By Jennifer Miles-Thomas, MD, FPMRS and Joshua P. Langston, MD
The COVID-19 pandemic has forced a rapid evolution of our country’s longtime office-based care delivery model, which will require continued innovation from health care providers struggling to meet patient demand.
Overall, the pandemic has exposed the fragility of our health care system. Many providers have either retired or stepped away from medicine for a new career, from primary care practitioners to specialists to nurses in offices and hospitals.
Meanwhile, patients who delayed visits for non-emergency care, routine monitoring and recommended screenings have created a pent-up demand for appointments, sometimes leading to unacceptably long waits. For physicians, the resulting pressure can feel overwhelming.
Yet medical practices have proven adaptable, too. Many have added positions for Advanced Practice Providers (APPs), such as the more than 30 Physician Assistants (PAs) and Nurse Practitioners (NPs) hired at Urology of Virginia over the past three years.
Another major adaptation was a rapid pivot to telemedicine. Today, we wonder if this monumental shift will become permanent for patients who either need or prefer virtual appointments, especially if in-person time slots are limited.
Such a change would require not only regular insurance coverage but federal regulations to govern complex legalities. For instance, temporary pandemic legislation waived certain licensing requirements to allow physicians to see patients in other states, which has now largely expired.
Once providers have greater clarity about the future of telemedicine, we can decide how to best integrate these virtual meetings into long-term patient care plans.
Interestingly, our experience has been that a majority of patients do still prefer in-person appointments. While this could be a temporary reaction from people who crave personal interactions after pandemic isolation, only time will tell.
In our offices, then, we must help patients feel comfortable despite lingering fears of infection and masking and social distancing requirements. Unfortunately, these factors can increase anxiety levels, particularly in elderly and hearing-impaired patients.
While most people understand these rules are for their safety, physicians may have to put extra effort into communicating clearly and calmly, checking that patients absorb instructions. Continuous disinfection of offices and limited waiting room seating also may persist.
As COVID-19 cases fluctuate over time, we will have to do our best to triage patients and provide high-quality care on a daily basis. Very likely, we will continue to adapt to new technology and telemedicine while also expanding the use of remote patient monitoring.
Medicine is undergoing a rapid shift, and area practices must stay at the forefront of changes that can help us deliver safe, effective and efficient care in the Hampton Roads community and beyond.
Dr. Miles-Thomas, a urologist with expertise in Female Pelvic Reconstructive Medicine, is President of Urology of Virginia. Dr. Langston, a urologist specializing in Men’s Health, is Chief Medical Officer of the practice. urologyofva.net.
