A physician assistant shares thoughts on the future of his profession.
It happened almost overnight—where I work in a fast-track medicine environment, what people might know as urgent care clinic—the number of patients coming in just dropped. This was right when everything started closing down, like mid-March. Right now we’re seeing a slow increase in both in-office and telemedicine visits, but we’re still not quite back to our baseline numbers. To give you an idea: before coronavirus, where we might have seen 30 to 50 patients a day inside each clinic, at one point we were seeing two to five. Of course, the number of visits that are done remotely jumped up incredibly as well, but not by the same ratio, which is somewhat worrisome—it’s like, are they sick or injured and just not coming in? That part is a little concerning.
Of course, we are actively directing people to virtual visits, in order to limit possible exposure to COVID-19. If they can, we want people to stay in their homes and try to do everything remotely. And there’s been very widespread adoption of this method—on both the patient and provider side. For instance, we’re doing video visits or phone visits for things that we would normally never do. For example, say a patient has symptoms of a urinary tract infection. We typically never would have treated that without the person coming in for a urine sample to test and confirm that diagnosis, because there’s a lot of things that it could be, even though one is most likely. But in this current situation, we’re encouraged to just treat empirically based on the patient’s story. This goes for all kinds of things—kids with ear infections, bacterial versus viral sore throat, bronchitis, sinus infection versus sinus congestion, etc.
It’s remarkable, really, how coronavirus has forced this rapid and pervasive adoption of telemedicine. After all, it’s not exactly new. For example, I’ve been a physician assistant for 10 years, and until recently I had never done a video visit. We’ve had the capability, but I just usually work in clinics that are quite busy physically. Once coronavirus hit, however, I was actually sent to the command center for video visits all day long.
I really think that this will change the way that medicine is practiced forever, because patients now have less reservations about having a remote medical visit. And of course, there’s pros and cons to that. For one, it’s far more cost effective. With anything healthcare in general, there’s always the goal to find less expensive ways of providing quality care. The downside is, well, there are a lot of benefits to seeing someone in real life, actually putting your stethoscope on them, hearing their lungs. But with such a contagious respiratory disease like COVID-19, there’s a trade-off between the benefits of that kind of contact, and the risk of contagion.
The other takeaway I hope will last beyond this pandemic is the very dramatic lowering of the threshold for staying in your home and not leaving if you’re sick. The idea of quarantining yourself—I hope people will take it seriously and it really sticks in our consciousness, even with just something like the common cold, which nobody wants either. Normally if you have a cold, you know, there’s this American work ethic where you just fight through it and do your normal day—go to work, go to the store. But the right thing to do, for the sake of everyone, is just take it easy and stay home. It would be better for everyone if that was the norm, so I’m hopeful these things stick. I’m hopeful that throughout all this, we’ll completely absorb the smart changes that need to happen now and keep them going forward.
Matt Spencer ’97 studied psychology at Marshall College. He earned a masters of science in physician assistant studies from Rosalind Franklin University, and is a physician’s assistant specializing in cardiology and family practice in San Diego.