This article originally appeared in the Spring 2022 issue of the Ontario Medical Review magazine.
Understanding virtual care’s place and purpose in medicine
The COVID-19 pandemic brought about a paradigm shift that fundamentally changed the health-care landscape.
Seemingly overnight, the health-care system was faced with unprecedented volumes of virtual care in the form of telephone/video appointments. Some doctors expressed early on that this virtual care revolution was long overdue despite the technical glitches experienced along the way.
Physicians and patients alike were faced with frightening unknowns about the virus and how care could be safely delivered in the initial days of the pandemic. Virtual care tools that already existed allowed essential connection between doctor and patient to be maintained, which was especially important during the extensive lockdown periods. Now two years later, with a better understanding of the novel coronavirus, and with better tools to limit its spread and growing vaccination rates, people are looking to understand how virtual care fits into this next phase.
Psychiatry practices were fortunate in that many of its services such as psychotherapies and medication management were readily adaptable to remote-visit formats to deliver patient care at the beginning of the pandemic. In my role as a community psychiatrist, I have seen virtual care yield immense benefits beyond the initial goal of decreasing the spread of infectious diseases such as COVID-19.
Increased access to health care, especially for remote communities and marginalized populations who are at higher risk of poor health outcomes, have been especially transformative. Some acute mental health issues can be addressed sooner as patients no longer have to fight against logistics such as: hours lost in commute times that negatively impact work/school, burdensome costs associated with getting to an appointment (For example public transit fees, gasoline prices, parking fees), and home-bound scenarios predating the pandemic. Collateral history can also be easier to obtain. Decreased cancellations and greater involvement from patients and their caregivers subsequently allows for recovery to happen more meaningfully. These pieces can be generalizable across practice settings within medicine.
Burnout is another important aspect to address. Virtual touchpoints have expanded options for physicians to better optimize the balance between work and home life. Clinical duties and professional meetings can be more efficient when travel time is no longer a rate-limiting step.
As has been the case throughout the pandemic, there continues to be situations in which patients need to be treated in-person and they should still have access to that. Even with more opportunities for in-person care becoming available, the above points still stand. A broader approach allows physicians to better match patients with the appropriate treatment settings, recognizing that a shift in percentages of who engages with which format of care will naturally evolve.
There is a full menu of care options now that needs to remain in place instead of being devalued if we want to avoid losing the gains made. Virtual care is a key ingredient in the prescription to end hallway health care and we should fill it.