We all have understood by now that life has been changed irrevocably by COVID-19. As physicians, while we navigate the rapidly changing waters of testing, prevention, and acute treatment, we are now becoming increasingly cognizant of the long-term effects of COVID-19 infection with post-COVID clinics already being established in many places.
Here are some of my thoughts on what practice should look like in the coming years, with respect to COVID survivors:
1. The focus should return to primary care. There will be a need for education and administration of the vaccine when it becomes available. Besides, the PCP would likely need to sort through various symptoms to identify which system is involved before specialist referral since complications can involve any system.
2. Since obesity and diabetes have been identified as potent risk factors for poor outcomes, we will need to re-evaluate how we treat these conditions, starting from nutritional interventions at the policy level. The epidemic of obesity and metabolic syndrome needs to be tackled urgently, and again our primary care physicians can play a major role here.
3. There will be a need for greater collaboration among specialists and subspecialists while treating COVID complications since the underlying pathophysiology is similar.
4. Rehabilitation (cardiopulmonary, neurological, cognitive, etc.) will be increasingly needed, and will require new guidelines to be formulated, especially from the standpoint of insurance coverage.
5. COVID survivorship programs may be needed for patients who have survived moderate to severe illness; these could be modeled on cancer survivorship programs.
6. Telemedicine should continue to be used as an adjunct to in-person visits for patient care even after social distancing restrictions are lifted as it can provide much-needed care to patients in remote areas.
Finally, this may be wishful thinking, but the COVID crisis has brought all the faultlines in our health care system to the surface. Perhaps we can repair some of them. At the top of my list would be the often meaningless documentation that is responsible for physician burnout. Maybe less stringent documentation requirements would enable us to communicate better with our patients and colleagues in a world where we all need to lean on each other.
Shuchita Gupta is a cardiologist.
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