Editor’s note: The NWT Medical Association shared the following statement with media outlets on March 22; it is included unedited and in its entirety.

NWT Medical Association concerned that Bill 40 for virtual care will adversely affect healthcare in the NWT

The NWT Medical Association has significant concerns with Bill 40: An Act to Amend the Medical Profession Act. Doctors in the territory believe that the Bill will adversely affect the provision of healthcare to NWT residents.

“We commend the government on the Bill’s provision to allow physicians licensed outside the NWT to continue to provide virtual consultation to NWT residents beyond the current public health emergency, when that care originates in a request from an NWT care provider,” says, Dr. Kate Breen, a Yellowknife Emergency Physician and an Executive Member of the NWT Medical Association.

This type of care occurs if a NWT physician refers a patient to a specialist physician in Edmonton and that care is provided by telephone or video conference. The consultation would then be transmitted back to the originating NWT healthcare provider. This system was established under the current public health emergency and has been in place since 2020.

However, states Breen, “the rest of Bill 40 is potentially harmful to the quality and cultural safety of patient care in the NWT. It would allow any physician licensed anywhere in Canada to apply for a virtual NWT license to provide care by telephone or video conference, regardless of their knowledge of the geography, communities, culture, or territorial resources and care pathways in the NWT.” This is problematic for many reasons:

These physicians would not have access to the NWT electronic medical records, and the visit would not be registered in the NWT electronic medical records for local health care practitioners to see what actions the “virtual” physician took.

The virtual physician would not be able to order lab or diagnostic imaging tests but could prescribe medications without doing a physical examination on the patient.

If something went wrong, there would be no record of the visit in the NWT and potentially no recourse for the patient.

If the “virtual” physician deemed it necessary for the patient to be seen by another physician in person, then how would the medical transport be arranged? We believe this will lead to worsening health inequity in the NWT and potentially increase costs to the system with no significant benefit.

In addition, the Bill would allow the Minister of Health to make separate arrangements with other provincial or territorial regulatory bodies, eg. College of Physicians, that could allow an entire class of physicians to be exempt from licensing in the NWT, either on the virtual registry or the traditional physician registry. Thus, this class of physicians would be allowed to practice in the NWT without any licensing approved by the GNWT aside from the Ministerial agreement and no record of the physician in the NWT records.

This would result in no oversight of these physicians, without recourse if something went wrong. We believe this to be extremely risky.

We also have concerns with the clause that would expand the government’s power to establish or adopt standards of practice as well as scope of practice. To be clear, we support establishing standards and scopes of practice but these should not be developed by the government. Government interests (eg. financial or political) do not always align with what is best medical practice or in the best interests of patients. These standards should be established by a regulatory body at arm’s length from the government with the appropriate knowledge to do so.

We have reached out multiple times to offer our input but have yet to receive any satisfactory response indicating that our concerns have been heard. Fundamentally, we believe that Bill 40 will be detrimental to the healthcare of NWT residents and should not be passed unless it is significantly amended.

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