Despite the promises of “universality” and “accessibility” enshrined in the Canada Health Act, virtual delivery of family physician services for mental health varies enormously across the country.
Before the COVID-19 pandemic onset, virtual delivery of physician services in Canada was rare – other than in specific settings, it was not included within publicly funded health services. Soon after the start of the pandemic, 50 per cent of outpatient care was provided through virtual modalities, an astonishing 56-fold increase, comprising 71 per cent of primary-care visits in the first months of the COVID-19 pandemic. This was a welcome change for many patients, who had reported substantial barriers to accessing virtual care in the past.
These changes also impacted accessing mental-health services for many patients, given that primary mental-health care physician services are publicly funded, and therefore free-of-charge to most patients. Our team’s work has demonstrated that anxiety and depression were the most common reason for people consulting family physicians in 2020.
Family doctors are a mainstay of mental-health services in Canada because their services are paid for by provincial and territorial Medicare programs. Billing codes included in the Schedule of Medical Benefits in each province and territory determine the range of services that are publicly funded. The biggest change after the start of the pandemic was that synchronous virtual care (where the physician and patient are interacting in real-time, using video or phone calls) became part of what was publicly funded across the country.
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Healthy Debate
May 28, 2023