The pandemic could put your doctor out of business

[Zorro]

Primary-care practices were barely eking by. If patients stay away too long, they’ll crumble.

Some coronavirus patients experience a mild fever or never know they were infected. Others crash quickly and unpredictably, five to 12 days after developing symptoms; every doctor on the front lines has been humbled by a patient who is fine in the morning and on a ventilator in the afternoon. To combat this problem, primary-care teams at my hospital are trying something new: calling patients on Days 2, 5 and 8 after we’ve diagnosed them with covid-19 and instructed them to self-isolate at home. We’re looking for signs of an impending crash. We’re also reaching out to our frailest patients and giving them instructions about what to do if they contract the virus.

I made 30 such calls last week to people living alone, struggling with food insecurity or grappling with mental health issues. These were some of the most meaningful conversations of my career. Our primary-care teams have undoubtedly saved many lives with the telephone surveillance, which takes about 30 percent of our doctors’ time and nearly all of our nurses’ time. Primary-care practices across the country are deploying similar programs.

We’re also doing it, apparently, for peanuts. Covid-19 has led to a revolution in telemedicine, but insurance companies will pay only for services that directly replace in-person visits. Our frequent calls don’t do that; a patient wouldn’t come back two days later just to check in. At the same time, our core pre-covid work has evaporated. We ask patients not to come in for preventive or chronic care, for both their safety and — to preserve our protective gear — ours.

That won’t stop us, of course; the heroism I see every day has nothing to do with remuneration. But the pandemic, to say nothing of the looming backlog of deferred medical care, will not retreat quickly, and it doesn’t help patients if primary-care providers go out of business.

https://www.washingtonpost.com/outlook/2020/04/24/pandemic-could-put-your-doctor-out-business/

[jimfields33]

1. Feel bad, but I feel more for the servers and other jobs

[Midnight Writer]

2. I had a doctor appointment last week. Had the whole waiting room to myself.

At a clinic with a dozen doctors, I didn't see one other patient. Parking lot was also empty.