Preserving Vital Access to Care for Long Covid, ME/CFS, & Fibromyalgia Patients Across BC
Summary of the Issue:
The BC-Centre for Long Covid, ME/CFS, and Fibromyalgia (BC-CLMF) provides an innovative, cost-effective, multidisciplinary chronic disease care model for individuals with ME/CFS, fibromyalgia, and Long Covid; this model offers a reduced cost to the system by using only MSP billing and leveraging group medical visit fee codes.
MSP virtual Group Medical Visit (vGMV) attendance caps, scheduled to take effect January 1, 2026, will collapse the clinic model, leaving over 6,000 British Columbians living with ME/CFS, Fibromyalgia, and Long Covid without specialized care. This loss of desperately needed specialist care will increase the burden on primary care providers, specialists, and emergency medicine, overburdening an already strained health system.
In order to save this innovative and deeply needed care model, we are asking for your support in telling the BC government and Doctors of BC that the cap on virtual group medical visits must be raised from 20 to 50, or other funding streams established, to maintain and expand this vitally important care. See “What can I do to support this care” on p. 3 for more information.
Why is this care so important?
As of 2019, an estimated 902,800 Canadians (2.4%) were living with ME/CFS and/or fibromyalgia. The Covid-19 pandemic exacerbated the situation, with over 3 million Canadians currently affected by Long Covid, which has significant overlap with ME/CFS and fibromyalgia. Individuals with ME/CFS, fibromyalgia, and Long Covid are high consumers of health care, but often report unmet needs and face challenges in accessing appropriate care. This patient population often ends up seeking care from overburdened primary care providers, or at urgent care and emergency departments that are not intended to manage complex chronic conditions.
Patients with ME/CFS are:
3x more likely to have 10+ GP visits
1.5x more likely to have seen specialists
2x more likely to have received overnight hospitalization
2x more likely to have used mental health services
2x more likely to report unmet health needs
How does the model work?
The BC Centre for Long Covid, ME/CFS, & Fibromyalgia (BC-CLMF) provides an innovative, multidisciplinary complex chronic disease care model that offers immediate access to all aspects of the program upon referral, preventing bottlenecks and reducing wait times to access care. Each patient receives a 1:1 consultation with an internal medicine specialist. Follow-up visits are primarily group-based and include medical visits, medication visits, patient education groups, and special lecture series run by physicians and multidisciplinary allied health such as physiotherapists, occupational therapists, and registered dietitians. This model:
Allows for high-quality, individualized physician care
Facilitates access for hundreds of patients each week
Allows for rapid access to specialist expertise and allied health treatment options
Eases the burden on other specialist referrals like cardiac, rheumatology, and neurology
Provides a shared care model with general practitioners to best meet patient needs
What is unique about this model?
The model provides access to specialist care immediately, offering a holistic approach that incorporates evidence-based medication, lifestyle, and psychosocial interventions. This model allows patients to access resources at any time during their illness or remission, preventing the need for repeat referrals and wait lists for conditions that are frequently relapsing and remitting. The group model allows for shared learning among and between patients in a way that is lost in programs that consist only of 1:1 treatment. Patients often praise the sense of community this clinic gives them while they deal with incredibly isolating diseases.
The virtual-first model supports patients from all over the province, many of whom reside in communities with no specialists who can manage their care, and most of whom are housebound due to the severity of their illness. Patient data from the clinic shows that 43% of patients live over one hour away from St. Paul’s Hospital, a site where the clinicians deliver some in-person services, and almost 1 in 5 patients lives in a rural or remote community.
What is the impact on the health care system?
Losing access will increase overall costs to the system, as patients with these conditions have much higher healthcare utilization when not appropriately treated. Complex chronic disease patients being forced to leave specialized care will overload an overburdened system. Access to this clinic reduces ER visits, specialist referrals, and hospitalizations.
Existing virtual group medical visits are frequently filled and have waitlists. Wait times for 1:1 intakes with the clinic’s physicians are steadily increasing, with the current wait period for 1:1 intake projected at up to 3.7 years and many new referrals coming in daily. Without access to virtual group medical visits, these patients will seek care from their primary care providers, other specialists, and urgent and emergency care.
The BC-CLMF is supportive of a cap that ensures high-quality care across the province. However, limiting the cap to 20 creates significant unintended consequences, greatly extending wait times for patients and rendering this clinic model not feasible without additional funding. This would slow access for patients, increasing prescription waits from 6 weeks to over 6 months and specialist expertise from weeks to years. If the clinic has to discontinue group visits and revert to 1:1 appointments, it would increase cost per visit for MSP, as 1:1 telehealth sessions are 7 times more expensive on average.
What does this mean for referring providers?
Over 2300 health care practitioners have made referrals to the BC-CLMF. Reducing the cap from 50 to 20 patients per vGMV will cut access to direct patient care by 60% at the BC-CLMF.
If this cap is not lifted, over 6,000 patients will be forced to shift the majority of their health care needs back to primary care providers and emergency departments who lack the time and capacity to effectively manage these conditions and care for them properly.
Can group care provide the level of care required for these patients?
The BC-CLMF recognizes the importance of balancing access to care and ensures each patient always has the opportunity for a private 1:1 with the interacting physician as well as follow ups as needed. In addition, the clinic provides significant 1:1 interaction with patients in its virtual GMVs.
This model has significant strengths for effective patient treatment. It greatly increases the number of patients seen by specialist physicians. In a standard model, the clinic would see 80 follow-up specialist visits weekly. In the group visit model this doubles to 160 follow-ups, while also taking on new patient consultations each week. This provides timely access to specialist care, reducing wait times, and ensuring timely and equitable access to care for this patient population.
What can I do to support this model?
Write in support of our model to Minister of Health Josie Osborne at HLTH.Minister@gov.bc.ca and CC the President of Doctors of BC, Dr. Charlene Lui, at president@doctorsofbc.ca, and info@lifelinebc.ca. Any background on your interactions with the clinic will provide important context for the Ministry and Doctors of BC. Please make sure to ask that they lift the virtual Group Medical Visit from 20 to 50.
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