The delivery of healthcare is of heightened concern for everyone as the COVID-19 pandemic plays out. In a short span of time, healthcare services were turned upside down by a contagious illness that overwhelmed hospitals in some parts of the country. Patients facing an ailment that they would otherwise have considered an emergency were afraid to seek help. Where do we go from here?
Crystal balls are in short order and there remain many challenges and changes ahead as the COVID crises continues to make inroads throughout the United States and the rest of the world. From where we are right now though, it is probably not too early to highlight some changes to medical care delivery where long-term change has likely incurred. Some of those areas include:
- Telemedicine: As we have discussed, telehealth has come to the forefront during the pandemic crisis. In the past, many physicians were willing to speak briefly with patients on the telephone. In remote and rural areas, telemedicine has been in use for years. With the rise of social distancing, telehealth has become vital for the treatment of patients with COVID-19 and for many other health concerns. The sudden necessity to work and also seek medical care via remote service has now become established in many quarters. While the convenience of telemedicine is clear, questions about the quality of care and potential poor outcomes have yet to be addressed. A physician or PA cannot fully observe a patient in a remote setting, nor can they provide direct treatment. A condition that might have been caught in the fullness of a physical visit may go missed. The price of telephone help, formerly inexpensive, may increase as well, leaving patients with less care at higher cost.
- Community care verses hospitals: The push of patients into suburbs and away from large urban hospital complexes may be driven by this novel coronavirus. Prior to the pandemic, retail behemoths like Walmart were already providing community-based care, with physicians, medical groups, and some laboratory facilities located in the Walmart brand footprint. Patient fear of hospital settings and their desire for care close to home may impact the choice between a hospital emergency department and a local Urgent Care center. While Urgent Care visits can triage a variety of common and benign medical problems, these spaces are no place for an emergent cardiac, pulmonary, or vascular event.
- Physician availability: The number of primary care physicians (PCPs) in the US continues to drop. PCPs provide essential care throughout a life span. The continuing decline in their numbers leaves patients with fragmented, specialized care through which serious ailments can slip.
The face and practice of healthcare is changing. Whether those changes ultimately improve the odds and medical service provided to patients remains to be seen.
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