Three months after Horizon Health Network introduced a virtual urgent care pilot at Sussex Health Centre and Charlotte County Hospital emergency departments, the New Brunswick Medical Society is requesting an immediate cancellation.
“We’re unsure of what the objective was of creating this because if it was meant to keep the emergency department open, it obviously isn’t going to do that because it’s not equal to emergency care,” said New Brunswick Medical Society president Dr. Lise Babin.
Patients who visit the emergency departments will still be assessed and registered as usual, but will then be offered a remote virtual doctor if their symptoms fit the criteria.
According to Horizon Health, the one-year pilot program was put in place to improve access to urgent care in communities where staffing issues have been challenging and emergency department hours have been reduced.
“As of January 31, 2025, 656 patients have received virtual care since the pilot began in November 2024. This represents 20 per cent of overall patient visits to the SHC and CCH ED during this time,” said Horizon Health president and CEO Margaret Melanson in a statement in CTV News.
She adds that overall, patient satisfaction has been extremely positive.
However, Babin says virtual care can’t replace an actual physician being present in the emergency department.
“There are a lot of ways that you can look at primary care. We spoke about access and obviously I think that was probably the objective with creating this program, but we have to look at quality as well and we know that being seen by these physicians that aren’t on site, it cannot be equal in quality of care as being seen by an actual physician and being able to be examined by them, but we also have to look at efficiency,” said Babin.
The Medical Society is concerned with resources being pulled from other duties as nurses need to be present for virtual care.
“Our point of view is that while virtual care can be part of the solution, we will always be more supportive of prioritizing in-person practitioners over virtual care. This is more of a band-aid solution while our regional health authorities work towards more long-term solutions for our health care staffing,” said Paula Doucet, president of the New Brunswick Nurses Union.
Babin says they’re also concerned with the program being contracted through U.S. private sector agency Teladoc.
Horizon Health confirmed its contract with Teladoc is confidential.
“We can confirm the contract covers a one-time procurement and licensing cost; the equipment required to provide virtual care, as well as the set-up of and any maintenance and technical support for that equipment; the coordination of care provided by the vendor; and physician remuneration,” said Melanson.
Babin says the physician who is physically on site is seeing more patients and all the urgent cases while receiving the same compensation.
“They’re being essentially paid the same for their time and then we’re adding a premium to that by paying this company to hire physicians and then we pay them for that, so efficiency wise I can’t see that this is an effective way of solving the issue of access to primary care,” she said.
The Department of Health has confirmed it is providing funding for the pilot based on a proposal from Horizon to address a critical staffing need within both hospital’s emergency departments.
“The Department of Health is providing up to $865,595 in funding from the 2024-25 budget to Horizon for the pilot project,” said communications officer Sean Hatchard. “Any additional funding would come from the 2025-26 budget, which will be presented in March.”
The Medical Society says that money could be better spent on collaborative care clinics within the province.
“I think we’ve got great ideas on how to incentivize emergency room physicians to work in rural areas. We’ve been working and advocating for these collaborative care clinics so we want to have these discussions with government and try to find other solutions that will be better quality of care and more efficient for government as well,” said Babin.
The Department of Health told CTV News it is “seeking long-term solutions to ensure New Brunswickers have access to the care they need when they need it” and the government is supporting 30 new collaborative care clinics with 10 being established this year.
Horizon Health says the pilot project is currently filling a gap within the health-care system through the use of technology.
“We know face-to-face care provided by an emergency physician is the gold standard for emergency and urgent care. However, face-to-face care is not always possible, and we must consider other ways to provide New Brunswickers with quality care when they need it,” said Melanson. “This solution is a very effective way to maintain services without compromising patient safety and standard of care.”
The Medical Society has not received a response from Horizon Health or the Department of Health regarding their request to cancel the pilot project.
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