Profits Before Patients? The Corporate Push into BC’s Primary Care System

Big business sees opportunity in replacing the family doctor with corporate clinics or virtual care. Advocates see peril. First in a series.

Licensed practical nurse Anita Dickson had a firsthand look at corporate-delivered telehealth care. She didn’t like what she saw.Photo by Jeff Bassett.

Andrew MacLeod
September 7, 2020 
[Excerpts] Anita Dickson recently saw the kind of primary health care one corporate provider is delivering in British Columbia. And it scared her. 
Dickson is president of the Licensed Practical Nurses Association of BC. She has worked everywhere from emergency rooms to hospices and knows the kind of attention that goes into providing careful, personalized health care.

Not long ago she was with a family member who was using Babylon, a service that Telus offers through its health division. “See a doctor from your phone,” Telus promises, with the cost covered by the province’s medicare plan.

Dickson could see that the service was convenient. But she was concerned about what she witnessed — and the risks to patients.

“There’s no connection. It’s just being able to call up and get a prescription, and that’s how [the patient] sees it, and that’s the scary part,” Dickson said. The Tyee is supported by readers like you Join us and grow independent media in Canada

“What I saw was this female doctor gave a prescription for several months of birth control — not knowing [the patient] hadn’t taken her IUD out,” Dickson said. The patient wanted to alter her menstrual cycle and didn’t tell the truth when asked key questions about the IUD. The pill and some types of IUDs both affect hormone levels; using both could create risks for the patient.
A doctor who had been providing care to the patient for some time would likely have identified the risk. But it would be difficult, if not impossible, for a doctor dealing with the patient for the first time, on the phone, to recognize the complication.

The BC Family Doctors, which represents doctors providing primary care, recently released a statement urging caution in the adoption of telemedicine and calling for closer scrutiny of the involvement of corporate care providers.

“The encroachment of private, for-profit telemedicine needs to be regulated and controlled,” the statement said. “BC Family Doctors calls on the B.C. government to regulate and control the expansion of private, commercial interests in for-profit telemedicine in B.C.”

Dr. Toye Oyelese says corporate care undermines the relationship between patient and doctor. And that means lower quality care. Photo by Jeff Bassett.

The statement argues that telemedicine is best when used as a tool within a long-term patient-doctor relationship. One-off episodic services “should only be provided as an intermittent and infrequent alternative to a patient’s family doctor,” it says.

Corporatization was pushing care in the other direction, it said, with a growing number of British Columbians using telemedicine and losing continuity of care.

The doctors’ group also said private companies should be required to meet the same conflict of interest standards accepted by family physicians and other regulated health professionals. It warned, for example, that pharmacies shouldn’t be allowed to gain by entering partnerships with telemedicine providers that agree to drive patients to them.

“These changes are necessary in order to provide for the protection and safety of patients,” it said.

Some worry the government will be reluctant to take steps that would hamper Telus’s business. 

To read the full article, click on: Profits Before Patients? The Corporate Push into BC’s Primary Care System

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