Role for Isolated Emergency Medicine Physicians During a Pandemic.

Unlike true virtual care where there is no expectation of a physical examination, the patients being reviewed virtually have undergone a triage assessment with documentation of vital signs, and a physical examination by a physician assistant (PA) Medicolegal concerns are low provided that the clinician is acting in good faith, within their normal scope of practice, and with the support of their hospital leadership team (Canadian Medical Protective Association, personal communication, correspondence, March 23, 2020) 1,2 PAs provide medical care for patients through physician delegation, which may include both written medical directives and direct orders 3 Each province has specific guidance available on the requirements and limitations of medical delegation Nearly all jurisdictions recognize that this supervision may be indirect with the supervising physician off-site 4 The PAs that work in our institution are also required to maintain certification with the Canadian Association of Physician Assistants and hold individual malpractice insurance to further mitigate medicolegal risks At the end of the call, depending on the complexity of the case, the virtual physician may relay the information to the on-site physician or nursing team leader if required, otherwise, documentation is noted in our EMR system