A prescription for overcrowded ERs: Primary care doctors need to see patients in-person again | CBC News

Many factors are contributing to the wait times in Ontario’s emergency rooms, including staffing shortages, but some experts say ERs are seeing higher volumes partly because patients can’t see their family doctor in person for normal seasonal illnesses.

“Our family doctor doesn’t accept patients in person with cough, runny nose, flu or COVID symptoms,” one Toronto walk-in clinic told CBC News.

That clinic is not the only one to have that policy. Another clinic said its doctors may not be able to see a patient, depending on their symptoms.

Many at least require a negative COVID-19 test if a patient is showing any symptoms. This is happening at a time when the health-care system is facing a crisis brought on not only by the novel coronavirus but also high case levels of influenza and respiratory syncytial virus (RSV). 

Family doctors should ‘switch gears’ now, expert says

Dr. Anna Banerji, an infectious disease specialist and associate professor at the University of Toronto’s faculty of medicine, says these policies are a remnant from early in the pandemic. 

“At the beginning, it was understandable because we didn’t understand how severe COVID could be and the fact that someone could get it and potentially have long symptoms or die from it.”

Dr. Anna Banerji is a pediatric infectious disease specialist and associate professor of pediatrics at the University of Toronto’s Dalla Lana School of Public Health. (Submitted by Mike Cooper)

Now, she says primary caregivers should be vaccinated and able to see patients in person using appropriate personal protective equipment, including masks and gowns.

“We need to switch gears now,” said Banerji. “I think that especially when we’re having a crisis with influenza, RSV and COVID.”

“It’s our job as physicians to see these people.”

That crisis has extended to the emergency department at Toronto’s Hospital for Sick Children, where some children are waiting up to 12 hours to see a doctor.

Dr. Dina Kulik, a Toronto-based pediatrician and the director of Kidcrew Pediatrics, says doctors should be seeing children in clinics so they can avoid overcrowded emergency rooms.

“It’s best to avoid the [emergency ward] when you can, unless your child really does need emergency intervention.” she says. 

Kulik says most of the illnesses currently affecting children are viral and will get better over time without antibiotics.

She says some of these include influenza A, RSV, stomach flu and other common coughs and colds.

Kulik says her clinic only sees symptomatic children at certain times to avoid getting immunocompromised or healthy kids sick.

“Before 3 p.m., there are no sick children in the office.”

A view of Toronto’s Hospital for Sick Children in August. Recently, children have faced wait times of up to 12 hours to see a doctor. (Carlos Osorio/CBC)

Another part of the problem with ER wait times, says Kulik, is the anxiety around RSV. She says many families are taking their children to ERs out of fear they may have contracted the virus.

But Kulik says this won’t help confirm a diagnosis.

“Unless a child is admitted, they’re not going to be swabbed for RSV or other viruses. Most things can be managed at home, but I think there’s a lot of fear.”

Simple prevention still best tool, doctors say

Even as some clinics continue to only see non-symptomatic patients or conduct appointments over the telephone, both Banerji and Kulik say the best way to avoid spreading sickness and contributing to the strain on Ontario’s health-care system is simple prevention.

“If you’re sick, wear a mask. Keep your hands very, very clean and really take a couple of days off if you’re not feeling well because we’re just spreading it around,” said Kulik.

They both say masking is still a very good idea as we get further into the fall and winter seasons when people spend more time indoors.

“My kids are in school masked and knock on wood, they haven’t been sick yet this viral season,” Kulik added.

Banerji also says there are a lot of young children who are not getting the COVID vaccine or flu shot. She says getting more children immunized would make a huge difference in helping the wait time crisis.

“Everyone has COVID fatigue, including myself,” she said. 

“I wish it would go away, but it’s not gone, it’s here. So we need to do the most we can.”

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