Alberta Politics
The Alberta doctor’s office of the future? (Photo: Jago Times, actual Alberta physicians may not appear exactly as illustrated).

The new two-tier medicine: real physicians for the rich, an Internet app for the rest of us?

Posted on March 21, 2020, 1:33 am
11 mins

Get ready for the new two-tier medicine!

Real doctors for the rich; Internet apps of the rest of us.

Alberta Health Minister Tyler Shandro (Photo: Government of Alberta).

You think I’m kidding?

Wednesday night, I found an email in my inbox from Telus Corp., the corporate monstrosity based in the Vancouver suburb of Burnaby that was once two excellent publicly owned utilities in British Columbia and Alberta. Or, as Telus would prefer us to yell its name, TELUS.

Telus President and CEO Darren Entwistle was reaching out to me personally, or so he said, “to let you know the TELUS team is here to support you and our fellow Canadians as we manage through COVID-19.”

Well, thanks, Darren! I really appreciate that, buddy!

Anyway, after the usual folderol about how Telus is taking important precautions to maintain social distancing that we’ve all heard from a variety of corporations these past few days, Mr. Entwistle went on to invite me to try something called Babylon by Telus Health.

Why they chose that name, I cannot say. The mysteries of corporate branding are, well, mysterious. I do not like the sound of Corporate Babylon, though.

Telus Corp. President and CEO Darren Entwistle (Photo: Telus Corp.).

Regardless, Mr. Entwistle personally advised me, through Babylon I now “have access to a free, customized COVID-19 online symptom checker, and patients in B.C., Alberta and Ontario can schedule a one-on-one video consultation with a licensed doctor at no cost from your smartphone and in the comfort and safety of your own home.”

Well, never let it be said that any old global catastrophe isn’t a chance for someone to make money, I concluded. End of story, I assumed.

When I checked yesterday to see what was up, however, I discovered a news release from the Alberta government informing me, “New app helps Albertans access health care,” and furthermore, “Albertans can now meet with Alberta-licensed physicians through their smartphone, thanks to an initiative by TELUS Health.”

“Albertans can use the service to check symptoms, book appointments, see a doctor, and get prescriptions and referrals for diagnostic imaging and specialists — all covered by Alberta Health Care,” the press release said.

It also contained a nice canned quote from Health Minister Tyler Shandro: “Alberta is pleased to partner with TELUS to deliver physician services in a new way. This app … comes at a time when our health system is actively asking people to self-isolate as a result of the COVID-19 pandemic. Using this app is an alternative to visiting physicians face-to-face when you’re not sure if your symptoms are related to the novel coronavirus or at any other time.” (Emphasis added.)

There was an even more enthusiastic quote in the release from my buddy Mr. Entwistle, who, among other things, told Albertans Telus hopes it can “mitigate the enormous pressure on our health-care system through our technology, human ingenuity and compassion.”

Peace River physician Dr. Heather Shonoski (Photo: Twitter).

Remember, this news release is from a government that until last Wednesday was openly at war with Alberta’s physicians, and which furthermore is relentless in its pursuit of ways to cut costs in public health care while skimming off potentially profitable business for its friends in the private sector.

As a medical layperson, Babylon strikes me as an exceptionally bad approach to clinical practice. Whether or not it has merits as an emergency plan in a crisis open to question.

There is no good replacement for a family doc,” Dr. Joe Vipond of the Canadian Association of Physicians for the Environment reminded me. “Walk-in clinics suck. I see such bad medicine from them. How could this not be 1,000 times worse?”

He’s right. Your family doctor has a relationship with you, and solid knowledge about your medical needs. A telephone service, as Dr. Vipond observed, “sounds like a ’scrip writing machine.”

In a post on Facebook, Peace River MD Heather Shonoski wrote: “Family physicians have been begging the health minister to allow us to provide virtual care to our patients so that we can keep our vulnerable patients at home and promote social distancing.

“Physicians from my clinic have called Telus and were told they cannot see their own patients through this platform, rather they would have to provide virtual walk-in,” she wrote. “We want to be able to see our own patients in our own critically underserved rural community where we know our local resources. We want to provide continuity of care, which has been proven to save lives and minimize resource use.”

Dr. Joe Vipond (Photo: David J. Climenhaga).

Allowing a doctor elsewhere in the province to advise patients not knowing conditions at local clinics and facilities is dangerous, Dr. Shonoski added. And she argued Alberta’s billing rates for telephone care by family doctors are too low: “Do we have patients physically come in to the clinic and increase their risk or do we shut down our clinics / go bankrupt / lay off our staff and keep patients safe? I guess the question is whether we as a society want family doctor offices.” (Emphasis added.)

According to Mr. Shandro’s press secretary, Steve Buick, Babylon tele-docs’ pay is based on Alberta Health’s basic $38 office visit fee. Family doctors, who can actually see your charts and know your history, are restricted to $20 per call, out of which they must pay the costs of running their practice.

App docs, of course, will redirect patients back to their family physicians as quickly as possible.

The few details provided in the government press release about how this is financed are extremely murky. “The service is being delivered to Albertans through an alternative relationship plan between the Alberta government and TELUS.” The project has a budget of $1.5 million.

Babylon could set the stage, though, for something the UCP, Mr. Shandro and Premier Jason Kenney would all truly love: two-tier medicine in which there were real physicians for the wealthy, and an app for the rest of us.

Dr. Shonoski noted that the College of Physicians and Surgeons of Alberta, the profession’s regulatory body, and the Canadian Medical Protective Association, a not-for-profit mutual insurance organization, have endorsed such telemedicine apps as Medeo and doxy.me, as well as use of email, telephone, Skype and FaceTime to provide virtual care. “Why is it that none of these are being supported?”

“I am very concerned that the government is using this pandemic to further their own push for privatization,” she concluded.

As a student of Alberta politics, I would not be at all surprised to see this extended to many more uses in less critical times, providing the opportunity for the United Conservative Party not just to save money by delivering significantly worse service to most patients, but to get some revenge by jamming the Alberta Medical Association in the next round of bargaining.

This a model already being applied with lamentable results to public post-secondary education, so from the UCP perspective, why not inflict it on public health care too?

Another government press release the same day, also using the global COVID-19 pandemic as a news hook, said pharmacists will now be used for “screening of patient health indicators.”

This too smacks of outsourcing work traditionally and more appropriately done by physicians. However, a close look suggests there’s not much there but political fluff intended to make it look like the government’s doing more than it really is.

I get it. This is an emergency. I also get it that this is a government that’s quite prepared to use the Shock Doctrine to push its ideological agenda. So beware!

Let’s not find ourselves lamenting: By the rivers of Babylon™, there we sat down, yea, we wept, when we remembered medicare.

NOTE: Telus CEO Darren Entwistle’s name was misspelled in an earlier version of this post. AlbertaPolitics.ca regrets the error. 

 

21 Comments to: The new two-tier medicine: real physicians for the rich, an Internet app for the rest of us?

  1. Connie Collins

    March 21st, 2020

    Just for the sake of clarity…Babylon Health has been around since 2013. It is not designed by Telus, they are in partnership by providing a nationwide app and Canadian access. Here is a direct quote from Babylon Health “With existing operations in the UK and Rwanda, plus plans in progress with major providers in China, the USA and the Middle East, we are on the path to achieving our mission.” BC Health has allowed their MSP ( provincial payment card ) to be used for services with Babylon Health for over a year now. They have a physician shortage and many have benefited from this. It appears Telus / Babylon Health are hiring Alberta licensed physicians which makes sense because of our prescription writing regulations. They are either billing AHS the 03.03A fee code which pays at $38. This code is for office visit assessments! Office physicians are forced to use the fee code 03.01AD which pays at $20. This is the issue! Physicians who choose to remain practicing but doing the responsible thing and closing their doors to patients, are getting HALF the pay that Babylon is getting. This is more than wrong and this is where Albertans need to be outraged and fight this payment amount. Yes in times of a pandemic, anything that takes the load off of the front line emergency health professionals is a must. We need have every resource possible, but inequity regarding electronic treatment and care is cruel and myopic. We may lose many physicians as a result of not being able to keep their offices running. This is exactly what Minister Shandro is wanting. Thin out the system, make it look as though it is failing, and then come to the rescue by likely using his Vital Partners private medical company in which he is co-founder and owner while his wife, Andrea Shandro, is co-founder and Principal. She has even posted the up and coming use of Telehealth and how her company is active in the pursuit and use of this system. Conflict of interest much?!

    Reply
  2. John McManus

    March 21st, 2020

    Politico , this morning, had an article from 30 thinkers looking oast the pandemic for change. The writers involved predict more acceptance and less opposition to telahealth, not only by video conferencing but through email.

    Reply
  3. Bill Malcolm

    March 21st, 2020

    My brother, a retired doctor, was bemoaning this past Monday morning, the stupidity of getting people to tramp down to see the doc for an appointment and getting infected by all the dopes hanging around waiting to see the doc. My clinic is part of Dalhousie University’s Student Health Services with at least a dozen physicians, and of course the university is a training ground for GPs.

    This observation about the insanity of going to a doctor’s office for health care where there was more likelihood of infection was after he heard about my annual checkup to get BP meds was due this past Wednesday. Almost immediately following that call with my brother, I got one from the clinic, advising me that all non-emergency visits were cancelled. Instead, I’d get a phone call from my doctor at the previously scheduled appointment time. I’ve known that doc for over 30 years since just after her graduation. Sure enough, it all happened as promised and in some ways was better than going in. My prescription was faxed in and I picked it up the next day, clad in at least the latex gloves I bought two weeks ago.

    So it can be done quite straightforwardly if there’s a will and a way. The ideologue running Alberta apparently lost his common sense as a teen if not earlier. Compassion and empathy zero, ideology 100%.

    We have a bulldog Chief provincial medical officer in NS, the sort of no-nonsense type who got our provincial pols in line weeks ago. They defer to him and back him up. No shifty body language from them when he’s at the mic. And his role and leadership was acknowledged by the premier in thanking him the other day, in a spontaneous speech, the depth, fluidity and feeling of which I’ve never heard from the man before. The pols know they’re lucky to have him.

    Telus? F*ck me!

    Reply
  4. Public Servant

    March 21st, 2020

    Every time you think the Kenney government could not possibly be more corrupt they lower the bar.

    Using a pandemic to enrich themselves and their cronies is the shock doctrine in living color.

    Reply
    • Expat Albertan

      March 22nd, 2020

      And worse, they do it at a time when we cannot take to the streets (or congregate at the legislature) to protest.

      Reply
  5. tom in ontario

    March 21st, 2020

    “Walk-in clinics suck.”
    My GP suggests that if a walk-in visit is needed, only go to the service provided in the building where he practises. This will allow the attending physician to access the patient’s records which includes a snapshot of their medical history and ongoing prescriptions. Obviously not every doctor is located in a large complex but if available, it could be the best alternative to seeing your own GP.

    Reply
  6. Political Ranger

    March 21st, 2020

    I guess this is to be expected. The UCP was a joke that every thinking person laughed out loud at when it was first announced. That it is populated and supported by ignorant, belligerent and low-functioning Albertans, some very notorious Albertans should not surprise anyone.
    These people have never been aware of actual realities, many of them believe and live their lives as if the Earth is only 6,000 years old. A test for UCP leadership is a belief in and an ability to expound on Ayn Rand’s economic fantasies. The whole idea of bringing forth some fantastical and imaginary version of the good ‘ol days is the fundamental operating philosophy, if such can be applied to these, of this mob.
    So that Kenney and his cabinet of mouth-breathing, slobbering idiots should be stooping so low as to be using this crisis to promote their crazy ways – well, it really should be expected.
    Again we see, here in Canada as in the USA, the real threat to human and community health is the conservatives in our midst.

    The important question today is what preparations do our decision-makers have for the flood of hospitalizations coming in the next few weeks?
    How are covid infected patients being separated from the non-infected patient population?
    How are the health care workers who work with the infected being separated from the health care workers who work with the non-infected patient population?
    How many ICU beds do we have in Alberta? In Calgary, Edmonton, Red Deer or GP?
    What is the expected need for ICU over the next few weeks and months?
    How and where will the recovering but still infectious patient population be treated?

    Other jurisdictions just a couple weeks ahead of us are building out thousands of remote infectious care beds. Other jurisdictions that are a month or more ahead of us are dealing with dozens and hundreds of deaths per day.

    We cannot rely on these dithering idiots to provide any preventive help or pre-planning in any way. Who is going to lead?

    Reply
    • Expat Albertan

      March 22nd, 2020

      “… it is populated and supported by ignorant, belligerent and low-functioning Albertans…”

      I share your contempt, but let’s not underestimate the enemy. Jason Kenney and the people who surround him are canny and time-tested politicians (of the con artist variety) who have perfected the ability to seem like they are in control and that they have a plan that will make our lives better. Kenney himself has boundless energy and focus. No, he’s not an idiot like the guy in Ontario or the one in Washington, which makes him all the more dangerous.

      Reply
    • Susan MacDonald

      March 22nd, 2020

      What an excellent response to this article. I love it when brilliant people point out corruption and offer workable alternatives. When people like Political Ranger call names they are characterising the bad actors accurately. This is so different from partisan back-biting and basekess claims. I am so glad there are thoughtful well-informed citizens to help me form responsible points of view.

      Reply
  7. Murphy

    March 21st, 2020

    The corpromorph former street-drug dealer that gets propped up on an old phone book in the Big Boy Chair in Queen’s Park was pushing interwebs home-schooling as part of the new austerity long before the Covid Boogeyman materialized. So be prepared to enjoy the rich new world of kids sitting at home on their computers, or the computers that Bill and Linda will so happily provide as part of the magical sharing economy embodied by multi-billionnaire corporate capitalists, in the company of their parents who are unemployed because the food-truck and and delivery-boy economy envisioned by our masters has collapsed in a sea of derivatives flatus. It is absolutely crucial for the grifter-yokels to wipe out the small class of public service workers with post-secondary education, and that is going to mean teachers and nurses and others in health and social services, ASAP.
    This busines with Shandro’s blind shares and his wife’s interests being completely removed from the business of his ministry is only the latest, albeit smelliest, round of grifterism. Trussler, the “Ethics” (wat dat?) Commissioner should be fed to the pets of the homeless.
    The class-war has turned hot because the military-intelligence strategy directed at China has completely failed, just as the insider-class’ last looting scheme blew apart. I just read some stats about the “Russian theft of the election in 2016”. Russians, of the garden scam-artist variety using click-bait, put up 88 000 posts in Facebook newsfeeds in the election period. Out of 33 trillion. So we are to believe that Cletus the Slack-jawed MAGA was able to sift through every 413 million posts, using his finely honed critical reading skills, to get to the one juicy nugget that swayed him from his position of supporting Hillary Clinton. Oh, those Russians!

    Reply
  8. Abs

    March 21st, 2020

    This is a classic case of punching when people are down. Everyone’s distracted, trying to survive. When the sun shines again, we will awaken to a Brave New World.

    The UCP is unrolling its hidden agenda. If you think it’s bad now, just wait. Watch the smirks of duping delight.

    The UCP has no regard for rules. They break them. Laws? They change them, retroactively. Albertans gave them a 55 percent majority, and so democracy with all its rights and freedoms will vanish as we shelter in place. The 55 percent of voters have kicked democracy to the curb for all of us. They will have to live with the consequences. The apathetic people who did not vote have this on their heads, too. Shame on you all! The 45 percent of us who voted against it saw this coming.

    Reply
  9. Just Me

    March 21st, 2020

    I imagine that at some point in the not too distant future, everything will be guided by a call-centre. This truly represents the most broadest, most universal application of social-distancing. Limit the people’s access to all services by channeling them through an anonmyous intermediary who provides the final and only assessments on any person’s situation. This has been called a path to efficiency, lower costs, and greater access for all. The problem is, as everyone knows about call centres by now, they are the certain path to poor services. (or no services at all) They are distractions meant to confuse and annoy people to the point where they just abandon their efforts and put up with their woeful state of care.

    The above is an example of the first-tier of service that the vast majority will receive.

    Applying the above to health care serves no one well, accept for the telcos who likely will provide the technology and the corporate interests that will profit from it. Alberta Health Minister Tyler Shandro, of course, represents the providers of the ultimate of best in care. Personalized care and relationship building with patients, Shandro and providers like him are the first step of health care privatization by stealth. This is the future that is unfolding.

    Get ready for all the soothing words from Kenney and his fellow travellers. And get ready to be put on hold when you’re health care service is needed the most.

    Reply
  10. Shirley Pott

    March 21st, 2020

    Get real fool! This not some deep conspiracy to undermine our society! It is another tool to use to keep people away from each other. If a sick person goes to a doctor’s office or ER and mingles with other sick people there for their own sicknesses , everybody gets the chance to catch whatever is around. If it’s COVID19 you have set off another cluster of infections. By accessing medical consultation remotely, people who need to be further evaluated can be separated out and directed to the appropriate resources who will know they are coming and how they should be handled. Stop bending stories to further your own narrative. This no time to be running your mouth creating crap!

    Reply
    • Dave

      March 21st, 2020

      No, its not a conspiracy. It is a ham handed way for a corporation to try profit off health care and provide diminished service. Instead of providing patients access to their own doctors, which would make sense, it it the on line equivalent to a walk in clinic, less efficient and therefore ultimately more costly to the health care system.

      Poorer service, more money for corporations. They are very good at it, especially the phone company oligopolies. Its not even free market competition when four companies collude to set the prices for years. We have laws about anti competitive corporate behavior. Too bad they are not enforced much anymore Telus is not your friend and they also tend to lay off a lot of their loyal staff at a certain age, which is also probably not entirely legal, but they seem to get governments to turn a blind eye to that too. The future is not friendly for those who work with Telus and expect a nice comfortable retirement.

      Reply
    • Kang

      March 21st, 2020

      Dear Shirley: you missed the point of the article. Doctors being paid by Medicare are paid less for doing the very same phone service that this private phone service claims to provide. That means the UCP are biasing the system in favour of their private sector friends. That means it will cost more and remove doctors from medicare and push them into the private sector. Don’t feel bad. Assumptions makes asses of of all on occasion.

      Reply
  11. Jim

    March 21st, 2020

    From what I have read the Doctor at the other end of the app only has to be licensed in Alberta, they don’t actually have to be in Alberta. Do we not see where this is going? A call centre full of “Doctors” in some low cost jurisdiction. Of course if we can afford some of the plans Mr. Shandro’s wife is selling perhaps we can actually see a doctor face to face. The arrogance is deeply offensive to thinking people. How does the average UCP voter perform the mental gymnastics to rationalize their choice? You are sitting at home in a house that you are not sure you will be able to pay the rent or mortgage on because you have been laid off from your oil field job. Your kids are at home and you will now have to teach them all the while thinking how you will feed them. The UCP government who you put your faith in to magically turn things around is not going to help you out. To add insult to your situation they are going to take the tax money you paid while working and give it to their donors. Is Rachel still a bloody socialist at this point? Even with your saviour in power you still lost your job and future. That debt the NDP ran up that you were so worried about is going to seem small compared to what Kenney will do when packs his bag and goes back to Ottawa.

    Reply
    • David Climenhaga

      March 22nd, 2020

      Ernest: I have not yet established how the business relationship between Babylon Health of the U.K. and Babylon Health by Telus works. It’s pretty clear there is one, given the similarity of both the unusual name and the corporate logo. I have sent requests for information to both the Alberta Government and Telus’s media relations department. I will update my readers as soon as I have some information on this interesting question. At that point, I may have some comments to make on the matter you have raised. DJC

      Reply
  12. R.C. Heather

    March 21st, 2020

    Great article. Any thoughts on what Babylon-TELUS will do w all that info they just gleaned?

    Reply
    • Abs

      March 22nd, 2020

      Sell it, of course! It seems to me that’s what the small print allows. People as commodities. Are we just a step away from becoming Soylent Green?

      Reply

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