Parents and health experts are speaking out after learning an online pediatric service that has helped keep sick children out of overcrowded Ontario hospitals will no longer be free starting next week due to provincial fee cuts.
KixCare, a clinic that offers 24-hour pediatric care, is making the move as the province is set to cut the fees it pays doctors for virtual visits from $37 to $15 per visit. patient on December 1st.
The clinic, which saw patients without a referral, will instead offer a paid monthly subscription that will cost parents $29 a month.
“This is just not the right time, if ever, to bring these cuts in,” said Dr. Harley Eisman, co-founder and chief physician at KixCare, which saw 20,000 patients virtually in the last year, according to co-founder and CEO Daniel Warner.
The cuts come as children’s medical centers across the country, such as Toronto’s Hospital for Sick Children, are struggling with climbing hospital admissions due to COVID-19, influenza and respiratory syncytial virus (RSV). Some patients wait up to 12 hours to be seen, according to data obtained from SickKids. And some parents say they have nowhere to take their child because their family doctor or pediatrician won’t see a patient in person if they have symptoms of COVID-19.
Virtual fee cuts ‘deplorable’, says parent
Leah Littlepage said the service has helped her 16-month-old daughter stay out of the emergency room at least four times in the past year.
“It’s unfortunate that funding for this program is being cut at exactly the same time that the pediatric hospitals are being overstretched,” said Littlepage, who lives in Ottawa.
She said when she heard KixCare would become a pay-per-access service because of the new reduced pediatrician fees, “my heart dropped.”
“Mothers’ groups are flooded with parents seeking medical help from each other because they have nowhere else to turn.”
Matthew Kantor, father of three children aged two, four and six, says the clinic has been “critical” for his family.
“The service has given us doctors who work at SickKids and this has been hugely beneficial to us… [They] has done a really good diagnostic job just through video conferencing,” said Kantor, who lives in Toronto.
Kantor’s youngest son was diagnosed Myhre syndromea degenerative condition that affects the connective tissue in the body.
“My son is in and out of SickKids more than once a month because of his condition … we’ve seen very long wait times, we’ve seen overflow lines, and it’s really because parents don’t have options.”
Eisman said eight or nine out of 10 patients KixCare sees were practically able to get the correct treatment method and had a positive outcome.
“We are not a service that was built to overload emergency departments or clinics and to dump patients in emergency rooms,” Eisman said.
Dr. Aviva Lowe, a Toronto pediatrician who consulted on KixCare, is urging the provincial government to maintain access to virtual care for all children in the province.
“Pediatricians, by and large, will no longer be able to offer virtual visits to patients for whom there is no prior relationship or referral, because the cuts are so significant that it is not sustainable to continue the type of care ” Lowe said.
“It’s very unfair for people who already have a doctor or have a referral to a doctor to be able to continue to access virtual care in the way they deserve,” she said.
“While those who are already disadvantaged by not having their own doctor or timely access to their own doctor … are going to suffer the most from the cut.”
Virtual care ‘intended to complement’ personal care: province
The Ministry of Health said it had reached an agreement with the Ontario Medical Association “on the implementation of the virtual care framework within the new physician service agreement.
“Throughout this process, the ministry has taken a patient-first approach to ensure Ontarians will continue to have access to the care they need, when they need it,” the ministry said in a statement.
“Virtual care is intended to complement in-person care, not replace it,” it reads.
“This approach has resulted in meaningful changes for virtual care, ensuring that a positive patient-physician relationship is fostered.”
Daniel Flanders, owner and CEO of the Kindercare clinic in Toronto, said he understands the Ontario government is trying to stem the tide of virtual-only clinics and is encouraging doctors to provide comprehensive ongoing care to patients.
But the province risks “throwing the baby out with the bathwater,” Flanders said.
“The changes that come along the way, which [are] will really severely limit access to primary care, especially for patients in areas where they don’t have a primary care provider … there will be patients who suffer because of that.”