Telehealth not the solution to doctor shortage, says physician

By Al Beeber - Lethbridge Herald on December 15, 2021.

LETHBRIDGE HERALDabeeber@lethbridgeherald.com

An Edmonton community physician suggests Telehealth services aren’t the solution to Alberta’s doctor shortage.
Ed Papp, who has practised for 48 years in the province’s capital, also says patients of rural physicians trying to provide acute care are even more disadvantaged than those in bigger centres.
“We used to be only able to charge for 15 calls a week. It used to be seven, then they moved it up to 15. In my clinic for instance, we do a ton of phone calls and we just take it as a loss leader. But now what they did is they capped us at 50 services and there’s no limit on those calls. So what they’re trying to do is force us into Telehealth,” said Papp.
“I’ve written to these specialists that send me this consult and they say ‘I examined this patient virtually.’ You talked to him on the phone, you call that an examination? I’ve written to some and said look ‘I’ve testified in court cases, I’m a respected expert witness with my training and everything and those are the kinds of things we’re going to look for. You won’t have a leg to stand on because you just talked to him on the phone,” Papp said.
“I had one guy said the blood pressure is this. Well, he went to Net Care which is the provincial health record now and patients can look at it themselves. Most of them get terrified because they see a red number and they don’t have a clue what it means. They look there and he says ‘whoa, the blood pressure was 122/82.’ Well, that was on a pre-op form I had done a year-and-a-half ago. I said ‘you didn’t even ask the patient to measure their own. You just said that’s what it was. For your information, they have had uncontrolled hypertension for a few months now because they can’t afford their medicine,”‘ said Papp.
“The government, after you’re over 65, is really restricting what you can have access to,” said Papp.
“This has been just a nightmare. . ..you can’t order the newest antibiotic or something because they go into the pharmacy and it’s going to cost them $365 for two months of pills because it’s not covered and the damn pharmacists will not give us a call and say ‘look, here are the medicines that are covered. Would one of those be appropriate?’ They don’t do that but they have no hesitation writing to me telling me what I should do.”
Papp said acute care is suffering in rural areas despite the best efforts of doctors.
“When you have occasion to use it, heart care still is pretty good unless you live outside of a major centre. The ambulances there are scoop and run. So that acute care is pretty good and most of the emergencies, if somebody shows up really acute like strokes, heart attacks and that, you can get the treatment under way to abort the attack, which is the technology we have now. But anybody that doesn’t live in that centre that does that, they’re screwed,” Papp said.
“The docs out there (in rural Alberta) are trying, these people are dedicated and they’re doing what they can but they don’t have the resources.”
He said it’s also problematic that pharmacists and others are being utilized more to provide medical services.
“The problem with non doctors now practising is they don’t know what they don’t know so they end up costing your system more and are actually increasing the risk to people. And the government’s done that; they now have pharmacists and physios and nurses and chiropractors and everybody practising medicine without an hour of medical training.”

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