A number of physician Colleges across Canada have updated their telemedicine / virtual care standards of practice to include new guidelines around appropriate referrals to in-person care. Currently, this includes:

Alberta
British Columbia
Manitoba
Quebec
Yukon
New Brunswick

In these provinces, physicians should determine whether virtual care allows for adequate assessment of the presenting patient concerns and, if it does not, support a referral to an in-person clinic. Each province has implemented this policy in different ways, which means the burden on the physician is greater in some provinces. The choice must be based on the patient's best interests and on compliance with ethical standards governing the practice of medicine.

To support physicians practicing on Maple, we’ve formalized relationships with in-person clinics. We have outlined guidance on how Maple providers can refer patients needing in-person assessment to these clinics in each of the aforementioned provinces.

Recommended approach based on the type of consultation

Private-pay consultations

If the case cannot be adequately assessed virtually, we ask that you reject the consult in the triage room. If you pick up one of these visits and in the first 5 minutes determine you are unable to help the patient virtually, you can advise the patient and proceed to “Complete without charge.”
If you discover during the consultation that the patient requires an in-person assessment, we recommend that you spend 5-10 minutes with the patient to provide clear recommendations for the next steps, including where the patient should seek care, and within what time frame.
You can offer to write the patient a custom note they can download using the custom note feature outlining your assessment. This note can be taken directly to an in-person physician so they do not have to explain their case in detail a second time.
Inform the patient that Maple can provide a copy of their consultation summary to the clinic where they seek care, including any notes you've made.
Complete the visit with charge.

Corporate and publicly covered consultations

Please refer to the provincial sections on the best approach for these consultations based on the specific policies.

Alberta

The College of Physicians & Surgeons of Alberta (CPSA) has issued standards for virtual care practice stating that virtual care should include the option to access in-person care if needed. The standard was implemented on January 1, 2022. Therefore, providers need to consider whether virtual care affords adequate assessment of the presenting concerns and if it does not, arrange for a timely in-person assessment.

Reference Documents:

Relevant excerpts from the practice standard: virtual care

Appropriate provision of virtual care

(#6) A regulated member providing virtual care must first ensure they have a physical clinic, or an agreement with a physical clinic within reasonable travel proximity of the patient, to fulfill the need for in-person care when appropriate, required or requested by the patient. A regulated member providing virtual care must:

Ensure they have sufficient training, knowledge, judgment and competency including technological to manage patient care virtually;
Consider the technologies available to the patient;
Adhere to best practices for technological security and use an appropriate platform or infrastructure suitable to engage in virtual care; and
Submit a Privacy Impact Assessment (PIA) to the Office of the Information and Privacy Commissioner of Alberta prior to adopting new information and communication technologies for the purposes of virtual care.

Policy for AB-licensed physicians

It is up to the physician to determine whether a situation or health concern is compatible with virtual care. The choice must be based on the patient's best interests and on compliance with ethical standards governing the practice of medicine. If virtual care does not afford adequate assessment of the presenting concerns, the provider needs to arrange for a timely in-person assessment.

When you begin a consultation and determine the patient requires an in-person assessment, you can utilize the list of AB in-person clinics compiled below or the following websites to assist the patient in finding an in-person clinic near them. When a patient needs to be referred in person:

Please ask the patient for their location and search for a clinic nearby.
Once you’ve located a clinic, please provide the patient with a custom note indicating the assessment and rationale for in-person care, that they can take directly to the clinic, or
You may also contact the clinic directly to provide additional context.

Maple is working to set up a referral pathway to ensure our providers can meet this requirement. In the meantime when a patient needs to be referred in person you can use the following resources:

Alberta list of clinics

Clinic Name	Google Maps	Address	City	Postal Code	Phone Number	Fax
Riverbend Family And Walk-In Clinic	Location	216-8338 18 St SE	Calgary	T2C 4E4	(403) 236-2344
Excel Health Family Practice And Walk-In Clinic	Location	3916 Macleod Trail SE	Calgary	T2G 2R5	(403) 454-9235	(587) 573-9235
Pinnacle Medical Beacon Hill	Location	250 12024 Sarcee Trail NW	Calgary	T3R 0A1	(587) 318-4520	(403) 567-8434
Pinnacle Medical Macleod Trail	Location	#15, 8720 MacLeod Trail SE	Calgary	T2H 0M5	(587) 779-5494	(587) 779-5495
Pinnacle Medical Crowfoot	Location	31 Crowfoot Way NW	Calgary	T3G 2L4	(587) 774-8698	(587) 774-8699
Pinnacle Medical Beddington	Location	#170, 8220 Centre Street NE	Calgary	T3K 1J7	(403) 910-2596	(403) 910-2597
Pinnacle Medical Hamptons	Location	#500, 1000 Hamptons Drive NW	Calgary	T3A 6A7	(403) 774-8698	(403) 777-2755
South Calgary Medical Clinic	Location	118-40 Sunpark Plaza SE	Calgary	T2X 3X7	(403) 254-4000
Coventry Hills Family Care Centre	Location	100 Country Village Road NE	Calgary	T3K 5Z2	(403) 226-6715	(403) 226-6748
Medical Express McKenzie Towne	Location	100-4700 130th Ave SE	Calgary	T2Z 4E7	(403) 726-8955	(403) 726-8956
Northgate Centre Medical Clinic	Location	2074-9499, 137 AVE NW	Edmonton	T5E 5R8	(780) 457-4250	(780) 457-8569
South Common Medical Centre	Location	9711 23 Ave NW	Edmonton	T6K 3L6	(780) 989-1212	(780) 989-3511
Millbourne Mall Medical Centre	Location	7609 Millwoods Rd NW #115	Edmonton	T6K 3L6	(587) 521-2022	(587) 521-2023
Parsons Medical Centre	Location	Unit 105 625 Parsons Road SW	Edmonton	T6X 0N9	(587) 754-5600	(587) 754-8822
All Healthy Medical Clinic	Location	12350 137 Ave NW	Edmonton	T5L 4X6	(780) 406-5514	(780) 406-5547
Blatchford Field Medical Clinic	Location	11541 Kingsway NW	Edmonton	T5G 3E8	(780) 809-1495	(780) 809-1494
Franklin Avenue Community Care Clinic	Location	#203, 8706 Franklin Avenue	Fort McMurry	T9H 2J6	(780) 715-1314	(780) 715-1700
Hines Health Services	Location	Suite 106-9616 Franklin Ave	Fort McMurry	T9H 2J9	(780) 790-6909	(587) 537-7701
Ross Creek Medical Clinic	Location	10101 86th Ave Suite 206	Fort Saskatchewan	T8L 4P4	(780) 589-3989	(780) 998-9993
GP Medical Clinic	Location	12225 99 Street	Grande Prairie	T8V 5Z4	(780) 533-4444	(780) 533-4443
Primacy Medical Clinic Medicine Hat	Location	1792 Trans Canada Way SE	Medicine Hat	T1B 4C6	(403) 502-8929	(403) 502-8955
Pinnacle Medical Okotoks	Location	1031, 200 Southridge Drive	Okotoks	T1S 0B2	(403) 917-0653	(403) 917-0654
Premier Health Okotoks	Location	116 Southbank Blvd	Okotoks	T1S 0L3	(403) 995-4055
Vineyard Medical Clinic: WestWinds	Location	#100, 3633 Westwinds Drive NE	Calgary	T3J5K3	(587) 955-9400	(587) 955-9401

British Columbia

In British Columbia, the College of Physicians and Surgeons of British Columbia (CPSBC) issued a virtual care practice standard. The standard was last revised on June 6, 2022, and will next be reviewed in June 2024.

Reference Documents:

Practice Standard - Virtual Care

Relevant excerpts from the practice standard: virtual care

Appropriate use of virtual care

The appropriate use of virtual care includes access to in-person care and is ultimately a professional decision of the registrant made in conjunction with their patients. The use of virtual care to screen patients prior to attendance at an office setting is critical during pandemics and epidemics to ensure those who may be suffering from contagious diseases are appropriately triaged. Virtual care is most appropriately used when integrated with comprehensive longitudinal primary care. In the context of episodic care, access to in-person care must be provided to patients as required and longitudinal care must be provided as indicated and required by patients. This requires formal affiliation with in-person providers where the patient resides. Virtual episodic care providers must be realistic about their ability to provide safe and effective services to patients in distant communities.

When providing virtual care, registrants must:

Consider whether the virtual care medium affords adequate assessment of the presenting problem, and if it does not, arrange for a timely in-person assessment done by themselves, or another registrant or nurse practitioner with whom the registrant has a pre-established agreement

Key points:

The policy applies specifically to registrants (only those who are BC licensed)
It does not govern the care of providers who are providing virtual care into BC without holding a license (“The College does not regulate physicians who are located outside of the province and providing virtual care to patients located in BC.”)

Policy for BC licensed physicians

To ensure providers can meet requirements, Maple has compiled a list of clinics across British Columbia. When a patient needs to be referred in person:

Please ask the patient for their location and search for a clinic nearby
Once you’ve located a clinic, please provide the patient with a custom note indicating the assessment and rationale for in-person care, that they can take directly to the clinic, or
You may also contact the clinic directly to provide additional context.

Directory searches for clinics:

British Columbia list of clinics

Clinic Name	Google Maps	Address	City	Postal Code	Phone Number
Abbotsford Medical Centre	Location	2051 McCallum Rd #101	Abbotsford	V2S 3N5	(604) 744-5133
Abbotsford Village Medical Clinic	Location	2050 Sumas Way	Abbotsford	V2S 2C7	(604) 504-7145
Abby Central Medical Clinic	Location	2855 Gladwin Road	Abbotsford	V2T 6Y4	(604) 557-9335
Allwood Medical Centre	Location	2752 Allwood Street	Abbotsford	V2T 3R7	(604) 850-6893
Gateway HealthCare	Location	#203 2051 McCallum Rd	Abbotsford	V2S 3N5	(604) 855-0677
Medimax Health Centres Abbotsford	Location	2479 McCallum Rd	Abbotsford	V2S 3P8	(604) 852-2279
Viva Care Mt.Lehman Road	Location	3122 Mt. Lehman Road	Abbotsford	V4X 0B3	(604) 381-4102
West Oaks Medical Centre	Location	Unit 310 32700 South Fraser Way	Abbotsford	V2T 4M5	(604) 557-9938
Whatcom medical clinic	Location	2362 Whatcom Rd #105	Abbotsford	V3G 0C1	(604) 853-5424
Atlin Health Centre	Location	164 3rd Street	Atlin	V0W 1A0
BC Drugs Medical Clinic	Location	9618 Cameron Street	Burnaby	V3J 1M2	(778) 999-9966
Brentwood Medical Clinic Inc	Location	4567 Lougheed Hwy, Suite 212	Burnaby	V5C 3Z6	(604) 294-8540
Dawson Medical Clinic	Location	4238 Dawson St	Burnaby	V5C 0B8	(604) 564-8555
Highgate Medical Clinic	Location	103-7188 Kingsway	Burnaby	V5E 1G3	(604) 777-9101
Jvon Medical Clinic	Location	44468 beresford st	Burnaby	V5H 2Y8	(778) 379-8299
Old Orchard Medical Clinic	Location	4429 Kingsway #11	Burnaby	V5H 2A1	(604) 431-6585
PolyCan Health Centre	Location	#102 & #205 - 9055 University High Street	Burnaby	V5A 0A7	(604) 545-0991
Prime Care Medical	Location	201-7315 Edmonds Street	Burnaby	V3N 1A7	(604) 519-3767
Station Square Medical Clinic	Location	6200 McKay Avenue	Burnaby	V5H 4L7	(604) 438-8288
Total Life Care Medical	Location	7155 Kingsway #250	Burnaby	V5E 2V1	(604) 438-9991
Welcome Medical Clinic Inc	Location	7885 6th Street	Burnaby	V3N 3N4	(604) 526-1303
Dr. Leyen	Location	50-45905 Yale Rd	Chilliwack	V2P 2M6	(604) 792-2266
Dr. Paul Basson - Family Physician	Location	100 F, 6640 Vedder Rd	Chilliwack	V2R 0J2	(604) 858-4833
Southgate Medical Clinic	Location	45905 Yale Rd	Chilliwack	V2P 2M7	(604) 795-7228
Highland Family Practice	Location	1966 Guthrie Rd	Comox	V9M 3X7	(250) 890-0919
Foothills Medical Clinic	Location	3387 David Ave #203	Coquitlam	V3E 0K4	(778) 285-5859
Plateau Medical Clinic	Location	F8M-1410, Parkway Blvd	Coquitlam	V3E 3J7	(604) 468-1500
The Well Medical	Location	1001 Austin Ave	Coquitlam	V3K 3N9	(604) 937-2520
ValleyCare Medical	Location	310 8th St	Courtenay	V9N 1N3	(250) 331-0500
Tamarack Medical Clinic	Location	1500 Cranbrook St N #191	Cranbrook	V1C 3S8	(250) 426-7724
Centuria Medical	Location	1500 Gordon Dr #2	Kelowna	V1Y 9R2	(250) 763-5152
Healthwise Medical	Location	1499 Gordon Dr #3	Kelowna	V1Y 9R2	(604) 904-7712
Mission Medical Centre	Location	3320 Richter St #102	Kelowna	V1W 4V5	(250) 868-8222
Kimberley Medical Clinic	Location	260 4 Ave	Kimberley	V1A 2Y6	(250) 427-4861
Langley Crossing Medical Clinic	Location	6339 200 St Unit 201	Langley	V2Y 1A2	(604) 539-0057
Murrayville Family Practice Group	Location	22112 52 Ave #204	Langley	V2Y 2M6	(604) 533-1140
Thunderbird Family Practice	Location	20159 88 Ave d114	Langley	V1M 0A4	(604) 888-6220
Goldenears Medical Clinic	Location	20395 Lougheed Hwy	Maple Ridge	V2X 2P9	(604) 465-1066
Westgate Medical Clinic	Location	402-20395 Lougheed Hwy	Maple Ridge	V2X 2P9	(604) 465-3900
Wellington Medical Clinic	Location	3200 North Island Highway #84C	Nanaimo	V9T 1W1	(250) 740-2100
Kootenay Lake medical clinic	Location	1140 Lakeside Dr	Nelson	V1L 5Z3	(250) 352-4666
Elicare	Location	610 6th St 228 B	New Westminster	V3L 3C2	604-545-0420
New Westminster Family Practice	Location	610 6th St #242	New Westminster	V3L 3C2	(604) 521-8522
DERM Lab - Well Health	Location	Suite 320 - 138 East 13th Street	North Vancouver	V7L 0E5	(604) 334-9060
Medlife Clinic	Location	845 Marine Dr #108	North Vancouver	V7P 0A8	(604) 770-1933
Parkgate Medical Clinic	Location	3650 Mt Seymour Pkwy #220	North Vancouver	V7H 2Y4	(604) 929-7321
9th Avenue Clinic	Location	3855 9th Ave	Port Alberni	V9Y 4T9
Quesnel Medical Clinic	Location	205 St Laurent Ave	Quesnel	V2J 2C8	(250) 992-8321
Healthvue Medical	Location	11700 Cambie Rd. #180	Richmond	V6X 1L5	(604) 270-9833
Wellness First Medical	Location	10111 No. 3 Rd #140	Richmond	V7A 1W6	(604) 272-2244
Central Saanich Medical Clinic	Location	1932 Mt Newton Cross Rd	Saanichton	V8M 2B1	(250) 652-2041
West Coast Family Medical Clinic	Location	1300-6660 Sooke Rd	Sooke	V9Z 0A4	(250) 642-4233
Elaho Medical clinic	Location	1337 Pemberton Ave	Squamish	V8B 0R1	(604) 892-5688
Cedar Hills Medical Clinic	Location	12860 96 Ave	Surrey	V3V 6A8	(604) 584-3531
Central City Medical Clinic	Location	10153 King George Blvd	Surrey	V3T 2W1	(604) 951-0885
Clover Care Medical Clinic	Location	17770 56 Ave Suite 102	Surrey	V3S 1C7	(604) 574-7883
Evergreen Medical Centre	Location	8960 152 St	Surrey	V3R 4E4	(604) 588-8181
Nordel Crossing Medical Clinic	Location	12080 Nordel Way #115	Surrey	V3W 1P6	(604) 543-0888
WELL Health - Panorama Village Medical Clinic	Location	15157 56 Ave #103	Surrey	V3S 9A5	(604) 574-0481
Park Avenue Medical Centre	Location	4634 Park Ave	Terrace	V8G 1V7	250-615-5040
Carepoint Davie	Location	1123 Davie St	Vancouver	V6E 1N2	(604) 915-9517
Commercial Drive Medical clinic	Location	1515 Commercial Dr	Vancouver	V5L 3Y1	(604) 255-5922
Eastvan Medical Building	Location	1750 E 10th Ave	Vancouver	V5N 5K4	(604) 879-7317
Marine Gateway Medical Clinic	Location	470 SW Marine Dr #301	Vancouver	V5X 0C7	(604) 227-3322
University Village Medical - Allison Road	Location	228-2155 Allison Rd, Vancouver, BC	Vancouver	V6T 1V5	(604) 222-2273 ext. 2
Dr. C.S. Jackson	Location	225-2306 Hwy 6	Vernon	V1T 7E3	(250) 260-3800
West Saanich Medical Clinic	Location	4442 W Saanich Rd #105	Victoria	V8Z 3E9	(250) 590-8378
Lakepoint Medical Clinic	Location	#202-525 Highway 97 South	West Kelowna	V1Z 4C9	(778) 755-0700
Towne Centre Medical Clinic	Location	18-2475 Dobbin Rd	West Kelowna	V4T 2E9	(250) 768-8315

Manitoba

The College of Physicians & Surgeons of Manitoba (CPSM) issued a Standard of Practice for Virtual Medicine on November 1, 2021 (reviewed with changes on Sept 29, 2022) to reinforce the importance of in-person care. The new standard requires Manitoba licensed physicians to include timely in-person care when clinically indicated or requested by the patient. It is not an acceptable standard of care to solely practice virtual medicine. A blended model of care balancing in-person and virtual medicine is required if providing virtual medicine.

Reference Documents:

Relevant excerpts from the standard of practice for virtual medicine

Provide good medical care

Members providing virtual medical care must have the ability themselves to provide a timely physical assessment of the patient. A limited exemption applies for patients in distant rural, remote, or institutional locations if this will hinder access to care. Directing patients to another healthcare facility, a walk-in clinic, or the Urgent Care or Emergency Department in non-urgent or non-emergent circumstances in lieu of an in-person assessment is not appropriate care.

Virtual medicine not meeting the standard of care

The requirement is to provide timely in-person medical care. Examples of virtual medicine that do not meet the Standard are:

Virtual medicine-based businesses that do not offer timely in-person appointments by the same physician (within 24-48 hours)
Physicians not offering in-person appointments, including during a pandemic, unless advised by a health authority to not see patients in person
Physicians restricting in-person visits with patients or having very limited in-person appointments inappropriately or without objective rationale.

Policy for MB licensed physicians

Given the requirement above that the physician practicing virtual care must also provide the in-person appointment, Maple has restricted care in Manitoba to be delivered only by nurse practitioners, and by physicians associated with a physical clinic in the province.

CPSM physicians using virtual medicine to provide medical care to patients must:

Disclose their identity to the patient and confirm confidentiality of the encounter;
Take reasonable steps to confirm the patient’s identity and that the patient is located in Manitoba;
Ask the patient if the physical setting is appropriate given the context of the encounter and ensure consent to proceed;
Offer the patient the opportunity for in-person care.

Quebec

The Collège des médecins du Québec (CMQ) issued detailed standards around the necessary conditions for carrying out “teleconsultations,” also known as “virtual care encounters.” The CMQ advises that physicians must always exercise caution and judgment when beginning a virtual care encounter.

The CMQ has issued strict guidelines and ongoing reminders to physicians on the importance of carrying out a quality clinical approach, both for virtual care and face-to-face. Specifically, the CMQ notes that when a physician is in a virtual care encounter, they will not be permitted to subsequently refer patients to the emergency room or hospital, request a consultation in specialized medicine or refer to a walk-in clinic for examination. Instead, there is a strict burden imposed on physicians indicating that they must arrange in-person care through a previously established referral pathway or corridor.

Reference Documents:

Relevant excerpts from the Reference Corridor Standard

Appropriate provision of virtual care

The reference corridor must allow the patient to be seen, in particular for a physical examination, within an acceptable time period for his state of health and at a reasonable distance from his home or from the place where he usually sees the doctor who performs the teleconsultation.

Policy for QC licensed physicians

Physicians practicing virtual care in Quebec should first clearly determine whether a situation is compatible and appropriate for a virtual care assessment. For cases that may require in-person assessment, physicians can accept the consultation as Maple has established an in-person pathway to refer patients.

QC in-person care pathway

To support providers in Quebec, Maple has partnered with in-person clinics in Quebec to provide patients with a pathway for in-person care. The program is available to all Quebec corporate patients.

If the request is for a concern that cannot be treated or resolved virtually, you should provide appropriate care based on the patient’s presenting condition.
After speaking to the patient, you can follow the instructions in the notice and the attached info sheet to issue a Care Recommendation.
With the Care Recommendation patients will speak with a member of Maple’s Care Concierge team who will assist them with scheduling an in-person appointment at our partner clinics.

Frequently asked questions

What happens after I issue a Care Recommendation?

The patient is prompted at the end of the consultation to submit their request to speak to the Care Concierge to book their in-person appointment. Maple’s Care Concierge is available to book appointments Monday to Friday, from 9 am-5 pm EST.

Are patients connected with a public or private clinic?
Maple has partnered with private clinics in Quebec. Patients are notified during the process that additional fees will apply when using private clinics and will always have the opportunity to go to a public clinic instead if they wish. We partner with private clinics to ensure there is sufficient capacity for patients to obtain a timely appointment to continue their care journey.

Are patients required to follow the Care Recommendation?
It is always up to the patient whether they use this pathway. The choice is theirs; if they wish, they can seek treatment through other options not affiliated with Maple, such as a public clinic or with their own family provider.

You can also utilize a list of QC in-person clinics compiled below or the following websites to assist the patient in finding in-person clinics near them. The process should include:

Asking the patient for their location and searching for a clinic nearby.
Contacting the clinic directly to provide additional context and to support the patient with being booked in.

Partner clinics

Clinic Name	Google Maps	Address	City	Postal Code	Phone Number	Fax
ELNA Médical - Carré Décarie	Location	6900 Boulevard Decarie	Côte Saint-Luc	H3X 2T8	514-373-3562	-
Privamed Brossard	Location	5955 Marie Victorin Boulevard	Brossard	J4W 2M2	1-855-655-6060	450-923-1551
Privamed Boucherville	Location	1052 Lionel-Daunais St. Suite 203	Boucherville	J4B 0B2	1-855-655-6060	450-906-1515
ExcelleMD Private Clinic / Marché Central	Location	9001 Boulevard de l’Acadie, #101	Montréal	H4N 3H5	450-735-8111	514-489-8111
ExcelleMD Private Clinic / Sanctuary Outremont Montreal	Location	6100 Avenue du Boisé, #113	Montréal	H3S 2W1	450-735-8111	514-788-8111
ExcelleMD Private Clinic / Saint-Eustache	Location	460 Rue du Parc, #101	Saint-Eustache	J7R 0C9	450-735-8111	450-473-1034
ExcelleMD Private Clinic / Terrebonne	Location	3195 Boulevard De La Pinière, #101	Terrebonne	J6X 4P7	450-735-8111	450-964-8111
Clinique Santé Plus / Vaudreuil	Location	11 Bd de la Cité-des-Jeunes	Vaudreuil-Dorion	J7V 0N3	450-319-0339	450-455-5127
Clinique MonDoc / Lévis	Location	1200 Bd Guillaume-Couture #402	Lévis	G6W 5M6	418-877-6767	800-210-8013
Clinique MonDoc / Cap-Rouge	Location	1147 Rue Charles Albanel	Cap-Rouge	G1X 4T9	418-877-6767	800-210-8013
Clinique MedicAxion	Location	1020 Rue Bouvier bureau 200	Quebec City	G2K 0H3	418-688-0331	581-300-6337
Clinique Santé 360 / L'Assomption	Location	831 boul. from L'Ange-Gardien North Suite 305 (3rd floor)	L'Assomption	J5W 1P5	450-589-6360	450-589-3600
Clinique Santé 360 / Anjou	Location	8666 avenue Chaumont	Anjou	H1K 1N5	450-589-6360	514-766-1030
UnionMD / West Island	Location	15000 Pierrefonds Blvd. 3rd Floor	Pierrefonds-Roxboro	H9H 4G2	514-400-3291	514-400-3292
UnionMD / Laval	Location	3498 Boulevard Sainte-Rose	Laval	H7P 4K7	514-400-3291	514-400-3292
UnionMD / Town of Mount-Royal (TMR)	Location	4175 Jean-Talon O	Town of Mount-Royal	H4P 1W6	514-400-3291	514-400-3292
UnionMD / Downtown Montreal	Location	1191 Union Ave	Montréal	H3B 3C3	514-400-3291	514-400-3292
UnionMD / South Shore	Location	3234 Blvd Taschereau	Longueuil	J4V 2N2	514-400-3291	514-400-3292
UnionMD / Gatineau	Location	86 Promenade du Portage, Suite 300	Gatineau	J8X 2K1	819-484-1281	514-400-3292
UnionMD / Ottawa	Location	1729 Bank Street, Unit 208	Ottawa	K1V 7Z5	819-484-1281	514-400-3292
Clinique infirmière Nord-Ouest / Rouyn-Noranda	Location	407 Av. Murdoch	Rouyn-Noranda	J9X 1G7	819-710-2466	819-975-2412
Clinique infirmière Nord-Ouest / Val-d’Or	Location	1731 3e Avenue	Val-d'Or	J9P 1W3	819-710-2466	819-975-2412
Clinique infirmière Nord-Ouest / La Sarre	Location	260 1re Rue E	La Sarre	J9Z 1K7	819-710-2466	819-975-2412
Clinique infirmière de Témiscamingue / Ville-Marie	Location	55 Rue Ste Anne	Ville-Marie	J9V 2B6	819-710-2466	819-975-2412
Priva Santé / Sainte-Marie	Location	774-D, rue Étienne-Raymond	Sainte-Marie / Beauce	G6E 0K6	418-386-2698	418-386-2668
Priva Santé / Saint-Georges	Location	9077, boulevard Lacroix	Saint-Georges	G5Y 2B4	418-386-2698	418-386-2668
Clinique Praxis / Boisbriand	Location	230 Chem. de la Grande-Côte	Boisbriand	J7G 3A2	450-437-1111	450-437-4042
Clinique Praxis / Blainville	Location	794 Bd du Curé-Labelle	Blainville	J7C 2K5	450-234-1515	579-477-0445
Clinique Praxis / La Prairie	Location	1650 Chem. de Saint-Jean	La Prairie	J5R 0J2	450-287-5050	450-285-0115
Clinique Praxis / Terrebonne	Location	1961 Chem. Gascon Bureau 201	Terrebonne	J6X 4H2	450-312-5050	450-312-0115
Clinique Praxis / St-Jean-Sur-Richelieu	Location	264 Bd Saint-Luc #300	Saint-Jean-sur-Richelieu	J2W 1C3	450-349-7070	450-349-5461
Clinique IPS Santé Plus	Location	3750, boulevard du Royaume, suite 201	Jonquière	G7X 0A4	418-758-1851	581-564-0110
Clinique IPS de Quartier	Location	950 rue Ste-Thérèse	Drummondville	J2B 4V8	819-253-0168	819-805-0288
Flowrence / St-Bruno	Location	1474, rue Roberval	Saint-Bruno-de-Montarville	J3V 0N1	450-500-1699	450-500-1699
Flowrence / Brossard	Location	500 rue des Éclaircies	Brossard	J4Z 0R1	450-500-1699	450-500-1699
Flowrence / Lasalle	Location	7315 Boulevard Newman	Lasalle	H8N 0H8	450-500-1699	450-500-1699
Flowrence / Kirkland	Location	16766 Route Transcanadienne, bureau 401	Kirkland	H9H 4M7	450-500-1699	450-500-1699
Flowrence / Outremont	Location	1010 Av. Rockland	Outremont	H2V 4P5	450-500-1699	450-500-1699
Flowrence / Griffintown	Location	1890 Rue Payette	Montreal	H3J 1P3	450-500-1699	450-500-1699
Flowrence / Plateau Mont-Royal	Location	4388 R. Saint-Denis #200	Montreal	H2J 2L1	450-500-1699	450-500-1699
Flowrence / Laval	Location	2400 Boul. Daniel-Johnson	Laval	H7T 2V5	450-500-1699	450-500-1699
Flowrence / St-Sauveur	Location	#222F Chemin du Lac-Milette	Saint Sauveur	J0R 1R3	450-500-1699	450-500-1699
Clinique Médicale Step	Location	5757 boul. Cavendish, #300	Côte-St-Luc	H4W 2W8	514-307-5757	514-320-5757

Quebec list of clinics

Clinic Name	Google Maps	Address	City	Postal Code	Phone Number	Fax
GMF De Laurier-Station (Centre De Santé Arthur-Caux)	Location	135, rue de la Station	Laurier- Station	G0S 1N0	418 728-3435	-
GMF Clinique Des Ponts (Clinique Des Ponts)	Location	1190-A, rue de Courchevel, bureau 301	Lévis	G6W 0M5	418 834-1177	418 834-9275
GMF Lévis-Les Rivières (Gmf Centre Médical Lévis-Les Rivières)	Location	809, route des Rivières, bureau 301	Lévis	G7A 2V2	418 831-3677	418 831-7967
Centre De Santé Collège Canada	Location	1231, rue Sainte-Catherine Ouest	Montréal	H3G 1P5	514 532-1093	514 282-1530
Centre Médical Et Dentaire Promed	Location	1250, rue Mansfield, bureau 2eme étage	Montréal	H3B 2Y3	514 845-1800	514 845-1800
Centre Médical Gestion Elna Pierrefonds	Location	12774, boulevard Gouin Ouest	Montréal	H8Z 1W5	514 684-0474	514 360-0426
Clinique D'urgence Saint-Denis	Location	8415, rue Saint-Denis, bureau 101	Montréal	H2P 2H1	514 388-5723	514 388-3423
Clinique Médicale Beaubien Et Des Érables	Location	2175, rue Beaubien Est	Montréal	H2G 1M5	514 721-6560	514 722-3070
GMF 8260 Et Rivière-Des-Prairies (Clinique Médicale Rivière-Des-Prairies)	Location	12021, 15e Avenue (R.-d.-P.)	Montréal	H1E 0A1	514 494-1603	514 494-6973
GMF 8260 Et Rivières-Des-Prairies (Clinique Médicale 8260)	Location	8260, boulevard Maurice-Duplessis, bureau 212	Montréal	H1E 3A3	514 643-1113	514 643-1767
GMF Ahuntsic (Clinique Médicale Omnisanté)	Location	3400, boul Henri-Bourassa E	Montréal	H2B 1T9	514 903-9995	514 903-9992
GMF Ahuntsic (Clinique Médicale Saint-Sulpice)	Location	1420, rue Legendre Est, bureau 12	Montréal	H2M 1H5	514 382-0552	514 382-4324
GMF Ahuntsic (Urgence 241 Ahuntsic Inc.)	Location	10302, rue Chambord, bureau 106	Montréal	H2C 2R5	514 382-0062	514 382-4856
GMF Centre De Médecine Familiale Saint-Laurent (Centre D'urgence Saint-Laurent)	Location	1605, boulevard Marcel-Laurin, bureau 200	Montréal	H4R 0B7	514 747-2555	514 747-7624
GMF Clinique Médicale L'actuel (Clinique L'actuel (Mts))	Location	1001, boulevard De Maisonneuve Est, bureau 1130	Montréal	H2L 4P9	514 524-1001	514 524-3831
GMF Clinique Medistat (Clinique Médicale Medistat)	Location	4965, rue Saint-Pierre	Montréal	H9H 5M9	514 624-4774	514 624-4704
GMF Clinique Mednam Lachine (Clinique Mednam Lachine)	Location	2000, rue Notre-Dame, bureau 301	Montréal	H8S 2G4	514 780-1873	-
GMF Clinique-Réseau Forcemédic (Forcemédic 1 Jean-Talon)	Location	1021, rue Jean-Talon Est, bureau 200	Montréal	H2R 1V6	514 787-1818	514 787-1898
GMF Cosmopolite De Saint-Laurent (Centre De Médecine Intégrée)	Location	2040, boulevard Marcel-Laurin, bureau 240	Montréal	H4R 1J9	514 747-9936	514 747-9331
GMF Elna Décarie	Location	6900, boulevard Décarie, bureau 3550	Montréal	H3X 2T8	514 373-3562	514 373-6071
GMF Elna Plateau Mont-Royal (Clinique Médicale Plateau Mont-Royal)	Location	1374, avenue du Mont-Royal Est, bureau 103	Montréal	H2J 1Y7	514 527-3997	514 527-3994
GMF En Route 2 (Clinique En Route Gare Centrale)	Location	895, rue De La Gauchetière Ouest, bureau F5- 335	Montréal	H3B 4G1	514 954-1444	514 954-1619
GMF Espace Santé Ids (Espace Santé Ids)	Location	8, place du Commerce, bureau 200	Montréal	H3E 1N3	514 798-2228	514 787-1929
GMF Forcemédic 3 Westminster (Forcemédic Gmf 6)	Location	2229, avenue Dollard	Montréal	H8N 1S2	514 787-1818	514 365-8558
GMF Forcemédic 4 Henri-Bourassa (Forcemédic Bourassa)	Location	601, boulevard Henri-Bourassa Est	Montréal	H2C 1E3	514 787-1818	514 798-2060
GMF Groupe Santé Westmount Square (Groupe Santé Westmount Square)	Location	1, carré Westmount, suite 300	Montréal	H3Z 2P9	514 934-2334	514 931-2929
GMF Homa Centre Médical Mieux Être (Clinique Médicale Mieux-Être)	Location	3841, rue Ontario Est	Montréal	H1W 1S5	514 524-3731	514 524-0675
GMF Médicentre Lasalle (Médicentre Lasalle)	Location	1500, avenue Dollard, suite 201	Montréal	H8N 1T5	514 366-4507	514 366-6901
GMF Médico-Centre Mont-Royal (Clinique Mont-Carmel)	Location	933, boulevard René-Lévesque Est	Montréal	H2L 4S4	514 282-9197	514 282-9197
GMF Médico-Centre Mont-Royal (Clinique Médicale Crescent)	Location	1198, rue Crescent	Montréal	H3G 2A9	514 933-8383	514 933-8383
GMF Médico-Centre Mont-Royal (Clinique Médico-Centre Mont-Royal)	Location	4689, avenue Papineau, bureau 101	Montréal	H2H 1V4	514 521-5555	514 521-0951
GMF Queen-Élizabeth (Centre Médicale Queen Élizabeth Urgent Care)	Location	2111, avenue Northcliffe	Montréal	H4A 3K6	514 481-4343	514 483-9673
GMF Santé Mont-Royal (Clinique Santé Mont-Royal)	Location	4480, chemin de la Côte-de-Liesse, bureau 110	Montréal	H4N 2R1	514 819-6649	514 731-6650
GMF-R 1851 (Clinique Médicale 1851)	Location	1851, rue Sherbrooke Est, bureau 101	Montréal	H2K 4L5	514 524-7564	514 527-5251
GMF-R 3000 (Clinique Médicale 3000)	Location	3000, rue Bélanger	Montréal	H1Y 1A9	514 376-7702	514 376-2639
GMF-R Brunswick (Centre Médical Brunswick)	Location	955, boulevard Saint-Jean, suite 308	Montréal	H9R 5K3	514 426-6677	514 426-3323
GMF-R Centre Médical Métro Monk (Centre Médical Métro Monk)	Location	2529, rue Allard	Montréal	H4E 2L5	514 769-9999	514 769-9008
GMF-R Clinique Médicale Angus (Clinique Médicale Angus)	Location	2601-rue, william-Tremblay, bureau 200	Montréal	H1Y 0E2	514 807-2333	514 596-1821
GMF-R Clinique Médicale Angus (Clinique Médicale Du Technopôle Angus)	Location	2601-rue, william Tremblay, bureau 310	Montréal	H1Y 0E2	514 807-2333	514 596-1821
GMF-R Clinique Médicale Diamant (Clinique Médicale Diamant)	Location	5885, chemin de la Côte-des-Neiges, bureau 401	Montréal	H3S 2T2	514 731-5994	514 731-9130
GMF-R Clinique Médicale Viau	Location	7600, boulevard Viau, bureau RP 336	Montréal	H1S 2P3	514 255-7755	514 255-7754
GMF-R Clinique Médicale Viau (Clinique Médicale Viau Inc.)	Location	4750, rue Jarry Est, bureau 204	Montréal	H1R 1X8	514 326-7203	514 326-3656
GMF-R Collectif Médica	Location	5700, rue Saint-Zotique Est, bureau 102-104	Montréal	H1T 3Y7	514 256-5700	514 256-9499
GMF-R Cosmopolite De Saint-Laurent (Clinique Médicale Le Plein Ciel)	Location	475, boulevard de la Côte-Vertu	Montréal	H4L 1X7	514 337-3171	514 337-6023
GMF-R Forcemédic 3 Westminster (Gmf Forcemédic Ouest)	Location	1, avenue Westminster Nord, 2e étage	Montréal	H4X 1Y8	514 787-1818	514 481-1816
GMF-R Maisonneuve-Rosemont - Domus Médica (Clinique Médicale Maisonneuve-Rosemont)	Location	5345, boulevard de l'Assomption, bureau RC-60 et 360	Montréal	H1T 4B3	514 257-7000	514 257-7003
GMF-R Métro Médic Centre-Ville (Clinique Médicale Métromédic Centre-Ville)	Location	1538, rue Sherbrooke Ouest, bureau 100	Montréal	H3G 1L5	514 932-2122	514 939-7154
GMF-R Polyclinique Levasseur (Polyclinique Levasseur)	Location	8000, boulevard Langelier, bureau 601	Montréal	H1P 3K2	514 383-0559	514 383-3430
GMF-R Polyclinique Pointe-Aux-Trembles (Polyclinique Pointe-Aux-Trembles)	Location	12905, rue Sherbrooke Est, bureau 103	Montréal	H1A 1B9	514 498-4050	514 498-8239
GMF-R Stillview (Clinique Réseau Statcare)	Location	175, avenue Stillview, bureau 104-155	Montréal	H9R 4S3	514 312-9552	514 697-4418
GMF-R Sud-Ouest (Clinique Médicale Du Sud-Ouest)	Location	4475, rue Bannantyne, bureau 103	Montréal	H4G 1E2	514 765-3600	514 765-9625
Polyclinique Médicale Transia	Location	750-A, côte de la Place-d'Armes	Montréal	H2Y 2X8	514 316-1987	514 316-3306
GMF Pont-Rouge (Clinique Médicale Pont-Rouge)	Location	20, route de la Pinière, bureau 204	Pont-Rouge	G3H 0M6	581 329-5570	-
GMF-R Proximité - Saint-Roch (Superclinique)	Location	400, boulevard Jean-Lesage, bureau 38, 3e étage Hall Ouest	Québec	G1K 8W1	418 781-0022	418 781-0020
GMF-R Maclinique Lebourgneuf (Maclinique Lebourgneuf) (Superclinique)	Location	725, boulevard Lebourgneuf	Québec	G2J 0C4	581 814-2701	418 948-9267
GMF-R Le Mesnil (Centre Médical Le Mesnil) (Superclinique)	Location	1300, boulevard Lebourgneuf, bureau 300, 3e étage	Québec	G2K 2N1	418 624-1800	418 624-1820
GMF-R La Cité Médicale (La Cité Médicale) (Superclinique)	Location	2600, boulevard Laurier, bureau 295, 2e étage	Québec	G1V 4T3	418 781-0480	418 659-7072
GMF-R Du Carrefour (Clinique Médicale Des Promenades) (Superclinique)	Location	3333, rue du Carrefour, bureau A222, portes 4 ou 5 à l'extérieur	Québec	G1C 5R9	418-663-6345	418 663-8621
GMF-R Saint-Louis (Clinique Médicale Saint-Louis) (Superclinique)	Location	3165, chemin Saint-Louis, bureau 220	Québec	G1W 4R4	418-653-1970	418 653-9956
GMF-R Lévis-Métro (Clinique Médicale Lévis-Métro)	Location	5700, boulevard Étienne-Dallaire, bureau 150	Québec	G6V 8R8	418 833-4977	-
GMF Québec-Nord (Centre Médical De Charlesbourg)	Location	14008, boulevard Henri-Bourassa, bureau 200	Québec	G1G 3Y8	418 628-9921	418 628-3203
GMF-R Val-Bélair - Valcartier - Sainte-Catherine (Clinique Médicale Val-Bélair) (Superclinique)	Location	1147, boulevard Pie-XI Nord, bureau 202	Québec	G3K 2P8	418 843-2473	418 843-0224
GMF L'hêtrière (Centre Médical L'hêtrière)	Location	3520, rue de l'Hêtrière, bureau 201	Saint- Augustin-de-Desmaures	G3A 0B4	418 651-3933	418 651-0256
GMF Côte-De-Beaupré (Clinique Médicale Côte-De-Beaupré)	Location	9745, boulevard Sainte-Anne, bureau 301	Sainte- Anne-de-Beaupré	G0A 3C0	581 540-0055	581 540-0056
GMF Sainte-Croix / Saint-Patrice (Clinique Médicale Sainte-Croix)	Location	6350, rue Principale	Sainte- Croix	G0S 2H0	418 926-3260	-

Yukon

The Yukon Medical Council (YMC) issued an updated Standard of Practice Telemedicine (Virtual Care) in April of 2022. The new standard states that physicians must assess the suitability of telemedicine to provide care for each patient encounter. Physicians must arrange for a timely in-person assessment if telemedicine would not be appropriate or if the patient requests in-person care.

Reference Documents:

Standard of Practice Telemedicine (Virtual Care)

Relevant Excerpts from the Standard of Practice Telemedicine (Virtual Care)

4. Appropriate use of telemedicine

4.1 Physicians must assess the suitability of telemedicine to provide care for each patient encounter. Physicians must arrange for a timely in-person assessment if telemedicine would not be appropriate or if the patient requests in-person care.

4.2 The appropriate use of virtual care includes access to in-person care. It is not an acceptable standard of care to solely practice virtual medicine. A blended care model balancing in-person and virtual medicine is required if providing telemedicine.

4.3 In the context of episodic care, access to in-person care must be provided to patients as required and longitudinal care must be provided as indicated and required by patients. This requires formal affiliation with in-person providers where the patient resides. Episodic care providers must be realistic about their ability to provide safe and effective services to patients by way of telemedicine.

4.4 Telemedicine is most appropriately used when integrated with comprehensive longitudinal primary care.

6. Medical care

6.1 Physical examinations

a. The physician must consider whether telemedicine affords adequate assessment of the presenting problem. If it does not, the physician must arrange for a timely in-person examination done by themselves or another physician, nurse practitioner or community health nurse with whom the physician has a pre-established agreement or relationship.

b. Directing patients to a walk-in clinic or the emergency department in non-urgent circumstances in lieu of an in-person assessment is not appropriate care. There is an exception for an out-of-territory specialist providing ongoing care to a patient who does not have a primary care provider, but the specialist should make reasonable efforts to establish a formal affiliation with a Yukon clinic where patients can access in-person care.

New Brunswick

The College of Physicians and Surgeons of New Brunswick updated their Virtual Medicine Guideline in February 2022. The new guideline requires each member’s practice of medicine to include timely in-person care when clinically indicated or requested by the patient. It is not acceptable to solely practice virtual medicine. A blended care model balancing in-person and virtual medicine is required if providing virtual medicine. The appropriate balance will depend on the circumstances.

Reference Documents:

Virtual Medicine Guideline

Relevant Excerpts from the Virtual Medicine Guideline

V. During and after engaging in virtual medicine

Assess the Appropriateness of the Use of Virtual Medicine for Each Patient Encounter. Members initiating virtual medicine must, based on the information available:
- assess the patient’s presenting condition and the appropriateness of virtual medicine to provide care; if not appropriate, then the member must recommend and offer an in-person assessment
Provide Patient-Centred and Evidence-Based Medical Care

Members providing virtual care must:

have the ability themselves to provide a timely physical assessment of the patient or, alternatively, by pre-arrangement with another practitioner, unless such is not possible without endangering the patient. Thus, simply directing patients on to another healthcare facility, a walk-in clinic, or the Urgent Care or Emergency Department, in non-urgent or non-emergent circumstances in lieu of an in-person assessment by the member or a designate is not considered optimum care;

VII. Contextual information and resources

Virtual Medicine not Meeting the Standard of Care
The requirement is to provide timely in-person medical care. Examples of virtual medicine that do not meet the standard are:
1. Physicians not offering in-person appointments, including during a pandemic, unless advised by a health authority to not see patients in person.
2. Virtual medicine based businesses that do not offer timely in-person appointments by the same physician or another specifically delegated practitioner.
3. Physicians unnecessarily restricting in-person visits with patients or having very limited in-person appointments.

Policy for physicians practicing in NB

Physicians practicing virtual care in New Brunswick should determine whether a situation is compatible and appropriate for a virtual care assessment. When you begin a consultation and determine the patient requires an in-person assessment, you can utilize the list of NB in-person clinics compiled below or the following websites to assist the patient in finding an in-person clinic near them. When a patient needs to be referred in person:

Please ask the patient for their location and search for a clinic nearby.
Once you’ve located a clinic, please provide the patient with a custom note indicating the assessment and rationale for in-person care that they can take directly to the clinic, or
You may also contact the clinic directly to provide additional context.

To ensure our providers can meet this requirement, Maple is working on setting up a referral pathway. In the meantime, when a patient needs to be referred in person, you can use the following resources:

Skip the Waiting Room New Brunswick
NB in-person clinics (listed below)

New Brunswick list of clinics

Clinic Name	Google Maps	Address	City	Postal Code	Phone Number	Fax
Coverdale Medical Clinic	Location	438 Coverdale Rd	Riverview	E1B 4R9	(506) 384-2100
Primacy - Main Street Family Medical Clinic	Location	165 Main St	Moncton	E1C 1B8	(506) 854-8805
Mountain Road After Hours Clinic	Location	1789 Mountain Rd	Moncton	E1G 5C4	(506) 388-9355	(506) 860-6367
Dr Louis Bourque Clinic	Location	1116 Mountain Rd	Moncton	E1C 2T3	(506) 855-1125
West Side Medical Clinic	Location	107 Catherwood St	Saint John	E2M 5J7	(506) 693-2273	(506) 672-3503
Marysville Walk-In Clinic	Location	231 Canada St	Fredericton	E3A 4A1	(506) 449-1653
New Maryland After Hours Medical Clinic	Location	636 New Maryland Highway	New Maryland	E3C 1K1	(506) 458-8927
Miramichi East After Hours Clinic	Location	4 Johnson Avenue	Miramichi	E1N 3B7	(506) 778-9942

Corporate Consultation Policy

In-person primary care referrals for VCNS

Quebec In-Person Assessments (IPA)

Quality of Care Committee (QCC) Policy

Learnings from the Quality of Care Committee (QCC)