SickKids sees surge in non-urgent ER visits as paediatricians refuse in-person checkups

TORONTO -

When Rose Chartrand's daughter Livia came down in September with a fever that lasted seven days, Chartrand suspected an ear infection and wanted to get it looked at.

The three-year-old had tested negative for COVID-19, but three different clinics told Chartrand they would not assess her in person due to their COVID-19 protocols.

“I can have a phone interview, but an ear infection, you should look in the ear,” Chartrand told CTV News Toronto. “What if it’s not an ear infection and it’s something else, and you can’t tell over the phone?”

“They just told me to go to the emergency room,” Chartrand said. “I was really angry, if I’m being honest.”

Across the province other parents are finding themselves in similar situations—told by some paediatricians or family doctors that if they want to be seen in-person, they need to go to an urgent care centre, even with a negative COVID-19 test.

Many doctors’ offices have not updated their COVID-19 protocols since the beginning of the pandemic, and although they have been encouraged by the province to consider in-person assessments when requested by the patient, many continue to provide only virtual care. The result has been an increase in visits to some emergency departments across the GTA, even for non-urgent reasons.

“There are a high number of patients that are presenting to our emergency department and it’s not the right place for them to seek care, for their care to be delivered,” Dr. Jason Fischer, the division head of paediatric emergency medicine at the Hospital for Sick Children, told CTV News Toronto.

This past August was one of the busiest in recent years at Sick Kids, he said, when it is typically a quieter month. Nearly 6,000 patients were seen in the emergency department—40 per cent more than the previous August.

Fischer attributes the increase to challenges accessing in-person assessments at primary care providers.

“We know that there are family doctors and paediatricians who are seeing patients in-person, and I think it’s really important for those practices that are not to take time to learn from those who are, how they’ve been able to change their workflows so they can best service their patients,” he said.

Filling emergency departments with non-urgent care requests can quickly strain the system, he said, when it comes to both staffing levels and resources. 

The Ministry of Health updated its guidance in July to state that in most cases in-person care can now be provided appropriately, and while virtual care has its place, doctors should consider patient requests for physical assessments.

The Ontario Medical Association’s paediatrics division, meanwhile, has encouraged its members to provide in-person care wherever possible, and has offered advice on how to do so safely.

Maple resident Ayesha Minhas tried to get her two children seen by their family doctor recently—one for a suspected urinary tract infection, and another for a chronic nasal issue—and despite negative COVID-19 tests and no symptoms, was told to take them to an urgent care centre.

“I don’t see why doctors cannot see the kids,” Minhas told CTV News Toronto. 

“I was so emotional, I was very frustrated. I said I don’t understand the protocols at this time, it’s 18 months into a pandemic, you are fully vaccinated, I am fully vaccinated, I’m telling you we don’t have COVID-19, and you can see on my chart it’s COVID-19 negative.”