What do we know today...
Like many of you, much of what we know today is still unclear and uncharted territory. The COVID-19 virus has many of us wondering how will our practices operate differently during this crisis, and what will a new normal look like on the other side?
I’ve spoken to countless providers, managers, and billing professionals, and it appears there are just as many different approaches being taken. Deciding whether to reduce patient appointments, work normally, or shut down all together, is highly dependent on the unique profile of your own practice. The health and safety of you and your staff are of upmost importance. If you or any of your staff are somehow immune compromised, you should probably begin shifting how you deliver healthcare for now. If you treat a high-risk population, you should probably begin shifting how you deliver healthcare for now. If you fall somewhere in the middle, you should probably begin shifting how you will transition your care delivery over time. The point being, no matter when we come to the other side of this, the new normal will demand a different process in the way you care for patients. Whether it’s more telemedicine, or wider boundaries in your office setting, most of you will be different.
There are so many directions this conversation could go, especially in the area of moral and economic decisions impacting yourself and staff. But let’s focus for a minute on the patients and the inevitable need to critical care access for our communities. Mind you, as I write, my thoughts are mainly internal medicine disciplines.
The social restrictions being implemented are primarily an effort to lessen the estimated strain on our critical care access. According to Dr Mikki Tal and Liz Specht, our healthcare system has approximately 1M beds. With 65% of those typically occupied, 330k beds should be available to the sick, and only a small percentage of those are for critical care. It is estimated that 1.9M patients will need access to hospital care and the big question is… in what time frame.
This is why you are so important to the equation. Let’s not focus on evaluating or diagnosing those with the virus. Let’s focus on your chronically ill patients and those who suffer respiratory distresses already. What will happen to those patients if you close and can’t manage them effectively? What about the diabetic patient that struggles to maintain control, or the asthmatic patient that could easily develop pneumonia? Sure, you can call in prescriptions but having the ability to continue visual and auditory engagement with the patient provides more data in your decision-making process to adjust their care accordingly. Having the ability to keep these patients out of the hospital is a critical role that you play right now in the pandemic. If offices close and/or reduce capacity to provide for patients, many times their only option is to go to the ER and take up resources that others will need. At some point, the possibility of deciding who does and who does not receive life or death care could happen.
It is essential we each find a balance between safety and access to care. Maybe that becomes varying logistics within your practice. It could and should become the implementation of telemedicine in your practice. It will certainly become a new understanding of disinfection and work flow processes. I urge you to begin considering the changes you should incorporate right now. You can neither afford to wait it out nor be so far behind the curve of change that you lose your impact in the lives of your patients and on this crisis.