With a month left before the changeover, many eVisitNB NPs say they won’t sign with Foundever
More than 70 eVisitNB nurse practitioners (NPs) are deeply concerned about the future of virtual healthcare in New Brunswick, as expressed in a letter addressed to the premier and health minister.
NPs currently serving New Brunswickers through eVisitNB are forwarding a letter today, Thursday, May 28, to Susan Holt and Dr. John Dornan, sounding the alarm over what many say are worrisome hiring practices by Foundever Assistance Services Corporation.
Foundever is set to take over virtual medical services from eVisitNB on July 1, following the province’s request for proposals issued last fall. The same company currently provides Tele-Care 811 services in New Brunswick. eVisitNB, which was created by Woodstock ER doctor Hanif Chatur and Stanley family physician Dr. Jonathan Clayton, has been providing virtual care services since the pandemic.
The NPs, who asked not to be named for fear of future employment repercussions, expressed apprehension after a handful were offered leadership positions at the new company.
“We are seriously concerned about how this company is going to operate,” said an eVisitNB NP who has helped over 11,500 patients since she started with the New Brunswick-born company in 2023. “Currently, we operate as independent contractors, collaborating with eVisit to see patients with the full support of our CEO, CNO, and a team of administrative staff. Foundever expects to run the same program with less than half of the support, which we feel confident will be detrimental to New Brunswickers.”
Those who were offered a leadership position with Foundever said they didn’t apply for the job.
“They were contacted through their LinkedIn profiles,” said the eVisitNB NP during a telephone interview. “We think it’s because no one responded to the job posting. We believe they sent offers to anyone who was listed as working for eVisit on their (LinkedIn) profile and who may have met the experience criteria,” she said. “A few were invited for an interview but were interviewed by an AI chatbot.”
In comparison, more than half of the nearly 200 NPs initially employed by eVisitNB were hired by its founder and CEO, Dr. Hanif Chatur.
Nurse practitioners sent a letter to the New Brunswick premier and health minister on Thursday, May 28. (Submitted)
Other nurse practitioners who reached out to Foundever to inquire about positions are concerned about the money they are being offered.
“With the NP Lead, for example, Foundever is offering about half of what the current NP Lead (with eVisitNB) is being paid. We all know what that position entails; the blood work checks, the follow ups. This is a big job. With that responsibility, they’re not paying enough.”
The NP said that, in addition to all the other changes, each NP will be responsible for following up on ordered bloodwork, rather than the company being responsible for patient safety.
“We are concerned that, without the huge support of our current admin team, patient results could fall through the cracks, exposing them to risk.”
Nurse practitioners who spoke with the River Valley Sun believe the company got wind of what they were doing, as several eVisitNB NPs received contract offers a few days after the letter was initially drafted.
“(They) were given 48 hours to sign a contract, which they are reluctant to sign, as it includes a statement that Foundever is not responsible for following up on patient results or referrals,” NPs said in their email to government. “eVisitNB currently has the capability to order and follow up on blood work and referrals, meaning we can provide complex patient care for patients with diabetes, hypothyroidism, and hypertension. However, with this change, the new platform will be relegated to a virtual walk-in, without the ability to continue to provide our current level of care. With this uncertainty, many of our Nurse Practitioners are leaving New Brunswick for other opportunities.”
NPs are also concerned about the new company’s plan to strictly adhere to a 20-minute appointment rule.
“That means that patients who need more time don’t get it. It also means that when something like a bladder infection can be solved in a few minutes, we can’t move on to help another patient until after the 20 minutes are up. We feel this will mean fewer New Brunswickers getting served. That doesn’t sit well with any of us.”
Original contracts sent to NPs noted they would need access to electronic records, as the company had not yet obtained the necessary permissions. Contracts sent later omitted that section.
The River Valley Sun reached out to the Department of Health for clarification on the NPs’ concerns.
In a statement from department communications officer, Morgan Bell, the official defended the new company.
“The new service provider will have access to the electronic systems and tools required to provide virtual care,” said Bell, in an email.
“As for your comments around appointment times, it’s important to note that there are background pieces that go into virtual appointments. This includes paperwork, charting, and ensuring referral paperwork is completed. The new service will be based on appointments, versus a virtual waiting room, and the allotted appointment time is not expected to negatively impact the number of patients that can be seen virtually. Also, booking the necessary time for scheduled appointments will ensure patients can receive the appropriate time with their provider.”
In response to Bell’s statements, the eVisitNB NP said they are providing patients with appropriate time.
“We are fully aware of all of the work that goes into each virtual appointment,” said the NP. “Currently we fulfill these obligations on our own time, and we do not require Foundever to allot time for us to do this. We also know how frequently we will experience ‘no-shows,’ when a patient does not attend an appointment.”
The NP goes on to say that if a patient misses their appointment, they can currently see another patient while they wait.
“With the new company, the max we can see is three per hour, and that is only if everyone shows up for their appointments.”
With only a month left before the scheduled service changeover, the province still says more information about the transition to the new provider will be available in the coming weeks.
“We will ensure that the public will know where to go and how to access virtual care when the time comes,” said Bell.
“How can they be ready when so few of us have been hired?” said the evisitNB NP. “It feels like NBers don’t know what’s going on,” she said. “We’ve been told there will be no issue, but that’s not what we’re seeing.”
Under the eVisitNB contract, NPs now have the flexibility to sign in and help when they have time. The new company will now require health professionals to provide their availability two weeks in advance and to adhere to a formal schedule.
“That doesn’t make a lot of sense for those who do this part-time,” the NP said. “The way it works now, if I get a few free hours after work, I can log in and see how busy it is and can help out. That won’t be possible under the new company. There is always a need, and if you can help, eVisit encourages you to do that.”
The Foundever contract also states that if an NP is working and a patient doesn’t show, they won’t be paid.
“It is so disturbing on so many levels,” the NP told the River Valley Sun. “Patients aren’t going to get the same level of care. We’ll be limited in our ability to help patients with chronic conditions. As it stands, they won’t have my back. It’s putting my license on the line. I don’t believe it’s going to be safe for us to work there.”
Another NP said she and other colleagues have started looking elsewhere for work. Since the new contract was announced, 61 NPs with eVisitNB have left virtual care to work elsewhere.
“It is deeply discouraging to consider leaving New Brunswickers with fewer experienced virtual care providers and fewer accessible healthcare options,” the NP wrote in an email. “eVisitNB was a thoughtful and innovative solution to a serious healthcare access problem. Many of us feel that an important asset has been discarded, and there are significant concerns and sadness surrounding this decision and the uncertainty of what comes next.”
In their letter, NPs reminded the premier and health minister that they are the “ones sitting in front of New Brunswickers daily, and patients are scared and understandably concerned about their ability to access healthcare beyond June 30th.”
Their email goes on to say that given the current state of Foundever’s hiring practices, “it is morally difficult for us to continue to reassure patients that the system will work for them.”
Their letter ends with a dire prediction for virtual health care in New Brunswick after July 1.
“With our current knowledge of Foundever, we do not believe they will be ready or capable for the task; nor do we feel they are investing the time and resources this province deserves.”
