1 Question, 5 Answers is a column where we ask different types of healthcare pros to weigh in on the same issue.
The challenges of battling the coronavirus this past year highlighted some of the best and the worst about our healthcare system. We cheered on and felt the deepest gratitude for the resiliency of frontline healthcare workers. And many of us experienced first-hand the shift to telehealth for all sorts of appointments. Yet the pandemic also e lack of access to care and information for minorities, lower income households, and the LGBTQ+ community all the more apparent.
To wrap up 2020 and support a healthy 2021, we asked five healthcare experts to share one thing they learned about our healthcare system this year and one piece of advice they would give patients for the new year. Here’s what they had to say.
Dr. Debashish Bose, MD, PhD, FACS
Medical director of the Center for Hepatobiliary Disease at Mercy Medical Center
Baltimore
One thing they’ve learned in 2020: I have learned that the American healthcare system works well for people who can access it well. During the pandemic, it has been my experience that those who are not insured or underinsured, those who are physically far from tertiary care facilities, and those who are inexperienced or unsophisticated in terms of dealing with the healthcare system are not getting the care they need. While this is always the case for these segments of the population, it has been exaggerated by the pandemic insofar as who we see coming for care. In cancer care, this is particularly disturbing because it will lead to poor outcomes for people who experience delays in diagnosis and treatment.
One piece of advice for 2021: I would like to encourage everyone to “see” their physicians, whether virtually or in person. It is potentially life-saving for significant numbers of people to keep up with screening, check-ups, and vaccinations, so keeping up with primary care providers is extremely important. Staying safe in the pandemic environment includes paying attention to all health issues, not just the virus.
Tearsanee Davis, DNP, FNP-BC
Director of clinical and advanced practice operations at UMMC Center for Telehealth and assistant professor at the UMMC School of Nursing
Jackson, Mississippi
One thing they’ve learned in 2020: I have learned that our health care system is resilient. For many, the COVID-19 pandemic left them in a place of despair, but not for long. When you think about the variations in access to providers, the social and economic disparities, and the limited resources available, healthcare leaders were faced with a huge challenge. While trying to keep patients and providers safe, leaders in the healthcare system had to think quickly to be sure people still had access to the care that was needed. I also learned that we have much work to do. The healthcare system needs to be more connected to allow for more seamless sharing of patient information during times of crisis. The work has begun, and I feel sure that we have learned a lot from this.
One piece of advice for 2021: I would advise patients to secure a primary care provider. There needs to be someone who understands your individual health care needs. During this pandemic, there have been many people who did not know where to go when they developed symptoms or when their conditions progressed. Because they did not have a primary care provider, they were spending time becoming familiar with clinic processes, which could have caused further delays in care. Primary care providers can make attaining the care you need easier, thereby preventing adverse outcomes.
Keisha Ray, PhD
Assistant professor in the McGovern Center for Humanities and Ethics at the McGovern Medical School, UT Health
Houston
One thing they’ve learned in 2020: Although I knew it before this year, 2020 and the COVID-19 pandemic have once again revealed the good and the bad about our healthcare system. Our healthcare system is mostly made up of hardworking, dedicated healthcare workers who put their patients first and make sacrifices to dispense quality care. Our system, however, is flawed and can make it hard for healthcare workers to do good work. When healthcare workers don’t have the resources they need or they have to work within insurance systems, bureaucracy and work-around administrative barriers, they are not able to give the kind of care that patients need. Furthermore, too often poor people, people of color, transgender people and people with disabilities are on the losing end and wind up being the ones who don’t have their healthcare needs met. Despite dedicated people, American healthcare as a system can make it difficult for them to adequately care for people in these groups.
One piece of advice for 2021: My advice is to prioritize health and wellbeing. I would encourage patients to take care of themselves the best they can given their financial and time constraints and to really make an effort to do so. Taking time off of work to relax, meditate, drink more water, see your doctor regularly, take a walk, find ways to de-stress, try not to over-work yourself and take the time to develop or engage with your hobbies. I know this is hard for many people, but if you can, I would encourage patients to look at 2021 as a year to dedicate yourself to wellbeing.
Ryan Howes, PhD
Clinical psychologist and author of the Mental Health Journal for Men|
Pasadena, California
One thing they’ve learned in 2020: People within the healthcare system are resilient, but the system itself still needs some work. We all saw how front line workers were pummeled with cases throughout this year, straining their physical and mental health to try to provide for a population in need. A more unified public education system from the government and healthcare organizations would likely have saved many lives. In my field, psychotherapy, my colleagues and I found an increased demand for services despite the fact that many of us moved to telehealth early in the pandemic. While the need was great and the therapists were willing to provide care, many clients were hindered by an insurance system that made it difficult to find in-network providers and a lack of reimbursement for out-of-network providers, which left too many people seeking help they couldn’t find. When the public seeks a treatment that clinicians are ready and willing to provide, and they can’t find a way to connect, something is broken.
One piece of advice for 2021: There is no wrong way to feel. Among many other things, 2020 was the year of emotion. Fear, sadness, anger, frustration, boredom and even joy played a prominent role all year long. For many people who had previously had routine lives or been too busy to tap into their emotions, 2020 brought them front and center. And for many people, they were concerned that what they felt was wrong—that they should or shouldn’t be feeling an emotion at a particular time. Some of these messages may have been reinforced by media or close social groups, others may be remnants from their past. I found myself telling people that emotions aren’t right or wrong, they’re just our psyche’s response to our world. Rather than feeling ashamed of these feelings and trying to correct them, we should accept them, listen to them and then use these emotions to help us make decisions and act.
Dr. Nicole Harkin, MD, FACC
Board-certified cardiologist and clinical lipidologist and founder of preventive telecardiology practice Whole Heart Cardiology
San Francisco
One thing they’ve learned in 2020: [This year] has taught us the power of healthcare innovation. While the healthcare system is notoriously quite clunky, when it became necessary to do so, it was able to pivot to meet the needs of patients. We learned the value of managing chronic diseases with telemedicine and digital health applications. This also highlighted the ever-growing disparity in our healthcare system, and socioeconomic determinants of health have never been more obvious.
One piece of advice for 2021: I continue to urge patients to remain vigilant to prevent exposure to the novel coronavirus with physical distancing and masking. While vaccines have arrived, we still have a long ways to go until herd immunity is achieved. That said, please do not neglect screening such as mammograms and management of chronic medical problems like high blood pressure and high cholesterol. If you’re nervous to go into the clinic, call your healthcare provider and see if you’re a good candidate for a virtual visit.
Responses have been condensed and lightly edited.