Proposed changes to the way physicians outside the territory provide virtual care could have negative consequences for patients, the NWT Medical Association says.
Last year, health minister Julie Green introduced Bill 40, which would allow medical practitioners licensed elsewhere in Canada to provide virtual care to NWT residents from beyond the territory.
In a Tuesday news release, the NWT Medical Association acknowledged such a change would help territorial physicians make referrals to healthcare practitioners elsewhere.
But the association said some of the bill’s proposed changes were “potentially harmful to the quality and cultural safety of patient care in the NWT.”
The medical association takes issue with plans to allow physicians anywhere in Canada to apply for a virtual NWT licence, regardless of their connection to the territory or knowledge of its geography and resources.
The association said taking that step could worsen healthcare inequity in the NWT and potentially increase costs to the territory’s healthcare system with no benefit.
According to the association, those physicians would not be able to order lab or diagnostic imaging tests, nor access NWT electronic medical records. That would be “extremely risky,” the association said, as there would be no record of the visit in the NWT, making recourse difficult for patients if something goes wrong – and preventing local physicians knowing what care was provided.
“Fundamentally, we believe that Bill 40 will be detrimental to the healthcare of NWT residents and should not be passed unless it is significantly amended,” Tuesday’s news release stated.
Dr Kate Breen, a Yellowknife emergency physician and member of the medical association’s executive, told Cabin Radio the proposal to expand virtual care should be “reconsidered with further input from physicians in the territory.”
The association separately objects to the bill’s proposed expansion of the territorial government’s power to establish or adopt standards, saying those standards should be established by a regulatory body at arm’s length from the government.
“There is a potential conflict of interest,” said Dr Breen, “because the priorities of the government aren’t always in line with the priorities that would be decided by the medical profession.
“As a self-regulating body, it’s important that it is the physicians themselves that establish their codes.”
In its news release, the NWT Medical Association said input had been given to the territorial government but it had “yet to receive a satisfactory response.”
On Monday, Breen said, a member of the committee reviewing the bill said the association’s feedback was being considered.
The health minister’s communications representatives did not immediately respond to a request for comment.
Report recommended simplifying licences
Virtual care – the practice of providing healthcare remotely, for example by phone or video – has played a role in the NWT’s healthcare system for decades and became particularly important during the Covid-19 pandemic.
The territorial government, setting out the basics of Bill 40 last year, said current policies and laws get in the way as medical practitioners can only provide virtual care if they are already licensed in the NWT.
According to the territory, Bill 40 would create a new category of registration and licensing for physicians practising virtual care. The bill would allow a register of physicians to be posted online, making their information more accessible to NWT residents.
Kam Lake MLA Caitlin Cleveland, speaking in the legislature in March 2020 – just days before the pandemic reached the territory – said there was a need for more virtual care in the NWT.
She pointed to recommendations in a February 2020 report on virtual care from a national committee co-chaired by a Yellowknife-based physician, Dr Ewan Affleck.
That report called for improved digital systems to better exchange healthcare information, simplified registration and licensing so physicians can provide virtual care across provincial and territorial boundaries, and creating payment models for virtual care.
Other MLAs have so far supported the proposed changes in Bill 40. The act passing its second reading in November 2021, with three readings required before a bill becomes law.