How Virtual Medicine Is Changing My Practice

If there is anything positive that can potentially come as a direct result of the COVID-19 pandemic, it is likely to be a turbo-charged advance in virtual medicine.

Although “tele-medicine”, in  one form or another, has been around for well over a decade (if not longer), it was essentially a side show. Even where widely used, tele-medicine was generally used to reach patients in settings where geographic distance made in-person consultations impractical.

In the past, this generally involved booking time in the tele-medicine suite where you could consult with the patient, who in turn had to travel to a local tele-medicine outlet at their end, for a video consult.

Thanks to the COVID lockdown and the advances in technology, this rather cumbersome process has dramatically changed (in a matter of weeks if not days!), thanks to smart phones.

By now most of us are routinely using Zoom or some other virtual platform (if not just the telephone) to consult and counsel our patients.

Not only have both providers and patients rapidly adopted this technology, but health authorities have, almost overnight, come up with new billing codes for virtual patient care that make this an economically feasible venture for healthcare providers, who in the past only got paid for office visits.

All of this has of course also affected by own practice (currently entirely virtual) and it is fair to say that both my patients and I are pretty happy on how things are going. In fact, looking back, one wonders why in the past we routinely expected our patients to endure lengthy commutes for a 20-min in-person appointment, which, as we now see, could easily have been dealt with using a smart phone during their coffee break.

Now, that everyone appears to be comfortable with this, it is hard to see us going back to the old ways. In fact, in Alberta, Alberta Health has just announced that they are making the newly instated billing codes for virtual consults permanent.

However, the fact that with virtual medicine, the geographic location of the patient becomes virtually irrelevant, one wonders what impact this will have on medical practice that crosses jurisdictions. Traditionally, the practice of medicine is tightly regulated from province to province – thus, for example, I am licensed to practice medicine in Alberta but not in neighbouring British Columbia or Saskatchewan, never mind outside of Canada.

Thus, although I probably receive twenty requests for consultation from people living with obesity from around the world each week, I currently have to decline giving any advice, as I am neither licencesd to provide medical care outside of Alberta, nor would this be covered by my medical liability insurance.

Virtual medicine of course has the potential to dramatically change this – in fact, there is now no technological barrier to me providing the exact same medical consultation to a patient living in Peace River, Alberta, than there would be to seeing a patient living in Dubai or Kuala-Lumpur.

It will certainly be interesting to see how the routine use of virtual medicine will challenge regulators as well as payers and insurers to come up with new models that will allow medical practitioners to provide direct medical consultations to patients, irrespective of where they my be on this planet.

Perhaps it will soon no longer matter if your patient lives in the same town, province, or even country as you do.

Vey much looking forward to reading your comments on these developments.

Interesting times indeed!

Edmonton, AB