Why Primary Care Doctors Must Step Up, Not Back, During The Coronavirus Crisis
When it became clear that the novel coronavirus would soon arrive here in the United States, I asked my father, James Chen, who founded ChenMed more than 30 years ago, what he was most worried about. “The emergency room,” he said, without hesitation. “America has been misusing the ER for decades, and that’s going to make dealing with the coronavirus very difficult.”
My father is referring to the fact that nearly half of all medical care in this country is delivered in ERs, according to a recent study by the University of Maryland School of Medicine. For some of these patients, an ER trip is necessary — someone gets into a car accident, has a seizure, or may be having a heart attack.
But many people go to the ER for non-life-threatening ailments like earaches, sore throats, rashes, and muscle strains. They make this choice for lots of reasons, but often what seems like the most direct route to immediate care is just a mirage. These patients could be seen more comfortably, effectively, and inexpensively by a primary care physician. More importantly, ER visits for non-emergency situations put a strain on a hospital’s resources — resources that will be taxed to the maximum in communities where the coronavirus is spreading rapidly.
Why You Should Avoid the ER During the Coronavirus Outbreak
Much has been written about when to seek medical help if you become ill and are concerned about the coronavirus. But across the board, trusted sources agree that your first course of action should not be to go to the ER, unless you are having a true medical emergency. There are several reasons why.
First, the waiting room carries risks. Many seniors, like our ChenMed patients, come from a population that is most at risk to have serious cases or die of the coronavirus. Sitting in an ER waiting room, surrounded by dozens of people who may be sneezing, coughing, and spreading germs, is a dangerous place for these patients to spend time.
Second, the waiting room is uncomfortable. The ER will prioritize patients who come in with the most life-threatening conditions, no matter how long others have been waiting. Those signs on the freeway touting low wait times may not be the reality if you arrive with a non-emergency. This often creates a frustrating and likely untenable situation, particularly for older patients and those with special needs. The longer that patients have to sit in the waiting room, the more likely they are to pick up the circulating germs.
Third, we need to keep hospital resources available for patients who truly need immediate attention. As more people contract the coronavirus and develop severe cases, more doctors, nurses, and other staff will be diverted to provide their care. That leaves fewer medical professionals available to attend to the other emergencies, putting people at risk.
So, what should you do? Before leaving home and going anywhere – since any public exposure could be a risk – call your primary care physician. A PCP has several advantages that an ER doctor doesn’t. He or she knows a patient’s medical history and can provide care tailored to the patient’s needs. If the patient is experiencing known coronavirus symptoms, a PCP can quickly coordinate with other providers and public health resources to access testing and treatment — both of which are critical for a positive resolution to the disease.
The Importance of Primary Care in Public Health Crises — And Beyond
People are understandably confused and frightened right now. There’s a lot of information — and misinformation — about the coronavirus being shared in the news, via social media, and in conversations among family and friends. This is a time for primary care to step up, rather than step back.
Our ChenMed providers are reaching out to patients to be more helpful than ever. Reminders to call us. Finding solutions for patients to get their medications without leaving home. Converting in-person visits to virtual visits when possible. And, sometimes, just connecting with them to make sure they don’t become isolated. This is everyone’s job: the PCP, their care team, social workers. Heck, we’ll get drivers, salespeople, and anyone else in the doctor’s office to pitch in so patients can feel happy, stay healthy, and stay home. In short, we’re doing more, not less, to support our patients during this difficult time.
My father wasn’t off base in expressing his concerns about the toll the coronavirus will take on ERs. Our country’s hospitals will bear much of the brunt of the coronavirus wave. But there may be a small, yet important, silver lining in this crisis. It’s providing us an opportunity to highlight the consequences of our country’s overuse of ERs and demonstrate the important role primary care has in helping to alleviate that problem.
That’s a lesson I hope we can carry forward into the post-coronavirus health care environment.