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Billed as remedy for doctor shortage, virtual medicine in N.S. hits bottleneck

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Early in the COVID-19 pandemic, virtual medicine offered a novel way for patients to see doctors during a lockdown and hope that technology could alleviate chronic pressure on a strained health system.

For many in Nova Scotia, though, the early promise has proven illusory.

Tim Neufeld, 28, from Dartmouth, N.S., has been on Nova Scotia’s wait-list for a family doctor for five years. He said in a recent interview that he was left frustrated after several unsuccessful attempts at securing a virtual appointment.

“The biggest hurdle is just accessing the system, having to log on between 8:59 a.m. and 9:09 a.m.,” he said, noting that when he tried to sign up for virtual care after 9:10 a.m., all the day’s appointments were already booked.

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“Obviously the demand far exceeds the supply, so there’s some pain around that and whether or not you’re able to even get the care you need.”

Sara Wallace, 48, from Dartmouth, compared the experience to “trying to buy concert tickets.” She said she tried unsuccessfully to schedule a medical appointment four times over two weeks before finally succeeding.

Nova Scotia launched its virtual health platform in May 2021, and it now has 67 health professionals — physicians and nurse practitioners — who provide virtual consultations on top of existing general practice commitments.

Brendan Elliot, a spokesman for Nova Scotia Health, said in an email that there are between 150 and 200 virtual visits available on a typical weekday, available to the 120,400 people in the province without a family doctor.

Elliot acknowledged that demand is high and said the province is trying to recruit more doctors and nurses to take part.

Zen Therani, founder and CEO of Vancouver-based digital consulting firm Xenex Consulting Inc., said in an interview that challenges are expected in the early stage of virtual care implementation, but a bottleneck at the booking stage is a problem.

“It really defeats the purpose” of virtual care, which should be increasing access to medical care and improving the patient experience, he said.

Therani, who has worked in digital health for 22 years, said a process like Nova Scotia’s that requires logging in quickly during a short time frame is likely going to be a barrier to those who have poor internet connection or are less comfortable using digital tools.

“We don’t want people to feel left behind,” he said.

Because provinces are implementing different methods of virtual care, access looks a bit different in New Brunswick, where virtual appointments are funded for everyone — not just those without a family doctor.

Kelly Stokes of Saint John N.B. uses virtual health care for herself and her young daughter through the province’s eVisitNB application.

The 27-year-old said in an interview the experience was “hit or miss” when she first tried it a year ago — but she said it has improved as some referrals were outsourced to nurse practitioners and doctors in other provinces. She said a nurse practitioner based out of Ontario provided care for her daughter last month.

New Brunswick’s eVisitNB, which is operated by virtual health company Maple, is staffed mostly by nurse practitioners and a few physicians who may be working remotely from other parts of the country.

Like Nova Scotia, Prince Edward Island reserves provincially funded virtual appointments for residents without a family doctor or primary care provider. In Nova Scotia that represents about 12 per cent of the population, and in P.E.I. it’s more than 15 per cent.

In Newfoundland and Labrador, where the medical association reported in June that about 24 per cent of residents were without primary care, virtual appointments are covered for everyone. The appointments are provided by Springdale, N.L.-based telemedicine company Medicuro, which employs 16 local physicians.

Last month, the medical director of a Medicuro virtual clinic called on the province to raise the cap on the number of daily appointments funded by the province. Dr. Todd Young said in a statement that the province’s limit of 40 virtual appointments a day is far too low given the number of residents without a family doctor and the circulation of influenza, COVID-19 and respiratory syncytial virus.

“The time is now to remove any restrictions to available reliable and professional health care,” Young said. The province’s health department has not said if it is considering funding more appointments.

Therani said it’s very positive to see that provinces are using virtual care to fill in some of the gaps caused by a shortage of primary care providers, and agrees that limits should be removed from virtual care whenever possible.

“Why would you want to put limitations on innovation and accessibility in that way?” he asked.

Therani said that while virtual care does not work for everything, there’s potential to use it strategically to increase efficiency in pre- and post-operative care, emergency medicine and mental health care.

Part of the challenge, Therani said, is that advances in telehealth have happened in a rush as the pandemic dramatically increased the need for virtual medical care.

“It’s difficult because a lot of this is happening in panic, it’s reactive,” he said, adding that there is a need to step back and look critically at the system.

Neufeld and Wallace both said that once their appointments were booked, they enjoyed the experience of using virtual care.

Wallace, who lost her longtime family doctor when he closed the practice in June, said that the virtual appointment she secured on her fifth attempt led to an in-person followup six weeks later.

She said that appointment, in a Halifax clinic reserved for virtual patients, was “the most thorough medical appointment of my adult life.”

It was a complete change from the “packed and overcrowded walk-ins” in the Halifax area she’s had to visit since losing her doctor.

“I think there’s real potential here for this to positively change the way things are done,” Wallace said.

This report by The Canadian Press was first published Dec. 7, 2022.

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Canadian assessment team deployed to Turkey after earthquake

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Canadian assessment team deployed to Turkey

A senior government official says a Canadian assessment team is on its way to Turkey to determine how Canada can contribute to earthquake relief efforts.

International Development Minister Harjit Sajjan was expected to formally announce the deployment of the Canadian Disaster Assessment Team this evening.

The senior official, who spoke on background pending Sajjan’s official confirmation, said the team consists of a handful of military and Global Affairs officials.

The official underscored that the deployment of the team does not automatically guarantee a further deployment of Canadian resources to the country.

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The earthquake, which razed thousands of buildings in Turkey and Syria on Monday, is one of the deadliest quakes worldwide in more than a decade and the federal government is facing criticism that the window to help with rescue efforts is closing.

Search teams from more than two dozen countries have joined tens of thousands of local emergency personnel and Canadian humanitarian aid workers with charitable organizations were arriving Wednesday

Defence Minister Anita Anand said late Tuesday that the federal government had not ruled out sending a Disaster Assistance Response Team, to help with the recovery effort, but that it was working to figure out what would be most useful.

The assessment team would recommend whether to send additional support, such as a DART.

Earlier Wednesday, Prime Minister Justin Trudeau announced the federal government would match funds donated to Canadian Red Cross relief efforts up to $10 million on top of an initial aid package of $10 million.

This report by The Canadian Press was first published Feb. 8, 2023.

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Canadian soccer player describes the horror of the earthquake in Turkey

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Canadian soccer player

Canadian soccer player Sam Adekugbe is one of the lucky ones. He managed to escape earthquake-ravaged Antakya in Turkey.

Some of his teammates and staff at his club Hatayspor are still missing.

The 28-year-old from Calgary is now safe in Istanbul with Canada captain Atiba Hutchinson, who plays in the Turkish Super Lig for Besiktas. But in a Zoom call Wednesday sitting next to Hutchinson, a sombre Adekugbe told a harrowing tale of being caught in the quake — and the horror of what he saw in the aftermath.

“Unfathomable. Something you never really expect,” said Adekugbe, who looked shell-shocked.

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Adekugbe was relaxing at home with some teammates after a 1-0 win over visiting Kasimpasa in a Turkish league game Sunday evening. The quake began as he started cleaning up his home when they left.

He started shaking, which initially made him think he was having a panic attack. Then the furniture and TV began to tip over and cups and dishes smashed in the kitchen.

He went outside to find the road split and people yelling amid freezing rain and lighting strikes. After witnessing the damage around his home, he drove the 20 minutes to the team training ground, seeing the devastation along the way.

“It just felt like a movie. You’re seeing collapsed buildings, fires. People yelling, people crying,” he said. “People digging through the rubble. Broken pieces of houses. Just things you never really expect.”

It got worse the closer he got to the centre of the city, which is located 1,100 kilometres southeast of Istanbul in a region bordered by the Mediterranean and Syria.

“Roads split. Bridges broken. Twelve-storey highrises just completely collapsed. Families looking for loved ones. Parents looking for their kids. Kids looking for their parents. It was just something unfathomable. Something you never really expect.”

Adekugbe says people are still missing, including the team’s sporting director, Taner Savut. There is confusion over the whereabouts of Ghana international Christian Atsu, who was at Adekugbe’s home that night.

Reports of Atsu being rescued are now in doubt, said Adekugbe, who joined the search for survivors after getting to the training ground.

“It’s also people who work around the team,” Adekugbe said.

He says one of the team’s equipment men died in the quake. So did the daughters and mother of a woman who works in the team kitchen.

The wife of another equipment man needs urgent medical attention, facing having her arm amputated if she doesn’t get it.

“Of course I’m thankful that a lot of my teammates have been found. But the people that do help the team, the people who work around the club, they still have loved ones that are missing and unaccounted for. Really it starts to hit home when you just see the agony, the desperation on their faces,” he said.

In the light of day, the horror grew.

“You’re looking through rubble trying to find your teammates. You’re trying to yell for them in like darkened spaces of apartments that used to be standing,” Adekugbe said. “It’s just something you never find yourself doing. People coming back with broken bones. People still missing to this day. It’s something you can’t really explain.”

Adekugbe and some of his teammates managed to get out thanks to his coach, Volkan Demirel, who used to play for Fenerbahce, another Turkish club based in Istanbul. He called the Fenerbahce president who organized a plane departing from a city about a 150-minute drive away.

Adekugbe and other Hatayspor players and staff were bused to the waiting plane, which took them to Istanbul.

“We were very lucky,” Adekugbe said.

“I just grabbed what I could … I have three suitcases and my dog.”

Hutchinson was waiting to take him in. Adekugbe had called him in the aftermath of the quake, showing him the damage via FaceTime.

He called his parents when he got to the training ground.

Antakya is renowned for its cuisine, which has many Middle Eastern influences. UNESCO (the United Nations Educational, Scientific and Cultural Organization) has designated Antakya as a “city of gastronomy.”

Adekugbe, who joined Hatayspor in June 2021 from Norway’s Valerenga Fotball, has won 37 caps for Canada and saw action in all three of Canada’s games at the World Cup in Qatar.

Born in London, England, he was three when his family moved to Manchester and 10 when it came to Calgary.

At 16, he moved to Vancouver to join the Whitecaps residency program. He signed a homegrown contract with the MLS team in 2013 but made just 16 appearances for the team over the next four seasons, spending much of the time out on loan.

Adekugbe had loans stints with Brighton in the English Championship and Sweden’s IFK Goteborg before joining Valerenga in January 2018.

While Istanbul escaped quake damage, Hutchinson’s concern for Adekugbe grew when internet connection was lost and a second quake hit.

Both players urged Canadians to donate to relief organizations to help the region and its people.

“There’s a lot of people that are still under the rubble,” Hutchinson said.

“People are just really in bad conditions right now,” he added. “It’s really cold here. Just making it through the day and the night, it’s extremely difficult.”

Follow @NeilMDavidson on Twitter

This report by The Canadian Press was first published Feb. 8, 2023.

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How much money is needed to retire in Canada

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Canadians now believe they need $1.7 million in savings in order to retire, a 20 per cent increase from 2020, according to a new BMO survey.

The eye-watering figure is the largest sum since BMO first started surveying Canadians about their retirement expectations 13 years ago. It’s also a drastic increase from the $1.4 million in savings Canadians expected to need for their nest eggs just two years ago.

The results reflect Canadians’ concerns about current economic conditions, particularly inflation and higher prices, said Caroline Dabu, head of wealth distribution and advisory services for BMO Financial Group.

“If you look at the average Canadian, they’re feeling the rising inflation costs,” said Dabu.

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“And so, not surprisingly, we are seeing that Canadians are feeling they absolutely will need more to retire.”

Canada’s annual inflation rate hit a four-decade high of 8.1 per cent in the summer of 2022 and has since fallen to 6.3 per cent as of December 2022. BMO Economics expects the country’s CPI to decline to around three per cent by the end of the year.

The sharp increase to Canada’s inflation rate in 2022 exceeded wage gains, eroding purchasing power for most families and heightening fears about the future. The BMO survey found that just 44 per cent of Canadians are confident they will have enough money to retire as planned — a 10 per cent decrease from 2020.

But while the $1.7 million figure may sound overwhelming to working-age Canadians, Dabu said the number says more about the economic mood of the country than it does about real-life retirement necessities.

“Certainly when we’re working with clients, we find that many overestimate the number that they need to retire,” she said.

“It really does have to be taken at an individual level, because circumstances are very different … But $1.7 million, I would say, is high.”

While rising inflation may require tweaks to a retirement plan — such as contributing slightly more to savings each month if you’re a young worker, or making cash flow adjustments if you’re nearing the end of your working career — Dabu said these changes don’t necessarily have to be drastic.

When it comes to retirement planning, Dabu said, knowledge is power. By working with a professional financial advisor and making a plan that encompasses individual circumstances and goals, Canadians can come up with their own retirement savings number.

“In the survey, we note that 53 per cent of Canadians didn’t know how much they will need to retire,” Dabu said.

“That increased confidence comes from knowing the exact number that I need to save for, and how I’m going to get there.”

The BMO survey also found that approximately 22 per cent of Canadians plan to retire between the ages of 60 and 69, with an average age of 62.

Millennial and generation z Canadians are the most nervous about their ability to save and invest right now, the survey found. However, all age groups — 74 per cent of survey respondents — said they are concerned about how current economic conditions will affect their financial situation, and 59 per cent said economic conditions have affected their confidence in meeting their retirement goals.

The BMO survey was conducted between Nov. 4 and 7, 2022 by Pollara Strategic Insights via an online survey of 1,500. The survey’s margin of error is plus/minus 2.5 per cent, 19 times out of 20.

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This report by The Canadian Press was first published Feb. 7, 2023.

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