Virtual clinic in Toronto shifts to private model after OHIP cuts

A health-care clinic forced to shutter after the Ontario government capped virtual service fees is now privatizing in an effort to continue offering gender-affirming care.

“The patients paying for care, it’s kind of a false choice,” Dr. Kate Greenaway told CTV News Toronto on Wednesday.

“I wasn't able to offer patients the services they needed under OHIP," Greenaway explained. "And so my choice really became: is this a service that’s important to offer, or should I close?”

Connect-Clinic, founded by Greenaway in Toronto, was the first of its kind in the province – offering virtual services for 1,500 trans, non-binary and gender-diverse patients – with a waitlist of 2,000.

In December, Connect-Clinic was forced to close after the Ford government reduced the amount virtual health care providers could bill the province for their services from up to approximatley $67 for a virtual visit to $15 for phone calls and $20 for video sessions.

“That funding change was catastrophic for us,” Greenaway said.

After Connect-Clinic shut its doors, PurposeMed, a virtual-care platform for underserved communities, reached out and asked if there was anything they could do to help.

Six months later, Foria, the new iteration of Connect-Clinic, was born.

Foria launched on Wednesday with Greenaway as the medical director. The clinic delivers virtual care through nurse practitioners who are not covered by OHIP and therefore are allowed to bill patients.

It's the latest platform, alongside a list of virtual clinics including Rocket Doctor and Kixcare, that pivoted to paid-for-service models in response to the government’s fee reduction.

Physical distancing and stay-at-home orders are forcing unprecedented change and innovation in public medicine that experts say will revolutionize how we access care. (Photo credit: Bongkarn Thanyakij from Pexels) “We’ve made our best effort to keep the costs of care with Foria as affordable as possible,” a note on the Foria website reads.

“We’ll continue to look for ways to make our services even more accessible,” the note goes on to say. Greenaway said the clinic is working on building a fund to support patients who can’t access their services.

When it comes to gender-affirming care, Greenaway said offering a virtual option is critical for the patients she serves. Wait times are extraordinary and clinics are often located in urban centres.

“Also, experiences of transphobia or discrimination make it difficult to present to a hospital,” she added.

Greenaway considers Foria the silver-lining of the "catastrophic" changes made by the Ford government, and, through it, will continue to offer critical services with as few barriers as possible.

“This is a ray of sunshine over some very dark days that we’ve passed,” Greenaway said.