If you’re a primary care physician, chances are that your practice has changed considerably during the COVID-19 pandemic. For all of us in the healthcare community, our lives, and the practice of medicine have been altered in numerous ways–from the extreme of temporarily closing our practices to the alternative of moving our practices online and shifting to telehealth. Often, we are managing chronic illnesses from afar, with patients who may also be learning how to use technology.
While the technology presents its own challenges, it also offers opportunities. Physician Performance LLC, a Massachusetts physicians group, hosts weekly Zoom clinical calls, which help our providers face challenges created by the pandemic with professional guidance from experienced physicians and specialty subject matter experts. During one recent call, Dr. Diane M. Brockmeyer of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center (BIDMC) noted three challenges that primary care professionals are facing right now, and gave guidance on how we can support each other and our patients during this time.
1. Convincing patients to go to the hospital when they need care. Many patients are afraid to go to the hospital, even if their medical condition dictates that the only way to provide the care that they need is in a hospital or emergency room. Unfortunately, COVID-19 did not provide relief from other medical conditions; people are still having heart attacks, suffering accidents, and getting sick with ailments other than coronavirus.
To address this challenge, it is essential to promote the safety of urgent care centers and emergency rooms. Dr. Brockmeyer talks with her patients about all of the modifications that have been in urgent care centers and emergency rooms to allow for safe care for all patients. Many in the Beth Israel Lahey Health (BILH) system have separate pathways and physical locations for COVID-19 and non-COVID-19 patients, which will likely alleviate patient concerns about visiting a medical center. In the BILH system, both urgent care centers and emergency departments are managed by physicians who work in the system, helping to maintain continuity of care once the patient moves from urgent to home care. 2. Feeling alone in making difficult decisions and diagnoses. Some primary care practices are functioning with a skeleton staff, and other offices are operating on a reduced schedule or are fully closed, with physicians conducting telehealth visits in place of in-person visits. As physicians treat their patients in this new way, the usual support networks may not be available for consultation when healthcare professionals have a question, concern, or just need to talk to a colleague.
Dr. Brockmeyer suggests finding a physician partner to work with as a “clinical buddy.” Running cases by this doctor will increase confidence in how you are managing patients distantly and will likely provide a huge benefit for borderline cases that can seem more difficult because of the way the COVID-19 virus presents.
3. Amplification of physician burnout during the pandemic. The COVID-19 virus has introduced another level of stress into an already stressful clinical environment. With the professional isolation that is accompanying this pandemic, physicians are working in conditions that could lead to greater levels of burnout. Dr. Brockmeyer recognizes that for physicians in a small or solo practice, the stress and pressure that this pandemic has created may be even more intense. Do not hesitate to reach out to your colleagues in other specialties, or who you know from training, to ask how they are doing; it’s likely that they’ll ask you the same questions, and you can both benefit from mutual advice and support.
While the COVID-19 pandemic has changed much about how care is being provided by healthcare professionals, support networks and help from colleagues is still available and can play an important role in navigating this crisis.