Parents and health experts are speaking out after learning that an online children’s 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 offering 24-hour on-demand pediatric care, is making the move as the province plans to cut fees for virtual doctor visits from $37 to $15 per patient on Dec. 1.
The clinic, which treated patients without a referral, instead offers a paid monthly subscription that costs parents $29 a month.
“This is simply not the time, if ever, to make these cuts,” said Dr. Harley Eisman, co-founder and chief medical officer of KixCare, which has treated 20,000 patients virtually over the past year, according to his co-manager. Founder and CEO Daniel Warner.
The cuts come as medical centers for children across the country, like Toronto’s Hospital for Sick Children, grapple with rising hospitalizations due to COVID-19, flu and the respiratory syncytial virus (RSV). According to SickKids, some patients wait up to 12 hours for an examination. And some parents say they have nowhere to take their child because their GP or pediatrician will not personally visit a patient if they have symptoms of COVID-19.
Virtual fee cuts are “regrettable,” says parent
Leah Littlepage said the service has helped her 16-month-old daughter stay away from the emergency room at least four times in the past year.
“It is unfortunate that funding for this program is being cut at the exact same time that children’s hospitals are becoming overcrowded,” 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 fell.”
“Mom groups are inundated with parents seeking medical advice from each other because they have nowhere else to turn.”
Matthew Kantor, a father of three children aged two, four and six, says the clinic has been “pivotal” to his family.
“The ministry has given us doctors who work at SickKids and that has been of great benefit to us… [They] did a really good diagnostic job just through video conferencing,” said Kantor, who lives in Toronto.
Kantor’s youngest son was diagnosed with Myhre syndrome, a degenerative disease affecting the connective tissues in the body.
“My son is in and out of SickKids more than once a month due to his condition … we’ve seen very long waits, we’ve seen crowded lines, and it’s really because parents don’t have options.”
Eisman said eight or nine out of 10 patients KixCare sees virtually were able to receive the right treatment and had a positive result.
“We’re not a service that was built to overload the ER or clinics and dump patients into ERs,” Eisman said.
dr Aviva Lowe, a Toronto pediatrician who has advised KixCare, is urging the provincial government to maintain access to virtual care for all children in the province.
“Pediatricians will by and large no longer be able to offer virtual visits to patients who do not have a pre-existing relationship or referral as the cuts are so significant that it is unsustainable to continue this type of care,” Lowe said.
“It is grossly unfair that people who already have a doctor or are referred to a doctor continue to have access to 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 … will suffer the most from the cut.”
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The Department of Health said it has reached an agreement with the Ontario Medical Association “to implement the framework for virtual care under the new Physician Services Agreement.
“Throughout this process, the ministry has taken a patient-centric approach to ensure Ontario residents continue to have access to the care they need, when they need it,” the ministry said in a statement.
“Virtual care should complement personal care, not replace it,” it says.
“This approach has led to significant changes for virtual care that ensure a positive patient-physician relationship is encouraged.”
Daniel Flanders, owner and CEO of Toronto’s Kindercare Clinic, said he understands the Ontario government is trying to stem the tide of purely virtual clinics and encouraging doctors to provide comprehensive and continuous care to patients.
But the province runs the risk of “throwing the baby out with the bathwater,” said Flanders.
“The changes that are coming our way [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 will suffer.”