Heroes of Another Sort: Primary Care Physicians During COVID-19
The hero moniker can be doled out a little too easily sometimes. During a global pandemic, however, there is no reason to be stingy. ICU doctors, nurses, and other hospital workers are putting their lives on the line to save others. Essential businesses all over our nation are remaining open and their employees are heroes to the people who need their services. These heroes are easy to spot. But with all that is going on and where we stand in this pandemic, there is another hero we need to recognize: Primary care providers – though they’ve always been heroes in my estimation.
Primary care providers are fighting a crucial prevention battle right now. As of April 6, 2020, more than 99.8 percent of all Americans were non-COVID. Primary care providers are heroes for every one of them; because they can help prevent them from getting the virus.
Sadly, the lack of recognition for the role of primary care is an all too familiar story in healthcare. Maybe a global pandemic can change that if primary care rises to the occasion. For too long, the power players in healthcare were the big hospitals full of amazing robotic devices and technology. The doctors at the top of the pack were the interventional specialists who saved patients from heart attacks, strokes, and crippling accidents. In this world, primary care providers were, all too often, seen as nothing more than glorified triage nurses to their higher-paid specialist counterparts.
That’s not how I saw primary care, or how anyone should. Primary care, when done right, has always been a heroic act to prevent people from needing acute interventions for their health. As “specialists” of primary care, we know how to do prevention. Sometimes it is easy – like when we vaccinate for polio, chickenpox, or measles. Sometimes it’s harder – like when we must stave off obesity, heart failure, or diabetes. But, we know how to deal with that too. We work to earn a patient’s trust, then educate and influence the patient to avoid choices that will prevent adverse health outcomes. With COVID-19, it’s no different. The hard work to earn trust, educate, and influence choices take center stage.
The primary care physician’s “vaccine” and treatment for now, is social distance and a lot of hand washing. Sure, we can rapidly study whether hydroxychloroquine and azithromycin, or other novel treatment ideas, work. But the basics of prevention never waiver.
Primary care providers need to start their prevention efforts by looking inward. Step one is practicing what we preach. It’s important to not only set the example and limit our impact on spreading the disease, but it helps earn trust. It is also the only way to ensure enough primary care providers stay healthy and to continue treating their patients. Second, when we talk to our patients – hopefully by phone or video as much as possible unless they have medical issues that require in-person care – we have to not just influence them on what to do, but educate them how to do it. Telling patients to do “social distancing” doesn’t help any more than telling someone at risk for obesity or other health conditions to “eat better and exercise.” They need specifics on how to practice the advice. In this case, how far apart from others do they need to stand? What is and isn’t a dangerous activity? How do they safely deal with a delivery person or the elevator in their building that gets them to their mailbox? When is the best time to go grocery shopping and avoid others? How often should they wash hands, for how long, and with what kind of soap? The list is endless. Many patients are truly overwhelmed with information that may contain conflicting or bad information from sources not nearly as reliable as their primary care doctor.
The heroes of primary care are getting creative about how to touch base with their patients and educate them with good and useful information. They’re also making it easy for patients to reach them and get prescription refills. Above all, they’re staying open and available with strong safety and cleaning protocols. This makes it possible for patients who are in real need with non-COVID issues to still come to the office and keep away from the hospital emergency room.
At ChenMed, prevention has always been central to our mission, but we are attacking it with renewed vigor to help reduce the spread and, hopefully, ease the burden on the heroes treating COVID-19 patients in the hospital. Every day I’m amazed by our primary care teams. They text patients educational information and encouragement, conduct virtual visits, see how patients are dealing with isolation, and find ways to get patients basic supplies. We’ve even seen some of our teams send out coloring and activity books to our patients to give them something to do while staying safe at home. This is what primary care should be everywhere – fulfilling the job of being accountable for health and doing what it takes to protect your patient’s well-being.
No one wants to fight this fight. Those who do it are heroes. But, so are the ones who help stop it from escalating. We know we can’t stop all new cases of COVID-19. Still, we should celebrate the heroes on all fronts of this pandemic, including the primary care doctors who are choosing to step up and champion prevention.
