Private-public partnerships not a threat to Canada’s health care system

A recent critique of private virtual medical care services in the article “Typology of virtual primary care in Canada. Making the implications clear,”¹ published in the November/December 2024 issue of Canadian Family Physician portrays them as drivers of inequity, fragmentation, and rising health care costs. However, this perspective overlooks a critical reality: private-public partnerships are not a threat to Canada’s health care system. They present an opportunity to strengthen it and expand patient access to care.

Canada’s health care system is burdened by increasing demands on physicians who are stretched thin. More than 6.5 million Canadians lack a family doctor,² leaving physicians overworked. To be clear, private virtual care companies do not always pull doctors away from the public system. Maple,³ for example, is staffed like a ridesharing service, enabling physicians to jump on and off the platform when it is convenient for them. Nearly all Maple physicians cover full-time public practice in addition to their time on our platform. They offer care on Maple during previously unusable downtime between patients or between shifts when no doctor would sign up for another shift—but many doctors willingly jump on an app knowing they can see a few patients and sign off any time they want.

The article argues virtual care lacks continuity, in part because patients do not always see the same provider. However, continuity is not about every visit being with the same provider; it is about coordinated care. Maple facilitates seamless provider handoffs through secure, shared digital records, ensuring health care professionals can access patient histories, diagnoses, and prescriptions. This model is no different from how group family practices and hospital teams operate. If we accept this in a family practice, why is it “fragmented”¹ in a virtual care setting?

Concerns about data privacy aim to discredit virtual care providers despite a lack of clear evidence in the article. A news story making similar broad allegations about the virtual medical care industry later issued a correction for misrepresenting Maple.⁴ We do not sell patient data for commercial gain. Privacy is fundamental to the trust between patients and providers, and we adhere to rigorous regulatory standards to protect it.

A persistent misconception is that virtual care increases health care costs by driving unnecessary in-person visits. Our experience with public health systems demonstrates the opposite. In Nova Scotia, where Maple operates a publicly funded, province-wide virtual primary care service, the province has reduced strain on emergency departments and walk-in clinics resulting in meaningful system-wide savings. Last year in Nova Scotia—bucking the national trend of rising ED use—lower-acuity ED visits fell by nearly 10%.⁵ In another long-term care initiative by Maple, 70% of virtual consultations prevented ED transfers.³ These examples underscore how virtual care can lower costs rather than inflate them.

Private providers of technology and infrastructure have long played a role in Canadian health care. Radiology in particular serves as a critical example of how private providers can seamlessly integrate into the public system. Most Canadians access diagnostic imaging through privately operated facilities, and these services remain an essential pillar of publicly funded health care. Virtual care follows the same principle: private providers create infrastructure that expands patient access to care while ensuring affordability and integration within the public system.

Rather than demonizing private operators of virtual care, we should recognize their potential. With growing patient demand and worsening physician shortages, expanding capacity and improving accessibility is not just beneficial, it is essential. The conversation should not be about whether private virtual care belongs in our system, but how best to integrate it to serve all Canadians.

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