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Dr. Fox to see Tignish patients virtually; recruitment efforts for permanent physician continue

Retiring Dr. Declan Fox has agreed to see Tignish patients virtually from his home in Ireland.
Retiring Dr. Declan Fox has agreed to see Tignish patients virtually from his home in Ireland. - Eric McCarthy

Doctor's last office day in Tignish is Friday. He will start seeing patients via a computer from his home in Ireland once a week starting in late October.


The Tignish Health Centre is about a month away from being one of the first healthcare centres in the world to offer virtual primary care to patients being seen by a physician in another country.

Dr. Declan Fox, who retires from his medical practice in Tignish on Friday, has agreed to see patients virtually at home in his native Ireland commencing in late October. 

The service will be offered just one day a week initially, although Dr. Fox believes he will need at least another half-day or full day a week to get caught up on all the reports and paperwork.

The health centre posted a message on Facebook Wednesday to inform patients that Health P.E.I. and the health centre are working with Fox to find an innovative way to provide patients some access to Dr. Fox, virtually, while efforts continue to recruit for a permanent physician.

Virtual primary care will utilize technology similar to the tele-rounding service currently being provided to in-patients at Western Hospital in Alberton, P.E.I.

Fox acknowledged the success of the tele-rounding program has given him confidence virtual primary care will work for his patients. 

“If they can make it work in Western (hospital), where the patients are the sickest in the area, it shouldn’t be difficult at all to make it work here,” he said Wednesday from the Tignish Health

Co-op Centre where he has been seeing a panel of 2,500 patients for the past five and a half years.

The Tignish Health Centre will not have to change its sign with Dr. Declan Fox retires Friday. He has agreed to continue to see patients, virtually. He will do it via a computer from his home in Ireland.
The Tignish Health Centre will not have to change its sign with Dr. Declan Fox retires Friday. He has agreed to continue to see patients, virtually. He will do it via a computer from his home in Ireland.

“He is not an easy guy to replace and he will be greatly missed for his contributions in West Prince,” Paul Young, administrator of Community Hospitals West, said of Fox. 

While Fox said his patients are saddened that he is retiring, the ones he’s informed about the virtual primary care model have been supportive.

“They’ve all been fairly happy about that,” he said.

He doesn’t know if that is due to the success of Western Hospital’s tele-rounding program, or simply an acknowledgement that he will still be overseeing their care.

He added he hopes to return to P.E.I. next year for a couple of locum contracts.

One of the nurses from Fox’s practice will continue to work at the health centre and will assist with Fox’s virtual care.

Fox is also hopeful Health P.E.I. efforts to recruit a nurse practitioner to the clinic will soon prove successful. 

Young was actively involved in rolling out Western Hospital's tele-rounding program and he has just returned from Vietnam where he spoke about the program’s success to 2,500 healthcare delegates from all over Asia. 

Young is also playing a leadership role in introducing virtual primary care to Tignish. 

The “what if?” discussions on primary care options started about six months ago, he said.

“It kept going back to, ‘what if we did this; what if we leveraged the success we’ve seen here at Western Hospital; what if we looked at the application of how we use virtual care and use it differently to fit another one of our needs?’” he said.

Health Centre information to patients Q&A’s
Q: What is being done to recruit a physician to take over Dr. Fox’s practice?
A: The Tignish Health Centre and Health P.E.I. have been working with the Recruitment and Retention Secretariat within the Department of Health to recruit a physician to take over Dr. Fox’s practice. Efforts are also ongoing to recruit locum and/or a nurse practitioner to provide temporary service while recruitment continues for a permanent replacement.

Q: What is Virtual Care?
A: Virtual care refers to any interaction between patients and their health care providers that occurs remotely and uses communication and information technology. It is used in many different health settings across Canada, including in Prince Edward Island through tele-rounding and telepsychiatry, as examples.

Q: How is using technology going to replace the health care provided by Dr. Fox?
A: The use of this technology will not replace the care that Dr. Fox has provided to his many patients. However, while recruitment efforts continue, the Tignish Health Centre and Health P.E.I. working with Dr. Fox, identified using technology as an interim way that some of Dr. Fox’s patients can continue to access primary care. 

Q: How do I book an appointment.
A: For an appointment with Dr. Fox, you will do what you had done previously by calling the Tignish Health Centre at (902)882-2260.

Young stressed virtual primary care is not groundbreaking in itself but this case adds a new element to the equation.

"(Dr. Fox) being in Ireland and providing care to patients in Tignish, P.E.I., I think we’re treading on new ground, certainly within the country, but I think that is going to be a first for across the globe, to look to a physician in another continent…and provide care to a patient in another jurisdiction.”

In introducing this new level of care, Young said it is beneficial that the physician who is pioneering the international model knows the patients he will be seeing, and his patients know him.

“The biggest benefit for us is it is Dr. Fox,” health centre manager Wendy Arsenault said.

The health centre is hosting a farewell party for Dr. Fox and his family Sept. 25 from 5 to 7 p.m.

Young admitted a lot of heavy lifting was required to make this virtual model happen. 

“We’ve had a tremendous team that has been working throughout this project to pull this all together. A lot of hands are continuing to move heaven and earth to make this a reality for Tignish, and we’re really excited about that.”

Both Young and Fox believe the attention the new virtual primary care model in Tignish generates will ultimately help attract a new physician to Tignish. Once that happens, the virtual care model would no longer be required in Tignish, but Young believes what’s being piloted in Tignish will help pave the way for similar services being offered in other communities when resources are challenged. 

“This can potentially reshape how we can access capacity to deliver care,” he suggested.

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