By Asim Jaffer, MD
As we head into our third straight year of trying to return to a new version of normal, I wonder what history will ultimately show that we have learned from this global pandemic. I am certain that I am not unique in how it has affected me personally. Unfortunately, almost everyone on the planet has the shared experience of having a family member or acquaintance that has suffered from or died as a result of the COVID-19 virus.
What we have learned as a country is that a public health crisis cannot be managed in a silo, independent of other determinants of health. The consequences of this global pandemic have reached every facet of our lives. Obviously, the virus has a direct effect to our health. It also affects our local communities, the economy, and even the development of our children as we navigate safe return to schools. It has highlighted the effect of social determinants of health and the effect that politics can directly create a division in the care of our patients – a reality that I had previously been naïve to thinking that we were immune to.
As I think back to any time before February 2020 BC (Before COVID), I realize that although I was very happy with my chosen specialty, I did not realize how truly fortunate I am to be a family physician. Over the last few decades, I believe our specialty has been under attack with an identity crisis. Even amongst our own ranks there has been a shift from self-employed to system-employed, and from full scope to focused practice. This may be the expected natural evolution due to the changing landscape of healthcare with the development of mega-health systems, but what I am pleased to see during this pandemic is that it is family physicians around the country that are best suited to address the needs of the nation during a health care crisis.
The heart of our specialty is based in community medicine and public health. When we were faced with a true public health crisis, it was family physicians in leadership positions that were able to advocate for the importance of population health. When we were concerned about the pandemic affecting our workforce, it was family physicians who were able to step up and continue to see patients in their clinics, homes, nursing homes, emergency departments, hospitals, and even in the ICU. There is no other specialty that can claim the ability to serve the full spectrum of our patients wherever they need us. I take great pride in our former graduates from Peoria as well as family physicians around the country who stepped up and volunteered to be available to work in the hospital or at COVID clinics if needed despite not currently working in those areas. These family physicians expanded their scope of practice as needed by relying on their training during residency even if it was not a part of their current practice. This is a testament to the importance and value of maintaining a full scope and comprehensive training curriculum during residency. Family Medicine graduates are comprehensively trained in the specialty that is most capable of meeting the needs of their communities.
This terrible pandemic has reinforced my belief that the central hub of any successful healthcare system whether locally or nationally must be primary care focused and specifically Family Medicine. The one thing the pandemic has blessed me with is the value of perspective. Despite the many tragedies that this pandemic has caused, despite the multiple death certificates I complete each week that are due to COVID-19, and despite the personal losses my family, friends, and colleagues have endured, I still consider myself extremely lucky. The overwhelming physical and emotional fatigue we are all facing as we care for extremely sick and dying patients is real. The challenges brought by COVID-19 are complicated by supply chain issues, early PPE shortages, changing and uncertain treatment protocols, and obvious staffing shortages. Through all of this I continue to be grateful that we are blessed in our roles as family physicians. We have the ability and educational resources to sift through the noise in the news and social media and pick out the scientific data that can be safe and useful to our patients. We have the ability to reach out and speak with our community and healthcare leaders. We have access to information that the general public does not readily have, which in itself can be a sense of comfort. As terrifying as this pandemic has been, I don’t know how much worse it would have been for me if I did not have access to updated information about the pandemic response and was at the mercy of non-clinical interpretation through the news media. When faced with routine daily stressors that we all have, we are lucky to be able to maintain perspective as we regularly care for patients that are critically ill due to this potentially preventable disease.
The inconvenience of not being able to dine at my favorite restaurant is a small price to pay when compared to the 35-year-old patient who hasn’t been able to see his children for a month due to his COVID hospitalization. During the height of the lockdown, many of my patients struggled with anxiety and depression from working at home and reduced social interactions. Although we as physicians were at some level of increased risk coming to our clinics and hospitals, we still had the ability to carry on much of our lives as before. Dealing with pandemic restrictions would have been much more difficult to comply with if I did not have the perspective we are lucky to have as family physicians.
Although this may be an unpopular sentiment if taken out of context, I am grateful for what this terrible and tragic global pandemic has done for me. It has made the biggest cheerleader for Family Medicine even more aware of how truly lucky I am to be able to practice the specialty I love at a time when our specialty is most needed. If ever there was a time to showcase the true value of Family Medicine in our country, this global pandemic has shown why Family and Community Medicine should be at the center of any successful health care system.