Ontario health officials urge doctors to see patients in person rather than virtually

The Ontario government is urging all doctors to care for patients in person rather than virtually, saying it's now safe given high COVID-19 vaccination rates and readily available personal protective equipment.

In a letter to Ontario physicians Wednesday, Chief Medical Officer of Health Dr. Kieran Moore, assistant deputy health minister Patrick Dicerni and College of Physicians and Surgeons CEO Dr. Nancy Whitemore say they've increasingly been hearing complaints about offices not providing in-person care. 

"There are limits to what can be done virtually and the standard of care is often difficult to meet in a virtual-care environment," the letter says.

While it is ultimately up to physicians to determine what type of appointment is needed, in-person care is necessary to make diagnoses and decide treatments and is what's expected, it continues.  

"There are many patients for whom the standard of care cannot be met in a solely virtual care environment," the letter reads.

Moore: 'It's so important to see people in person'

Speaking during a news conference on Thursday, Moore said they've heard from patients that they want to be seen in doctors' offices, as well as from physicians who want to see their patients.

"I absolutely understand that from a clinical practice vantage point, it's so important to see people in person," he said. 

"You can't do a physical examination. you can't take blood pressure and you can't provide immunization through any virtual means, and patients need to physically get seen and physically examined," Moore said.

"We have gone through a rough year and a half where patients have perhaps not felt comfortable going to their family physician's office and some family physicians may have not felt comfortable providing direct one-on-one care." 

But Moore said with high immunization rates, low risk of infection, very good understanding of infection prevention, good guidelines and good screening, it's much safer now to see patients.

Moore said he is also concerned that there might a backlog of patients who have not had a physical exam and have not had their heart or lungs listened to if they've had respiratory or cardiac complaints.

"If they haven't had their blood pressure checked, haven't been immunized or had any kind of cancer screening such as a pap smear, all of that backlog we hope over the coming year can be met and that has to be done in person," Moore said.

"We'll be monitoring because we can look at this from a billing perspective whether the trends are heading in the right direction, whether primary-care physicians are going back into their offices."

The chief medical officer said the letter is "a recommendation" and he does not foresee any consequences from the college or from the ministry if doctors do not heed the advice.

This month, CBC News reported that Toronto parents were struggling to get in-patient appointments with their child's pediatricians, even after testing negative for COVID-19. They were instead referred to SickKids emergency department or St. Joseph's Just For Kids Clinic for what turned out to be illnesses like a stomach bug or ear infection.

Both hospitals have reported a surge in patients with relatively minor illnesses this summer and fall. A spokesperson with SickKids told CBC News that August, usually its quietest month, was the busiest so far this year, seeing close to 6,000 patients. Parents reported wait times of up to 10 hours.

Sonu Maan has been trying all summer to get her one-year-old son Keish examined by his pediatrician for a fever, cough and runny nose, but he hasn't been allowed in the clinic even after testing negative for COVID-19. On Tuesday, she said he once again has a fever and is hoping this letter pushes his doctor to see him in person this week. 

The college previously told CBC News specialists are getting referrals for patients who haven't first had a physical examination to determine if they actually need to see one.

The Ontario's Patient Ombudsman and Advocacy Centre for the Elderly have also reported an increase in complaints from patients not able to see their doctor in person.