyone in the province responsible for protecting the public in these sorts of things, is there?