Виртуальные врачи стали новой нормой для сельских больниц Альберты из-за нехватки персонала

Inside rural Alberta's shift to virtual ER doctors 16 hospitals across Alberta have used VEP since its launch, AHS said Paula McLaughlin, who has lived in Coronation, Alta., for more than 50 years, says she got severe food poisoning last month. A rush to the east-central Alberta town’s emergency department resulted in a new experience for her: seeing a virtual doctor. McLaughlin said she was vacationing in northern B.C. when she fell ill. "I got to the point where I couldn’t even lift my legs," she said. Due to her other health issues, McLaughlin said she was anxious to return to a familiar hospital and drove back to Alberta. When she called the emergency room (ER) at the Coronation Hospital and Care Centre, staff informed her no on-site doctor was available and that a virtual physician would treat her. "I thought, ‘Oh no. Now, what does that mean?’" she recalled. But the experience was surprisingly positive, McLaughlin said. An on-screen physician appeared and instructed nursing staff, she said. He watched them check her stomach and McLaughlin said he stayed online “until all my lab work was sent away to see what kind of food poisoning I had." Virtual emergency physicians have become a routine backup option for Coronation, a community of roughly 900 people that is located about 210 kilometres southeast of Edmonton. Alberta Health Services (AHS) introduced the virtual program there in October. According to AHS, the virtual emergency physician program remotely uses experienced emergency doctors, allowing local staff to respond to non-life-threatening issues via video. Ron Checkel, Coronation's deputy mayor, said residents are often initially anxious. "They are a bit apprehensive … at first, because it's something different," he said. "But it's probably the best care you can get." Checkel said critical patients are stabilized and transferred to staffed emergency departments in Castor or Stettler, towns northwest of Coronation along Highway 12. But the community expects some new physicians to start in Coronation's ER soon, he said. Better than a closed ER Heather Smith, president of the United Nurses of Alberta, noted AHS piloted the virtual program in places like Hinton and Beaverlodge in January 2025. It has since expanded to serve more than nine communities provincewide. "We may not consider it the best option, but it is a better option than hanging a ‘closed’ sign on your emergency room doors," Smith said. While designed for non-life-threatening cases, Smith emphasized that medical situations can change quickly. If a patient goes into cardiac arrest, nurses can initiate life-saving protocols, she said, adding that those situations are “fortunately infrequent.” For Smith, however, the reliance on virtual ER doctors is an alarming signal that Alberta must urgently recruit rural physicians. Concerns grow for larger regional hubs The coverage gap is primarily a rural issue, as most rural emergency physicians are actually local family doctors simultaneously managing full-time clinics or delivering babies, according to Dr. Brian Wirzba, president of the Alberta Medical Association. "It becomes challenging to staff on a 24/7 basis," he said. AHS’ virtual program allows patients to be assessed locally, but Wirzba expressed concerns that larger regional hubs like Hinton and Edson are relying too much on it. "[They] are feeders to some of their local hamlets," Wirzba said. "The larger the community, the more commonly you're going to get life-threatening issues that need to be addressed more urgently with a physician on site." He said Hinton and Edson haven’t had ER physicians on several occasions over the past year, leaving a gap in coverage between Edmonton and Jasper. Beyond logistics, Wirzba noted virtual doctors lose some critical diagnostic tools, like listening to a patient’s heartbeat. “We really value when we're seeing patients one on one,” he said. “You lose that in a virtual appointment.” In an email statement to CBC News, an Alberta Health Services (AHS) spokesperson wrote that since launching in January 2025, the Virtual Emergency Physician (VEP) program has eliminated 98 per cent of emergency department service disruptions that would have been caused by a lack of on-site physician coverage. Sixteen hospitals across Alberta have used the program since its launch, the statement said. AHS added that feedback from physicians and staff has been positive, and the health authority has not experienced any notable logistical challenges in connecting patients with a virtual physician. "Physician recruitment, particularly in rural communities, is a longstanding national challenge," the spokesperson said, noting that programs like VEP serve as a temporary bridge to alleviate service disruptions until permanent recruitment occurs. Coast to coast The shift toward virtual emergency care is happening in other jurisdictions as well. "This is certainly not localized to Alberta," said Dr. Shelley McLeod, a clinical epidemiologist who is the research director of Toronto’s Schwartz/Reisman Emergency Medicine Institute. McLeod led a 2022 provincial evaluation of virtual emergency care in Ontario. Her study found almost two-thirds virtual urgent-care patients were discharged home, while 16.2 per cent were referred to the emergency department. Despite some positive metrics, McLeod called the program a "Band-Aid on a gaping wound" that cannot fix localized physician shortages. McLeod said oversight is necessary to standardize the program, as virtual care transcends borders. "We need to have a national system of evaluation," McLeod said. "We can compare what's happening with virtual urgent care in B.C. to Alberta to Ontario to Newfoundland to Quebec."