According to recent research, patients who got virtual treatment from a doctor outside of their family care team were 66 per cent more likely to attend the emergency room within seven days than those who received virtual care from their own family doctor.

The findings were reported in JAMA Network Open.

Researchers from the University Health Network (UHN), Unity Health Toronto, and ICES conducted the study, which found that patients who received virtual care outside of an existing family doctor-patient relationship were 25 per cent more likely to have an in-person visit and 88 per cent more likely to have another virtual visit within seven days.

"This study sheds light on how different types of virtual care impact downstream healthcare use--our findings show that the relationship between a patient and their virtual care doctor makes a difference," said lead author Dr. Lauren Lapointe-Shaw, an adjunct scientist with ICES, general internal medicine physician and scientist at UHN, and Innovation Fellow at the Women's College Hospital Institute for Health System Solutions and Virtual Care.

"Within an existing and ongoing relationship with a physician, patients are less likely to go elsewhere for further care," added Dr. Lapointe-Shaw.

The study included over 5 million Ontario residents who had a family doctor and had a virtual visit between April 2021 and March 2022, and methods were used to match 4.1 million patients whose virtual visit was with their own physician and 1 million patients whose visit was with an outside physician.

In a secondary analysis, the researchers found that patients using "direct-to-consumer" telemedicine clinics were three times more likely to visit the emergency department within seven days, compared to patients seeing their own family doctor.

"Direct-to-consumer" clinics are virtual-only walk-in clinics, and they offer on-demand virtual care without an in-person exam.

More than 6.5 million people in Canada don't have a family physician, and virtual care is believed to be an important access point for patients.

"Virtual care done right can improve timely access to care--both for people who do and don't have a family doctor," said co-author Dr. Tara Kiran, an adjunct scientist at ICES and a family physician at St. Michael's Hospital of Unity Health Toronto.

"But if it's not integrated with in-person care or delivered by someone who has access to your health history, there is a risk that we're adding more churn to the system."