The future of virtual care is in relationships

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  • Y. Right says:

    “Continuity of care” is a crock — even if a patient is rostered for years with a family doctor within a team, that doesn’t actually mean any worker in that team will even keep the appointment made hours, days, or weeks before. So the EDs fill up and the patients are blamed as “bse”, “not sick enough”, being “mental”, having gas when its actually a stoke or heart attack, “merely constipated” (that was my 20+ son, who actually needed an emergency gallbladder removal within 36 hours, like *all* of his aunts in their 30s) or whatever label is derogatorily applied. While this author sounds great, too many of her colleagues give the impression that “continuity of care” mainly means “continuity of billings” or “exclusive rights to control the health care services” a patient is qualified for, and while a 20-something female is sympathetic, so qualifed for true care, a 50+ female is likely to have her concerns minimized to the point of barely-disguised, contemptuous dismissals – unless the issue is life-threatening and so allows the professional team to stroke their own egos by acting as heroes. And yet, the medical industry staff wonder why trust in the profession is declining, or why so many of us avoid health care businesses unless we’re in extremis.
    The author is correct when he writes, “Virtual care’s adoption curve risks widening this chasm.” I’ve now had 3 virtual visits, and while the last one was fine, the first two with a family doctor who was supposed to treat my chronic conditions (but didn’t) were clearly designed for her benefit – not mine. Yes, I fired the princess, as I cannot trust a credentialled physician who ignores blood work results that even this layman could read and understand. (Nor was the bloodwork fiasco her first strike; it was just the final straw.)

  • Marg Wood says:

    Thank you, Dr. Nowak. I wish all doctors were as caring as you.
    Marg Wood

  • Barbara Sklar says:

    In Ontario, and I suspect other provinces, we already have a call centre for health issues and a few Doctors On Call. Why not adapt these exiting services to provide virtual visits. R.N.s and N.P.s can do a better initial screening, resulting in less callers being sent off to the E.R. Also, if you already have a doctor, they should all be accessing the same technology, and be able to connect to other doctors, and hold joint consultations, etc. to ensure safety re confidentiality. Seamless care will save money and lives.

  • Duncan Sinclair says:

    Given the ubiquity of the technology to make virtual care as effective as it is and will be increasingly, that Emily has “medical records” (plural) is irresponsible and that HER record(s) are not available to her is shameful.

  • Allan O'Dette says:

    Dr. Nowak,

    Excellent article.


  • Joy Hataley says:

    Next comes the Hologram…
    and increased opportunities for continuity. However, if the OHIP SOB fails to value continuity, it will at best be accessible to only those whose physicians thrive on passion alone.
    An insightful and enlightening article Dr. Nowak!

  • michael kates says:

    Well done Dominik
    My issue with Virtual is when it comes to duplication of services and assessing virtually when better visualization or assessment is required. Virtual is convenient and my other concern is, like anything it can be abused. Guidelines need to be in place fit that. Well done and keep it up!! Mike Kates

  • Rick Menassa says:

    Great article making the clear distinction between telemedicine, a onetime event, and Virtual Care being a connected, patient centred approach that facilitates care continuity to patients, whether local to the physician or in remote communities. This is aligned with our vision at http://www.healthespresso.com where a connected, patient centred platform connects not only the primary physician, but the entire circle of care to avoid service duplication, fill care gaps for better health outcomes.


Dominik Alex Nowak


Dominik Alex Nowak, MD MHSc CCFP, is a family physician, health systems strategist, and faculty member at the University of Toronto.

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