Life as we know it has been upended by the COVID-19 pandemic. Every aspect of our health care system is affected; in particular, our nation’s frontline workers are being stretched like never before. From managing the pandemic long term to physician well-being, social determinants of health (SDOH), and health care reform, the incoming Administration should heed doctors’ warnings to foster a health care system that works for everyone.
With nearly half (49%) of U.S. physicians believing COVID-19 won’t be under control until after June 1, 2021, America is experiencing a prolonged period of uncertainty and turmoil. Physicians live through a historical shift in the way we practice and deliver care to patients. Not only is the delivery of care changing, but those delivering the care are also under more pressure than ever. Now is an opportunity for policymakers to rebuild a system with physicians and our patients in mind.
The announcement of President-elect Biden’s COVID-19 task force is a step in the right direction, but more physicians must be included in this effort. With only two physicians on the thirteen-person task force, there is room for improvement. For the pandemic and beyond, insights from physicians are invaluable. We are on the ground with patients every day. We suffer with them and tirelessly work for better health outcomes. Yet, too many things stand in our way. Not only do regulatory burdens affect how we can care for patients, but we are also struggling ourselves.
Recent data found that nearly 1 in 4 physicians (22%) know a physician who committed suicide, and 58% express feelings of burnout. In addition, 13% of physicians have sought medical attention for mental health problems because of COVID-19’s impact on their practice or employment situation. Physician wellbeing was a public health crisis long before COVID-19. Now, we see the pandemic exacerbate this issue. Physician burnout rates were at an all-time high prior to the pandemic and have increased significantly over the past eight months.
One longtime driver of physician burnout is the inability to account for SDOH, the conditions in which people are born, grow, live, work, and age. This includes factors like socioeconomic status, education, neighborhood, and physical environment, employment, nutrition/food security, access to health care, and social support networks, all of which have a major influence on individuals’ health and, therefore, health care costs in America. We see this come to light in daily practice. In fact, 88% of physicians said their patients had a serious health problem linked to poverty or other social conditions, and the pandemic has only worsened this issue. This problem will manifest itself in future consequences, with 34% of physicians strongly agreeing that SDOH will drive demand for health care services in 2021.
Physicians also agree on policy steps to ensure access to high-quality, cost-efficient care for all. Namely, 89% want to streamline prior authorization for medical services and prescriptions. Physicians agree that simplifying access to mental health services and providing insurance coverage for the diagnosis and treatment of COVID-19 are important steps. These combined won’t fix our health care system, but it’s a start. When looking to the future, physicians also call for more affordable health insurance for patients and increasing the number of physician leaders.
As an additional measure to ensure better care, America’s physicians have also prescribed a hybrid health care system. When asked to rank their preferences for the U.S. health care system’s future direction, physicians ranked a two-tiered system featuring a single-payer option plus private pay as the best direction.
Despite the immense amount of data out there, physician insights are not being incorporated into national health care conversations. Our current system is directed by policymakers and business executives instead of physicians. As the foundation of health care, physicians know what is best for our system and the patients we serve. These insights must be included in any health care reform discussion and if we hope to improve access to quality care.
As the next Administration prepares for the work ahead, physicians are here to help.
Ripley Hollister is a family physician.
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