NWT Medical Association Concerns Virtual Care Bill 40 Will Harm NWT Health Care

Editor’s Note: The NWT Medical Association shared the following statement with the media on March 22; it is included unedited and in its entirety.

NWT Medical Association Concerns Virtual Care Bill 40 Will Harm NWT Health Care

The Northwest Territories Medical Association is very concerned about Bill 40: An Act to Amend the Medical Profession Act. Territorial physicians believe the bill will harm the delivery of health care to NWT residents.

“We commend the government for the provision in the bill allowing physicians licensed outside the NWT to continue to offer virtual consultations to NWT residents beyond the current public health emergency, when this care stems from a request from a NWT care provider,” said Dr. Kate Breen, emergency physician in Yellowknife and executive member of the Northwest Territories Medical Association.

This type of care occurs if a NWT physician refers a patient to a medical specialist in Edmonton and care is provided by telephone or videoconference. The consultation would then be forwarded to the originating NWT health care provider. This system was put in place as part of the current health emergency and has been in place since 2020.

However, says Breen, “the remainder of Bill 40 is potentially detrimental to the quality and cultural safety of patient care in the NWT. This would allow any licensed physician anywhere in Canada to apply for a virtual NWT license to provide care by telephone or videoconference, regardless of their knowledge of geography, communities, culture or territorial resources and backgrounds. care in the NWT. This is problematic for several reasons:

These physicians would not have access to the NWT electronic medical records, and the visit would not be recorded in the NWT electronic medical records for local health practitioners to see the actions taken by the “virtual” physician.

The virtual doctor would not be able to order laboratory tests or diagnostic imaging, but could prescribe medications without performing a physical examination of the patient.

If anything went wrong, there would be no record of the visit in the Northwest Territories and potentially no recourse for the patient.

If the “virtual” doctor deemed it necessary for the patient to be seen by another doctor in person, how would the medical transport be arranged? We believe this will lead to worsening health inequities in the NWT and potentially increase costs to the system without significant benefit.

In addition, the bill would allow the Minister of Health to enter into separate agreements with other provincial or territorial regulatory bodies, e.g. College of Physicians, which could allow an entire class of physicians to be exempt from licensing in the NWT, either on the virtual registry or the traditional physician registry. Thus, this category of physicians would be permitted to practice in the NWT without a GNWT-approved license outside of the Ministerial Agreement and without a physician’s record on file in the NWT.

This would result in no oversight from these physicians, with no recourse in the event of a problem. We think this is extremely risky.

We are also concerned about the section that would expand the government’s power to establish or adopt standards of practice as well as the scope of practice. To be clear, we support the establishment of standards and scopes of practice, but these should not be developed by government. Government interests (for example, financial or political) do not always align with what is best medical practice or in the best interests of patients. These standards should be set by a regulatory body that is independent of government and has the knowledge to do so.

We have repeatedly reached out to offer our input, but have yet to receive a satisfactory response indicating that our concerns have been heard. Fundamentally, we believe Bill 40 will be detrimental to the health care of NWT residents and should not be passed unless significantly amended.

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