The virtual doctor will see you now
Local startup disrupts the typical medical visit: instead of waiting to see a doctor, at QDoc the doctors are waiting to see you
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Since March 2020 when the pandemic began, there have been 5.3 million virtual medical appointments in Manitoba — doctors speaking with patients over the telephone or via some other digital communication means.
Doctors Manitoba, the Canadian Medical Association and others have conducted surveys about the experience and there has been an overwhelming endorsement from both doctors and patients about the experience.
The CMA’s survey showed a 91 per cent satisfaction rate of patients using virtual care during the COVID-19 pandemic.
Doctors Manitoba, the organization that represents more than 4,000 physicians and medical learners, are fully on board with the concept, something that Keir Johnson, spokesman for Manitoba Doctors, said physicians have wanted as an option for many years.
“It is still surprising to me that it only started because of the pandemic,” Johnson said. “It may be one of the few good things that have come out the pandemic.”
So suffice it to say the timing is right for the launch of QDoc, a Winnipeg medical technology startup just launched by pediatric emergency medicine specialist Dr. Norman Silver and long-time medtech expert David Berkowits.
Although just out of the gate — QDoc had 177 visits in April — it is being designed as the Uber for medical clinics to help link local patients, especially the elderly, parents with young children and people in remote locations far from a hospital or medical centre easily and quickly — and at no cost — with local physicians using an innovative patent-pending technology.
Silver, a medical practitioner for more than 20 years, has also been a serial medical innovator. Along with Berkowits he helped found the Minor Illness & Injury Clinic which was the first urgent-care clinic outside a hospital in Manitoba, the Penicillin Allergy Clinic with locations in Brandon and Winnipeg and he and Berkowits launched a COVID testing site at Red River College over the course of just eight days in the fall of 2020, one of only two still operating in the province.
“I’ve always been interested in finding gaps in health care and filling them,” he said. “What I like to do is find the pain points and fix them. Not just complain about them.”
While he admits he has a track record of needing to take on a new project every three years, he believes QDoc is different, so much so that he recently resigned from his position at Health Sciences Centre’s Children’s Emergency.
Silver and Berkowits only started talking about the idea a year ago and the company. (The two are also brothers-in-law.) It already raised $1 million through the North Forge Angel Network, has 10 programmers on staff and 21 doctors and counting on call.
Easy to use on-line registration puts a patient in a virtual waiting room. Algorithms match the patient with the most appropriate physician (including the ones in closest proximity to the patient) and the system is designed for very prompt response — as quickly as two minutes or less.
Berkowits, who is well known among the startup community in Manitoba, worked for many years designing sophisticated medtech applications in Alberta. The system he designed for QDoc uses natural language processing to self-populate forms. Every QDoc appointment is recorded, summaries are provided to the patient and to their family doctor, and QDoc automatically bills Manitoba Health and retains 15 per cent of the fee as its source of revenue.
In accordance with the most recent regulations from the College of Physicians & Surgeons of Manitoba, QDoc’s doctors will ensure ongoing care is properly organized — it already has partnership agreements with three medical clinics in Manitoba — or referrals to specialists.
Dr. John Neufeld, a family doctor with certification in emergency care, who is also the medical director at Peguis First Nation, is one of the first doctors on QDoc.
“This is to fill in the gaps in care, not to replace the system of family medicine,” he said. “In general I really only hear gratefulness from patients when we get off the phone.”
Jackie Van De Velde is definitely in the grateful camp.
Last week her youngest son, a seven year old, got hit in the nose with a baseball bat at the end of his team practice.
The mother of four young childrenwho lives on a farm near Mariapolis two hours southwest of Winnipeg, said, “I’ve seen a number of emergency rooms in my day.”
She was made aware of QDoc through a sister-in-law who is a doctor associated with Dr. Silver.
She signed on to the site — “it’s a super easy website to navigate through,” she said — entered her personal information and Manitoba Health number, typed out the concern and uploaded a photo of her son’s injured nose.
She got a call from the doctor two minutes later.
The doctor arranged a call with an ear, nose and throat specialist who called the next day and made an appointment for the very next day when the nose was re-set.
“I was extremely happy with the experience,” she said. “If I had to drive him to Boundary Trails Hospital, which is an hour away and potentially wait three hours to see a doctor and maybe just be told to take Tylenol and drive home, it would have been a big inconvenience.”
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Silver and Berkowits have worked closely with the College of Physicians & Surgeons of Manitoba (CPSM) and believe their regulations, while more rigorous than other provinces, are appropriate.
“We created a plan somewhat based on CPSM guidelines,” Silver said. “I quite like the college guidelines. They protect patients and Manitoba doctors as well.”
Berkowits said, “Our focus is on continuity of care. There are other services out there where you may call up and see a doctor in Ontario and they will deal with a problem and then say go to emergency or go see your family doctor then leave you off floating on your own.”
Dr. Todd Watkins, associate CEO of the Canadian Medical Protective Association, the organization that protects the professional integrity of physicians and compensates patients, said there is no pattern of concerns about medical care with the rapid rise in virtual health care — which he and the majority of the health-care establishment believe is here to stay.
“The pandemic has really lit a fire under all of us, showing us the role virtual care could play because we were forced into it,” he said. “The role for all of us in the profession and those who regulate and govern it, is to ensure standard practice related to virtual care.”
Dr. Taft Micks, a Brandon doctor — who was named one of this year’s Canadian Emergency Physicians of the year — is also part of the early cohort of doctors taking calls on QDoc.
“It is awesome,” he said. “I think it is a game changer and hopefully it will continue to grow.”
Micks said in addition to providing medical attention to under-serviced groups, the enterprise can also make a contribution to decreasing greenhouse gas emissions by reducing hours of driving to and from medical appointments.
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Sliver and Berkowits have big ambitions for QDoc but they are not going to force its growth across the country. They would like to have 100 to 150 doctors on the network in Manitoba over the course of the next year as the service becomes more well-known in the province.
Silver is glad to be launching in Manitoba, which has the lowest number of family physicians per capita in the country — and that was before the pandemic — according to Doctors Manitoba.
“We are under the radar here,” he said.
He has studied existing national tele-health companies in Canada and the U.S. and said, “They have started the educational process. We are just going to do it a lot better.
“We can pilot it here. No one else is coming to Manitoba. We can free range then explode across Canada and the U.S.”
They are already thinking about a software-as-a-service model for international expansion where it would be harder for them to recruit the physician network.
Martin Cash has been writing a column and business news at the Free Press since 1989. Over those years he’s written through a number of business cycles and the rise and fall (and rise) in fortunes of many local businesses.
Updated on Saturday, May 21, 2022 5:14 PM CDT: Clarification in the eight paragraph of the story to say that Silver and Berkowits helped found the Minor Illness & Injury Clinic.