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PHYSICIAN’S CORNER: WHAT POST-ACUTE COVID-19 LOOKS LIKE FOR PHYSICIANS - THE GOOD, THE BAD, THE INTERESTING
Physicians


You’ve made your way to the physician’s corner of the pMD blog, welcome! Here you’ll find information written for physicians, by physicians. 

This post is written by Richard E. Lehman, MD, Pediatric Critical Care Medicine.

Last year, the world was rocked in ways that no one could have predicted or even imagined. With 2020 and more than half of 2021 behind us, and as the world adapts to a new normal, what does this post-COVID environment look like for physicians, practices, and patients? In this blog post, we’ll take a look at the good, the bad, and the interesting in relation to the impacts of the pandemic on medical practices and their patients, as well as what to expect moving forward.

THE GOOD


Prior to the start of the pandemic, the use of telemedicine was somewhat of a novelty. Some practices began tinkering with this technology for their chronically ill or remote patient populations. As the spread of the virus started gaining speed, practices soon found themselves deep in the throes of figuring out how to integrate video visits into their daily routine and how to help patients through one of the worst global medical crises in recent history. The increased use of telemedicine brought to light the benefits of incorporating technology into patient care, providing flexibility and accessibility to patients who need it most. It also showed us that its success and continued use are largely dependent on an appropriate reimbursement model. Without it, practices may be less incentivized to adopt telemedicine or are likely to face financial challenges. I would hope to see and anticipate seeing some practices adapt to a hybrid model that incorporates both telehealth and in-person visits, barring any reimbursement policy changes. There are still some aspects of medicine that require face-to-face care with a provider but for those less complex scenarios, why not give the patient (and practice) a choice?

THE BAD


In an era where data is more accessible than ever, misinformation is simultaneously on the rise and finding its way into the general public. As a result, we saw more and more hesitation around believing the data and science presented about COVID-19 and mitigating its spread. People tend to forget that science evolves and adjusts as more data is collected. However, the public is constantly being bombarded with quick one-liners and sensational headlines in the media, many of which are inaccurate statements. This mistrust permeated throughout the country and, in my opinion, has been devastating to the medical community. With the rapid vaccine deployment, it's understandable that patients have questions regarding the effectiveness and potential unknown side effects. Over time, with more data, we’ll be able to paint a better and more clear picture to patients surrounding the vaccine. It's our job as physicians to answer questions and help them make informed decisions based on their medical history. 

So, what does this mean for health care moving forward? It means that medicine is now even more having to compete with the media and navigate that influence on their patients. Providers are not only health care professionals but are also now having to manage public health and society concerns. However, while we all have differing opinions about what to do and how to cope in certain situations, I believe providers need to elevate their approach towards a more open and transparent environment with patients, allowing for more engagement and helping prevent patients from finding other, less reliable sources of information surrounding their care. We should embrace the questions and not shut people down when questioning what they believe to be fact. The COVID crisis is under the microscope, so being open to conversation and providing thoughtful explanations can provide a stable foundation with patients. 

Health care is changing as rapidly as the world and we should take away from this recent pandemic lessons in not only handling future outbreaks but also handling patient trust where trust has been lost. The bottom line is that how we collect data and release that information needs to improve. For example, how many people test positive for COVID-19 doesn’t tell the same story as to how many of those patients are severely ill, hospitalized, and/or need a ventilator. The foreseeable future holds residual pandemic effects, and providers will be expected to work even harder to regain patient trust.

THE INTERESTING


While many of the impacts of the pandemic are fairly obvious or have been discussed at length for the past year and a half, there are also plenty of areas of medicine that have seen a ripple effect and are likely to change moving forward. As a pediatric physician, an interesting event that resulted from 2020’s lockdowns was the decrease in child immunizations. According to a recent article in the Morbidity and Mortality Weekly Report, infants and toddlers up to age 2 years in Michigan have been falling behind on their immunizations, showing a decline in January 2020 through April 2020 compared to 2018 and 2019. Only the hepatitis B vaccine dose given at birth, typically in the hospital, did not decrease. This is just one example of the many impacts a pandemic can have on ancillary health care, which is just as important to recognize. Since many ancillary services in health care require in-person visits and render telehealth a suboptimal solution, providers are looking towards new strategies to maintain essential services.

It’s hard to imagine that the first half of 2021 sped by so quickly, considering everything we’d been through in 2020. As we navigate the good, the bad, and the interesting in relation to this pandemic, we can’t forget that COVID-19 will still continue to have a presence moving forward. A practice’s ability to adapt in the face of sudden change is essential for successful patient care and its survival as a business. We should continue to learn from one another and work through challenges together despite our differences in hopes to quickly combat any future outbreaks. 

Dr. Rick Lehman is a veteran critical care physician, providing care to pediatric patients across the country. He’s “grown-up” with the changes in health care over the last 20 years related software and has been directly involved with implementing new EMR systems at multiple hospitals, often transitioning them from paper to digital systems. His frustrations surrounding inefficient EMRs while managing his critical care patients have driven his passion for changing these health care systems to create better provider workflows.

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