Positive reactions
Tignish clinic operates one day a week while efforts to recruit replacement physician continue
TIGNISH – A virtual health clinic being piloted at the Tignish Co-op Health Centre is “going well,” says the doctor on the other end of the high-tech digital connection.
Before retiring from his practice at the Tignish Health Centre at the end of September and returning to his native Ireland, Dr. Declan Fox agreed to a Health P.E.I. offer to pioneer a virtual clinic in Tignish.
He launched the one-day-aweek initiative in early November and now is seeing about 15 patients every Wednesday. “They all know me and they’re all very happy to see me,” said Dr. Fox. “It’s not just nice for them to see me; we get the job done.”
Fox had been staffing a clinic at the P.E.I. health centre fulltime since 2014.
He said the model of care there “always depended very much on everybody working up to their full scope, on making the most efficient use as possible of the doctor, because the doctor was the scarcest resource.”
That hasn’t changed with virtual care.
Tanya Ellsworth, Licenced Practical Nurse (LPN), who had worked with Fox since 2014, remains the first point of contact with patients, learning their medical history and issues. She then discusses the patient’s needs with Dr. Fox who is in the next room – virtually, across the Atlantic Ocean.
Sitting in front of a computer monitor in the study of his home, just outside of the Northern Ireland village of Newtownstewart, Fox then greets the patient and completes the assessment.
He is able to order prescriptions and forward them electronically to the pharmacy of the patient’s choice, and prescribe a course of treatment.
“A lot of (patients) are really optimistic about it.
“They’re happy to see him because most of the patients who are coming back here really loved his way of treating patients, the way the practice worked, so they’re really happy about getting in and actually getting to sit down and chat with him,” Ellsworth said. She admits people in the community are really curious about the virtual care model.
“There would still be certain things not suitable for this model of care, simply because I cannot put my hands on the patient,” Fox acknowledged, suggesting some unusual neurological examinations, for instance, would have to be performed with a physician physically present.
To that end, he is able to view the list of patients in advance and decide which ones he can see in the virtual clinic.
Patients need to sign a consent form to take part in the pilot.
Lee Doucette of Cascumpec has been to the clinic once since virtual care was launched and will be going back.
“I like the system,” he said, “considering what it would be with nothing.”
Doucette said he was already familiar with tele-conferencing, so the service Dr. Fox provided electronically was not surprising.
That element of familiarity is important, says health centre manager Wendy Arsenault. “He’s still their family doctor; he’s just in Ireland.”
Fox acknowledged the service is only intended to be in place until a physician is recruited to take over the practice he had in Tignish.
He believes the exposure the health centre gets from piloting virtual care will actually serve as a recruitment tool.
In the meantime, he is already planning an eight-week locum in West Prince starting in February. Unless a doctor has already been recruited to fill his spot, he thinks the most practical place for him to do his locum will be in Tignish.
Fox also sees potential for virtual care being expanded to include other physicians. He suggested doctors, possibly as close as Charlottetown who wouldn’t be able to commit to a drive to and from Tignish, would be able to commit to virtual care in Tignish from their offices wherever.
“We’ve seen quite a wide variety of patients and haven’t encountered anyone that hasn’t been able to have their care managed over virtual care,” reports Christina Phillips, Primary Care manager for West Prince. Appointments take about 20 minutes, on average, just slightly longer than the average appointment length when Fox was physically present.