Hybrid medical clinic in Windsor at risk of closing after province cuts payment for virtual care

Medical clinic at risk of shutting down After the province slashed payments for virtual care appointments, the owners say the clinic is no longer available. Sijia Liu reports.

A hybrid medical clinic in Windsor is at risk of shutting down after the province cut payments for virtual appointments.

The Good Doctors medical clinic in Windsor is one of 17 across the province facing possible closure. The CEO says operations are no longer viable after the province reduced the amount it pays for a virtual visit from $37 to $20.

On Friday, Good Doctors closed its Mallorytown location in rural eastern Ontario.

“It was a very difficult decision having to close our location in Mallorytown. Unfortunately, it may not be the only one. All the other clinics are at risk as well,” said Leo Liao, Good Doctors CEO.

Unlike a typical virtual clinic, Good Doctors operates with the assistance of an onsite nurse or clinical assistant.

“For example, when someone comes in with a sore throat, we can look in the throat. We can do a physical. The doctor can see what the nurse sees, using digital equipment,” Liao explained. “The quality of medicine is different. The risk of a wrong diagnosis is much lower when you have physicals.”

Liao is calling on the province to exclude Good Doctor’s hybrid model from its virtual care fee reduction change.

This new fee structure is also forcing some virtual-only healthcare companies to reduce service.

Kixcare, a company that offers 24/7 virtual access to pediatric healthcare experts, had to shut down its urgent care services. Instead, the company is charging families a monthly $29 fee for access to health practitioners.

“It’s untenable to keep a clinic viable with that degree of defunding,” said Dr. Aviva Lowe, pediatrician at Kixcare. “The fees as it pertains to walk-in virtual care visits for pediatricians when there's no pre-existing doctor-patient relationship or referral are substantially reduced by over 75 per cent.”

The possible closures come as a new study by the Ontario Medical Association (OMA) finds no evidence the pivot to virtual care resulted in patients turning to the emergency department.

“We did not find evidence that enrolled patients substituted emergency department visits because of less availability of in-person care,” Dr. Jasmin Kantarevic, the OMA’s chief economist, wrote in the study.

“This finding is important given concerns about virtual care adversely affecting quality of care, leading to calls to substantially reduce care delivered virtually.”

The research looked at records from 7,936 family physicians and family health organizations between April 2020 and March 2021.

“This study shows that the unprecedented strain on emergency departments is not associated with patients being unable to see their family doctors in person,” OMA President Dr. Rose Zacharias said in a statement.

“These findings are important because virtual care, when medically appropriate, allows patients to connect with their doctor from the privacy and comfort of their own home.”