Question: I think I need to see a doctor, but I’m worried seeking care will put me at risk of getting COVID-19. What should I do?
Answer: Public health recommendations amid the COVID-19 pandemic to ‘stay home’ are valid and necessary, but what should you do when you get sick?
Last week I had a family member in Ontario call me in BC seeking medical advice because they felt socially obligated to avoid health care facilities. It was great to see Canadians doing their part to practice physical distancing recommendations. But I felt it was prudent for them to be seen non-urgently, and found myself unsure where to recommend they go. After doing some research, I directed them to be remotely assessed by a local family physician. Within an hour, they were on their way to a pharmacy to pick up a prescribed medication.
Your next doctor’s appointment may be a digital one. A 2019 review study found that patients may be more satisfied with telemedicine versus face-to-face encounters and that the technology improved access to care. The management and diagnosis of patients across a number of presenting complaints was similar in virtual compared with in-person visits.
While telemedicine programs have taken off in the US, the uptake in Canada has previously been slow for a number of administrative reasons. Provincial licensing variation, privacy concerns, adequate telemedicine training, and the inability to physically examine patients using the technology are all limitations that have made regulatory bodies reluctant to its use outside of circumstances that necessitate it.
In February of 2020, the ‘Virtual Care Task Force’ – a collaboration of the Canadian Medical Association and the regulatory bodies of family doctors and specialists – released its recommendations for expanding the implementation of virtual care in Canada.
The timing of these recommendations has been ironically timely.
The COVID-19 pandemic has forced the hand of governments to expedite telemedicine implementation. The College of Physicians in Ontario, BC, Alberta, and most other provinces have responded with new guidelines around telemedicine, and provincial governments have created new fee codes physicians can use to see patients virtually while maintaining maximal physical distancing measures.
Canada’s public health departments have been clear with their valid and necessary message to all – if you have respiratory symptoms that are not severe, stay home. If you are concerned you have COVID-19, you are encouraged to use online self-assessment tools and to follow the advice from the assessment or from a possible subsequent telephone conversation with a health practitioner before visiting a healthcare facility. And if if you are ill and cannot manage, do not stay home. Seek care.
My experience with my family member last week reminded me that navigating the healthcare system is already difficult, and it becomes increasingly complicated during a time of such extraordinary uncertainty and change. I think there are a number of simple things that we can do to help avoid overwhelming our system while keeping ourselves and each other safe.
- Continue to practice physical distancing and follow the daily advice of your provincial Chief Medical Officer of Health.
- If you are experiencing respiratory symptoms or think you may have been exposed to COVID-19, complete the appropriate self-assessment tool and follow its recommendations. (BC, Alberta, Ontario)
- If you have a family doctor, become familiar with their current telemedicine options, as continuity of care is ideal. You might not need to see them today, but knowing how to access them when you need it is important.
- If you do not have a family doctor, try and become familiar with telemedicine options in your local community. The websites of walk-in clinics often have this information.
- If you are experiencing an acute health problem you believe needs to be physically examined by a physician, or if you are ill and cannot manage, then seek care. COVID-19 may be putting the health of many Canadian’s at risk, but it should not interrupt Canadian’s access to care for things ranging from fractures and lacerations to more serious events, like heart attacks and strokes.
Health care workers continue to come into work so that Canadians can stay home and stay safe. This is our job. If you think you might be ill and need care, don’t feel guilty about doing something about it. Telemedicine is an important resource we can all use while maintaining proper physical distancing. And Canadians should still seek in person care when they need to.