You can see a doctor virtually without being examined – physical contact unnecessary. In fact, some medical interactions happen by voice only or text messaging so even “seeing” your doctor has been made superfluous.
You can arrange for prescription renewals, get time off from work, arrange for various tests (blood, urine, sputum, imaging and so on) and deal with chronic issues without a family doctor through various applications using pharmacists, nurse practitioners and sometimes just helpful algorithmic computer programs. No doctor necessary!
Welcome to the new world of iDOCTOR, standing by, ready 24/7, to deal with all medical conditions for all patients in all languages with empathy and kindness. They do not discriminate. Just pay a monthly fee.
This is the solution being offered for the 6+ million in Canada who don’t have a family doctor, including the homeless, immigrants and refugees, the disabled, Indigenous populations, the disenfranchised and those with high needs. This solution solves every problem of a rapidly shrinking pool of family doctors due to burnout and a growing doctor-less population.
There can’t be any unintended consequences, can there?
It makes total sense, right? There can’t be any unintended consequences, can there? So let us think through a few clinical scenarios:
Jean Pierre is a Metis paraplegic with one kidney, one leg, chronic kidney infections on chronic antibiotics, multiple cardiac stents, multiple medications and limited financial resources. He will just text iDOCTOR for help when he gets a stasis ulcer or has chest pain or has high fever and cloudy urine. Or he can go to the nearest Emergency Department (ED) that is open from his mobile home in Bracebridge, Ont. Easy peasy.
Sadia is a new immigrant. She has four children under 10 years of age. Her husband was killed in Syria. She is living in a temporary accommodation hotel. She has no phone, no computer, no internet and poor English skills. When her child has a laceration from the broken cabinet, or another gets an itchy rash that seems to be spreading, or another gets a productive cough, then she can just ask her pharmacist to help. Or she can go to the nearest ED. She will have to walk with all four children because she has no car and no bus tickets.
Vanessa is a 22-year-old autistic, intellectually challenged individual with chronic mental health issues in assisted living. She is struggling with sleep disorder and narcotic addiction due to chronic pain. She is using marijuana to calm her nerves and help her sleep. But her stomach is in terrible pain. She frequently uses the online iDOCTOR for medical advice. It says what it always says after talking to her for 10 minutes and billing her, which is: “Go to the ED!” How does that help her on this Labour Day long weekend?
Each one of these examples shows the limited value of iDOCTOR.
This will become our new standard of care in Canada. Simple problems are dealt with by Artificial Intelligence or non-family doctors apps run by private, for-profit corporations. Real medical conditions still will need family doctors to diagnose, treat, educate, manage and provide support over time. And there are lots of spare family doctors around, right? All others will be shunted to the ED. And ED are not too busy, right?
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I have read this Blog, it’s very informative, which is easy to content for us and others, there are various new things as well. Keep it up…
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When the COVID vaccine first became available, vaccinating everyone at once was neither feasible (not enough vaccine available) nor practical (human resources and logistics) so our public health leaders prioritized access based on who would benefit most. These priorities relied on medical and epidemiological evidence which almost all agreed were reasonable and fair as we waited our turn. Access to primary care is a determinant of health just as vaccines are. In the long run, we may be able to increase PCP supply. For now, to help people like those in this article, we should, first of all, put them at the top of the list for a PCP. Then, we need to create more PCP access by publishing attributes of those who least benefit and asking people who fit those metrics to give up their PCP, stay in line for a while and use the types of online services described here. While these services may not be as effective as a PCP for complex medical problems, presumably effectiveness improves in inverse proportion to complexity. Our public health leaders could provide added incentives for these lower risk individuals to temporarily cede their priorityPCP access passes, like coupons for dental care or eyeglasses or other services not covered by government health insurance, but which may do more for improving their health than a PCP.