Virtual care has stabilized at about one-third of visits as the sixth wave of the pandemic in Canada ebbs from about twice that at the peak of the first wave but is up more than tenfold from pre-pandemic levels. This has created huge changes and challenges, which the author reviews in an attempt to make workable policy recommendations and find a balance among competing priorities. Falk revisits recommendations from his Health Canada report (Falk 2021), updating and expanding on recommendations concerning remuneration, licensure, equity and access. He introduces newly available data on specialty and primary care use and discusses the practical implications for change management and system development. He expands his recommendations for aggressive regulatory changes and standards for digital health and virtual care.  

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