*Disclosure: Kariba Health is a paid sponsor. As always all my opinions are my own*
Dr. Rawson graduated from the University of Cape Town in South Africa in 2003, worked in South Africa for a few years in very busy township hospitals, where she gained tremendous experience both practical and across a wide range of diseases and specialties. She then moved to Canada in 2006 and worked in Saskatchewan for two years doing emergency room and family practice work. After that she moved to Abbotsford where she worked as a GP for a while before moving to Vancouver where she spent six years working in paediatric oncology at BCCH before transitioning back to family practice six years ago. She has since completed a post graduate diploma in practical dermatology from the University of Cardiff and also occasionally teach 1st and 2nd year medical students at UBC. Dr. Rawson also provides Botox for treatment of migraine and cosmetics and accepts referrals for dermatology assessment. She is married to a software engineer and is a mom to two girls aged 9 and 6.
What is Kariba Health?
Kariba – What is the Story Behind the Name?
When developing the brand/logo etc I was working with a designer and we wanted to come up with a name that would be simple but still stand out and be easy to remember and pronounce. Many clinics are named based on their location or the doctor’s name and I was looking for something a bit different. After a lot of brainstorming we came to Kariba. I grew up in Zimbabwe in Southern Africa and spent many childhood vacations on a dam on the Zambezi River, called Kariba. So, while it won’t have much meaning to the most Canadians it is still very personal to me and where I come from.
How has your clinic evolved/adapted as a result of COVID19?
Prior to COVID-19, I was working in a typical family practice office doing face to face visits. Kariba as a medical clinic had already begun development and we had even made an offer for a space to lease, but we quickly shifted our focus as we realized that the needs of patients and physicians had changed. Since March 2020 I have been doing primarily virtual medicine with some limited in person care where absolutely necessary.
What security measures are in place for patients to feel secure about participating in virtual appointments?
Security is very important to me and is something strictly monitored by the College of Physicians and Surgeons of B.C. Physicians are only able to offer virtual care through approved platforms and we follow a number of regulated guidelines. I use an electronic medical record (EMR) system which is one of the newest and most up to date and secure platforms available. All video calls and electronic communication are done directly through the system. We offer both video and phone calls for the patient visit with a secure messaging system for other needs. Phone calls are inherently more secure so this is the recommended means of communication for anything a patient would consider sensitive. Many of the third party apps being used elsewhere are not considered secure with many reports of breaches and holes in their systems. Since we started with this as our primary focus, we weren’t forced to compromise, as many clinics have done. While there is no single provincially approved system for communication, the College does have guidelines and recommended EMRs.
Do patients complete consent forms to do virtual appointments?
We have a comprehensive consent form which we send to every patient prior to their visit. All patients need to sign this extra form before we can see them.
How has quality of care been impacted by virtual appointments?
I think there are many ways that virtual visits can improve care, one of the main areas that I see benefiting is mental health issues. By removing the unnecessary time normally associated with a doctors visit (no driving to the office, or waiting room) I am able to have more frequent visits. Many patients also find that they have much lower anxiety than they would have with a regular in-person visit. Busy professionals also benefit from not having to take big chunks of time out of their day for simple things like prescription refills and routine blood work. I have also seen virtual care benefit families. First-time parents with newborn babies can be seen from their home and checked on much more frequently than we typically would in an office. There are huge benefits when seeing older children virtually too. If you ask most parents, the time and effort before and after the visit far out-weigh the time with the doctor and we eliminate all that wasted time. Children are also definitely more comfortable in their home environments.
Do you think that virtual appointments will replace face-to-face care?
There are many instances where an in-person visit is warranted and we can accommodate that. There are many more instances where an in-person visit isn’t necessary. I hope virtual care will increase access to primary care and that patients will contact their GP more regularly. People won’t hold on to issues to deal with multiple things at one visit and hopefully will deal with things as they come up which should have the effect of many issues not becoming worse.
Do you think virtual appointments will reduce/increase the number of times a patient contacts their GP?
I think that the number of visits will go down, until patients get used to the new ways to see their GP. Certainly in-person visits will reduce because so many things simply don’t require it. I think the flip side is that the level of care in all cases will increase. I have been surprised to discover how much is able to be done virtually and how much time and effort it saves both the patient and the doctor. Virtual care can’t fully replace in person care, but I do think it is going to replace much of it. It does mean that when you do see your doctor face-to-face, the care will likely be significantly better.
Are there any disadvantages of virtual appointments?
There are sometimes some minor inconveniences, but most are small and reasonably easily overcome. Small issues with internet connection or audio issues can make natural conversation difficult. Obviously there are things which cannot be done virtually like skin biopsies, pap tests, suture removal. We’ve found these to be infrequent and are easily referred to a partner physician who specializes in these things.
What are the long term plans/impacts for your clinic now?
Our plan is to offer a hybrid model of care with visits starting with a virtual consultation progressing to in-person examinations as needed. We are looking into new and inventive ways of offering physical spaces. We are investigating a mobile clinics and “pop up” clinics in locations that have been left unoccupied due to COVID-19. Since we can offer care to anyone in B.C, we’ve already attracted patients on the Island who were struggling to find a GP nearby. While physical spaces will primarily be in Vancouver, co-ordination of care and long term continuity of care will be offered to anyone in B.C.
How does your clinic stand out from others?
Kariba stands out as it offers virtual family practice. Most virtual health care platforms offer one time visits and no continuity of care, patients don’t build up a relationship with a doctor. What we are hoping to do is to develop a doctor-patient relationship as you would in a regular practice but with all the convenience of virtual care. We are a new type of clinic and will always be pushing to find better more efficient ways to offer a high standard of ongoing care. Like many things that were unfamiliar at first like ride sharing apps, instant messaging and streaming audio, I hope that this kind of practice becomes part of the fabric of everyday life.
My Virtual Appointment Experience
Step 1- Booking
Step 2: The Appointment
On the day of our appointment, we received a link and a one-time code via text/email, 5 minutes before your start time which allowed us to log-in to the video appointment. The video appointment started and the quality of the video and audio was very good. We encountered a small temporary technical glitch where Dr. Rawson’s video froze for a minute but the audio still came through and it did not hamper the appointment in any way. We had sent in some pictures, which she said were very helpful for her assessment. The appointment lasted about 10-15 minutes