by Frank LoVecchio, DO, MPH, FACEP, ABMT
Symposia Medicus faculty member Dr. Frank LoVecchio gives his thoughts and opinions on the pandemic and what COVID-19 has taught us about the U.S. Healthcare System.
A challenging game played by teens is to ask me how to spin bad events into a positive. I applied this philosophy in trying to find some good that may result from the COVID-19 pandemic. COVID-19 has claimed greater than 200,000 American lives and changed medicine forever while exposing specific lapses in our healthcare system. Millions of Americans are out of work and this has left families uninsured, bringing to question why employment and health insurance need to be so closely tied. Perhaps a minimum of universal coverage for Americans for basic medical services (and ideally prevention) is necessary. Multiple tiers could be developed with patients and/or insurers paying for “better plans.”
Healthcare providers (HCP) can treat patients remotely, using telemedicine, instantly reshaping services ranging from routine check-ups to addiction treatment. It has been assumed that in-person HCP visits were always necessary, and COVID-19 has clearly and safely debunked this belief. Insurers have allowed similar payment for these telemedicine visits despite the “lack” of a complete physical examination and by loosening regulations on video conferences. It was inconceivable to imagine a patient showing a physician an exam finding such as a wound or rash and the clinician diagnosing and treating it without multiple cumbersome layers of electronic security.
COVID-19 has further exposed disparities in healthcare delivery especially among minorities and the poor. COVID-19 is killing people of color, particularly black people, and lower socioeconomic populations at a staggeringly disproportionate rate. Obviously, the virus cannot recognize skin color or financial status, but this has highlighted a need for improvement.
Drug companies, often considered “evil” by the public, are now viewed by many as the heroes in the fight against COVID-19. Without the federal government decreasing regulation and increasing financial partnership, the race for a vaccine or treatment would have taken tenfold longer. Ideally these partnerships and efficiencies will continue. Experts have assured the public that the streamlined FDA approval process will not result in patient harm and we are cautiously optimistic.
A microscopic virus of less than 100 microns, or 1/100th the diameter of a strand of hair, COVID-19 has exposed America’s healthcare treatment, planning, and testing to be clearly overwhelmed. Ideally, we will respond by building a better plan for another pandemic.
Although I am obviously biased, immense pressure was placed on emergency rooms and intensive care units whereas elective surgeries halted. Ironically, despite many hospitals at near full capacity, most were losing money during the COVID-19 fight because the “money maker” procedures and surgeries were postponed. Now with the volume of patients decreasing, hospitals are immediately decreasing staffing in these units that were vital only 30 days prior. Hospitals and physician practices across the country have laid off support staff and cut wages or benefits for their staff doctors.
To find a silver lining out of the pandemic, perhaps healthcare will use this time to improve primary and preventive care and address healthcare disparities. Health insurance and public health models will improve. One can only hope.
Dr. LoVecchio is professor of Emergency Medicine, Medicine, and Pharmacology at the University of Arizona, College of Medicine. He practices research, emergency medicine, medical toxicology and addiction medicine. He lives in Phoenix, Arizona.