Changes in medicine that will remain long after COVID-19

Sick of hearing the phrase “the new normal”? So are many in healthcare and elsewhere. Despite its vague meaning, the sentiment has some substance. The COVID-19 pandemic has ushered in intense changes to medicine, from restrictions on who can visit hospitals to how physicians engage with patients. If only for now, medicine is experiencing a “new normal,” and doctors are feeling the effects.

Will COVID-19’s effects on healthcare remain after the pandemic subsides?

The answer depends on the specific change in question, who’s making the prediction, and how leaders in government and healthcare react to a post-pandemic world. But, broadly, physicians are likely to operate in a healthcare system altered by financial ruin, technology, and other evolutions spurred by the pandemic.

While it’s hard to gauge how long-lasting changes stemming from COVID-19 will affect individual physicians and patients, it’s important to prepare for what’s next. MDLinx probed the journals, private surveys, and expert commentaries to understand what to expect. Here are 4 changes that are good bets to remain long after the pandemic.

1. Clinics and hospitals close

Healthcare has been consolidating for years, as large health systems gobbled up their smaller competitors to gain stronger financial footing. Now, COVID-19 has placed more pressure on all healthcare organizations, from hospitals to independent primary care clinics.

The pandemic and its restrictions on elective procedures and outpatient visits have resulted in a “dramatic” drop in hospital revenues, according to a commentary in The New England Journal of Medicine. The American Hospital Association estimates that COVID-19 has collectively cost US hospitals more than $50 billion per month since March. By mid-August, at least 18 US hospitals had closed this year.

Small private practices—including primary care clinics—are also threatened. COVID-19 has financially harmed 97% of 724 medical practices in a recent survey. What’s more, 6% of 558 US primary care physicians said in late spring that their practice had shut its doors, at least temporarily. HealthLandscape, meanwhile, anticipated that more than 58,000 primary care practices might close or reduce their operations by the end of this past June.

“In the aftermath of COVID-19, there will be significant pent-up demand for healthcare services, and a significant loss of providers could reduce the system’s capacity to the point where it is impossible to catch up on the accumulation of deferred care while also meeting ongoing demand,” wrote the authors of the NEJM commentary.

2. Telemedicine goes mainstream

It’s not all bad news. When the feds relaxed telemedicine reimbursement rules in response to the pandemic, the use of virtual care soared, according to a McKinsey survey. Experts and advocates have claimed for years that telemedicine serves patients through expanded access and more affordable care.

Physicians took a liking to telemedicine, according to findings published in Gastroenterology, with 67% of clinicians and patients at one large practice viewing virtual appointments as positive and acceptable alternatives to in-person appointments. COVID-19 has inspired healthcare organizations to adopt and implement high-tech telehealth systems at scale.

Patients, meanwhile, reported a desire to see virtual care, including telemedicine and remote monitoring tools, continue. According to an Accenture survey of 2,700 patients, 60% said they want to keep using technology to meet with healthcare providers and manage their conditions.

Will reimbursement rules allow virtual care to continue to grow? That’s up to Congress. But Seema Verma, MPH, administrator of CMS, said this month that “reversing course would be a mistake.”

3. New protocols remain in the clinic

In addition to virtual check-ups, some experts argue that hospitals and clinics will cement COVID-era operations, visitor, and design protocols well after the pandemic.

Tennessee’s Children’s Hospital at Erlanger, for example, has already decided to implement training to enable clinicians from one department to work in another, analyze how it manages patient care, and even send fewer staffers into the operating room. Other health systems and technology vendors are preparing for a future in which the waiting room is virtual, much like during the pandemic, instead of physical.

For its part, the CDC has advised medical practices to “make long-term changes to practices and procedures,” including no longer using porous materials for seating, leaving doors open, and upgrading ventilation systems.

Buildings themselves might evolve, too. “After this pandemic, we are for sure going to see a difference in the way our codes are written and the way that we approach the built environment,” said Jenny Han, a director of healthcare design for Skender, a large construction firm.

4. The medical supply chain changes

The disruption to vital medical supply chains has emerged as one of the most frustrating aspects of the pandemic, inhibiting patient care and physician workflows alike. In hundreds of articles and social media posts, physicians and clinicians excoriated governments, vendors, and healthcare organizations for shortages of personal protective equipment, ventilators, and even pharmaceuticals. So, how will critical supply chains change?

Hal Mueller, chief supply chain officer at The Ohio State University Wexner Medical Center, wrote that his institution established a streamlined approach to tracking and storing medical equipment and set stronger protocols for vetting vendors. Now and after COVID-19, hospitals and medical practices must build strong bonds with local manufacturers and distributors, while adapting to new standards of care, Mueller added.

Experts claim that COVID-19 exposed weaknesses in the hospital supply chain. They’ll need to create redundancy programs designed to share resources among hospitals and move supplies across the country as needed, according to the health data vendor Moxe. Healthcare organizations are also likely to expand the kinds of PPE they accept. “The result will be an optimized supply chain with versatile equipment, built-in redundancies, and better prepared for surge capacity,” the company wrote.

And expect changes in the global supply chain: A poll conducted in June found that more than 60% of supply chain managers across industries anticipate leveraging new or alternative companies to rebuild what COVID-19 disrupted.

What COVID-19 changes mean for physicians

There’s no telling how much—or little—this pandemic will affect hospitals, clinics, and physicians in the long term. But the evidence that some effects will become permanent is compelling.

In some ways, that’s good news for physicians. Who doesn’t want patients to have more access to virtual care, less infection-prone clinics, and needed supplies? In other ways, the pandemic’s footprint on healthcare could prove damaging to doctors and entire communities.

The best hope anyone has to survive and thrive in a post-COVID world is to brace for “the new normal,” no matter how badly the phrase resonates.