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A mayor in rural Newfoundland says most people in his community who needed urgent care in the past few years arrived at the local health centre and “talked to a TV.”
Kevin Pittman said some of the older residents of St. Lawrence, N.L., were especially weary of the virtual urgent care services at the U.S. Memorial Health Centre, which are provided by Teladoc, a private company, through a contract with the provincial health authority.
Having a nurse on site helps, and people can get help quickly, especially with their prescriptions, he said. But as Newfoundland and Labrador expands virtual care, Pittman and the association representing the province’s doctors say it’s no replacement for in-person physicians.
“It’s stopgap measure,” Pittman said, adding: “Especially when you have a community that’s more than 60 per cent senior citizens who’ve grown up seeing a doctor.”
Newfoundland and Labrador’s provincial health authority had paid Teladoc about $32.1 million as of April 30 to provide virtual primary care to people without family doctors, and to staff emergency rooms and urgent care centres with virtual physicians, spokesperson Mikaela Etchegary said in an emailed statement.
The health authority first announced a two-year agreement with the company in November 2023 worth $22 million, with plans for Teladoc to serve five emergency rooms and expand as needed. That contract has since been extended into this fall and officials are now preparing a call for proposals from virtual care providers to sign a new deal, Etchegary said.
As of May, Teladoc was operating in 10 emergency rooms and four urgent care centres across the province, she said.
“Virtual emergency support has proven to be an effective solution for maintaining access to urgent and emergency care in communities where physician coverage challenges may otherwise impact the availability of local services,” Etchegary said in a recent emailed statement.
“As always, every effort is made to arrange in-person coverage before virtual coverage is used.”
Teladoc Health is headquartered in New York City, and Teladoc Health Canada’s headquarters are in Toronto.
NLMA president Dr. David Metcalfe says the province must attract and retain more doctors. (Evan Mitsui/CBC)
Dr. David Metcalfe, president of the Newfoundland and Labrador Medical Association, says the expansion of Teladoc’s services is a symptom of an unsolved doctor shortage. The province must attract and retain more doctors, he said in an emailed statement.
“Virtual care was never intended to replace a patient’s access to their own family physician or become a permanent substitute for emergency care,” Metcalfe said.
Teladoc’s expansion into more communities is “not a sign of success, and it’s not the standard patients should expect in a modern health-care system,” he added.
Pittman said the emergency room at the U.S. Memorial Health Centre is now closed and the virtually-staffed urgent care clinic is the only option for quick medical attention. There is a family care clinic, typically staffed by a locum, but that doctor doesn’t take on urgent cases, he said.
The nearest emergency room is in Burin, N.L., which is a 25-minute drive away — not a huge distance in rural Newfoundland, Pittman acknowledged. But the loss of accessible, in-person medical care is a big change for his community and the many residents within it, he said.
The town is also an industrial hub, with a nearby mine and fish plant, each with a few hundred employees, he added.
“If one of those workers gets hurt on the job there, they’re headed to Burin, not to hospital, which is a couple of kilometres away,” he said.
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