Bill proposing virtual healthcare 'extremely risky', says N.W.T. medical association

The N.W.T. Medical Association says proposed legislation to let out-of-territory physicians do virtual consultations would ultimately hurt patients.

In a statement on March 22, the association said it has "significant concerns" with Bill 40: An Act to Amend the Medical Profession. The bill — which was tabled in the Legislative Assembly on Nov. 26 — would mean physicians in other provinces and territories wouldn't have to get an N.W.T. licence to treat patients, if those patients have a referral from a local doctor or nurse practitioner.

It would also create a new type of licence for physicians who offer virtual care without a referral, among other changes.

In its statement, the medical association said it reached out to the government to offer input but didn't receive a "satisfactory response."

Dr. Kate Breen, the association's secretary and an emergency physician in Yellowknife, said in the statement that the association commends the part of the bill that would allow virtual consultations at the request of an N.W.T. doctor — a rule that's been in place since the COVID-19 public health emergency began in 2020.

But she took issue with the rest of the bill, arguing it would create a class of physicians who wouldn't be accountable to N.W.T. rules.

"This would result in no oversight of these physicians, without recourse if something went wrong. We believe this to be extremely risky," she wrote.

Amendments needed, physician says

Breen said the bill would let any physician in Canada apply for a virtual N.W.T. licence even if they know nothing about the territory. They would not have access to N.W.T. medical records, she noted, and the visits wouldn't be recorded for local doctors to review.

She claimed the bill would let virtual physicians prescribe medication without doing a physical exam; and questioned how medical transport would be arranged if the physician decided the patient needed to be seen by a doctor in-person.

She also pointed to part of the bill that would create N.W.T. "standards of practice" for doctors — something she said should not be created by government, but rather by an arms-length regulatory body.

"Government interests ... do not always align with what is best medical practice or in the best interests of patients," she wrote.

The bill has not yet been debated in the Legislature, but the impact of virtual healthcare so far during the pandemic has been lauded by some N.W.T. MLAs as the territory grapples with a shortage of health staff.

The staff shortage has led to service reductions in some community health centres and the temporary closure of the birthing unit at Stanton Territorial Hospital in Yellowknife.

On Feb. 21, Kam Lake MLA Caitlin Cleveland gave a member's statement in the Legislative Assembly about the burden the health care system faces, with a pileup of patients needing surgeries, access to specialists, testing and treatments.

At that time, she noted virtual care has brought new opportunities, but said the territory must "get creative" with staff recruitment and community care.

During the same meeting, Health Minister Julie Green called virtual healthcare "one of the game-changers" from the pandemic.