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Can Medicine Transcend Beyond The Clinic Walls? I’d Like To See Us Try.

Discussion in 'Hospital' started by The Good Doctor, Oct 11, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

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    Nothing like a tragic global pandemic to make everyone rethink their careers. This past year and a half have brought a lot of changes to the workplace. Many of us don’t want to go back to the way things were. According to a Pew Research Center survey from late 2020, of the 71 percent of employees working from home because of the pandemic, more than half, given a choice, would want to continue working from home. Even for work that has to be done in person, there has been a large shift. Look at the rise of the “independent worker” in the gig economy. Pre-pandemic, more than a third of workers were already working in the gig economy — during the pandemic, participation exponentially increased among blue and white-collar workers. In fact, a report by Upwork found a 24 percent increase in people deciding to join the gig economy, with the top two occupations new freelancers entered into being computer engineering and business operations. Flexibility of setting and hours is one of the biggest benefits the gig economy offers, and the pandemic has underscored how important and needed latitude is in the workplace in general.

    How does this translate to our sector, health care, and the role of the provider, which is usually not a position synonymous with flexibility? For many of us who practice medicine, our paths were set in stone decades ago with long hours, massive patient loads, admin duties, and licensing red tape all being the norm. medical careers are still based around centuries-old guild-style apprenticeships in a way that most other education and work is not. The pandemic has started challenging that status quo.

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    Prompted by COVID-19, many physicians moved to telemedicine to continue seeing patients — probably the fastest and most efficient technology transformation in health care in the past few decades. The COVID crisis was a unique moment of accelerated change in health care systems and at the individual level. The mentality of clinicians has changed — we want more opportunities to practice the way we think will best help our patients and better sustain our careers. How can healthcare afford more flexibility to those it employs?

    Approaching health care from both sides

    I’ve been a surgeon for more than 20 years. I also founded a provider credentialing software company six years ago where I serve as CEO. Taking this dual road, physician and entrepreneur, was by no means an easy path — in fact, I’m honestly not sure I’d recommend it — yet I’m grateful because it’s afforded me a dual perspective when it comes to our health care system. It’s inspired me to be less rigid and to approach the health care industry with a more flexible lens.

    The pandemic has shown me that flexibility is actually very much wanted and needed in our sector and other industries. Flexibility to practice outside of the traditional four-walls-of-the-clinic. Flexibility to easily practice across state lines without mounds of red tape. Flexibility to meet our patients in the middle and give them more avenues to access care. The health care landscape is still very much stuck in the 20th century, and the turnover rate for physicians verifies this. A recent survey from The Medicus Firm included some compelling data, including nearly 20 percent of doctors plan to make a career change within 12 months and about 8 percent are “definitely” leaving — another 10 percent are “most likely” making a career change. This data says to me that physicians are burned out, physicians want flexibility in how they practice that’s not really afforded to them in our current health care system, and physicians want change.

    COVID-19 transformed the standard for health care

    While not a new innovation, telemedicine’s use during COVID-19 skyrocketed, and it’s proven to be an essential tool for patients navigating hectic work schedules, childcare, and active lifestyles. But it’s also beneficial to the provider and health care organization. There are no silver bullets in health care, and that includes telemedicine — we still need to address the major challenges such as gaps in health equity that make telemedicine less accessible for some, as well as hesitancy to adopt its use. However, plenty of studies have shown telemedicine’s benefits; having that kind of flexibility leads to more productivity for the organization providing care, and it can provide more functionality all around, including eliminating overhead costs, removing the need for cleaning the office before and after every visit, and cutting down on waiting times. According to Astrud Villareal, MD, “If you were to ask me now what words I associate with telemedicine, the ones I mentioned in the beginning still apply. However, new words have joined the group: gratitude and privilege. It’s a privilege to take care of people, and I’m feeling that lesson now more than ever.”

    It’s important that health care policies also support this boom. For example, look at the changes we saw in licensing regulations during the pandemic. Last year, President Trump signed an executive order to permanently expand telehealth benefits for Medicare recipients beyond the pandemic and new legislation was introduced to Congress earlier this year to make these changes and flexibilities permanent. The Interstate Medical Licensure Compact — an agreement created to streamline traditional medical licensing processes and take the burden off providers who want to practice in other states — continues to grow.

    During COVID, licensing regulations changed quickly to enable providers to work when and where they were needed. This should be the norm, not the exception during a crisis. We should be joining with others in our sector to advocate for making the emergency rules around telemedicine privacy and reimbursement permanent.

    Physicians need more flexible practice options

    Flexibility in medicine has the potential to pivot around the needs of health practitioners with varying lifestyles. Now that we’ve spent more than a year experiencing what it’s like to work remotely, many people do not want to return to a cookie-cutter career in the office post-COVID-19. For primary care physicians, psychiatrists, mental health therapists, and other health professionals, we know that we are not tied to one avenue of practice anymore as the workplace has shifted in the past year. With telehealth and virtual care startups becoming a new standard, we can now practice medicine the way we want and embrace these new models that are about efficiency and personalized care. This opens up a world of opportunity to redefine what it means to work in health care.

    My big takeaway: Absolutely, there are times when you need to be face-to-face with your patient. Yet looking at the broader picture, COVID-19 has shown us that in many instances, we can perform at an optimal level while remote. In my experience, I’m often able to see more patients, and the quality of the connections I form with them is higher when I don’t have to shuffle them around in an office. Aside from the bonds I’m able to create with my patients, I’m also more productive without the distractions of sitting in an office. Expanding the options that we as patients and providers have readily available to us is, in turn, making health care more efficient for all of us.

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