By Thomas DeRosa, CEO, Retraining and return of doctors.
Telehealth, also known as telemedicine, is an oft-cited solution to the myriad health problems created by the shortage of doctors in the US. Virtual care provides access to doctors for those who might not otherwise have it due to things like a lack of nearby doctors in their rural community, mobility issues or lack of transportation. But the idea that telehealth is a panacea for everything that plagues us in the healthcare sector is misleading. Telehealth doesn’t solve the underlying problem: we still don’t have enough doctors to meet the demand for telehealth.
GPs help patients stay healthy and prevent illness and are usually also a patient’s first stop on a disease journey. The US is expected to have a shortage of 17,800 to 48,000 primary care physicians by 2034, according to the Association of American Medical Colleges. The shortage can already be felt by anyone who has recently tried to make an appointment with their GP and was told they could be seen in weeks if not months.
The Covid-19 pandemic led to more doctors burnout and early retirement, further exacerbating the shortage of doctors. However, it also forced healthcare providers to quickly focus on technology and innovation to provide virtual care. From phone calls and video appointments to devices that remotely monitor glucose and heart rate, the healthcare industry has worked bravely to ensure continuity of care for some of the most critical patients.
As we come out of the pandemic with a variety of new telehealth devices, I think we need to prioritize the most necessary telehealth tool of all: the primary care physician.
Caring for the GP in primary health care
Whether we’re talking about a practice that has expanded to include telehealth or a telehealth-only service, GPs need to be supported to provide high-quality care in this medium.
Indeed, a pre-pandemic study published in 2019 found that family health programs often do not provide adequate telecare training. From delivering what’s known as a “web-side” way of care to digitally tracking HIPAA compliance, primary care physicians need telehealth training.
This training is critical to the success of remote primary care. The training must contain the following elements:
• The basics of how the telehealth software works
• Cyber Security Best Practices
• Interpersonal communication skills, such as eye contact and speaking clearly and slowly, to ensure understanding during virtual visits to patients
Some of the biggest challenges facing new primary care physicians lie in technology. Glitchy Wi-Fi and low quality video and audio can be a terrible experience for both the doctor and the patient. Work closely with a support IT team to test and troubleshoot systems before telehealth training begins; this can contribute to a smoother transition to online care.
Like doctors who see patients in physical facilities, primary care physicians should also be fairly and equitably compensated. While there are several reasons experts cite to explain the growing shortage of primary care physicians, lower salaries are partly to blame. Get GPs relatively lower wages than their specialty physician counterparts, which could lead to more physicians leaving the practice and fewer medical students interested in entering a primary care practice.
Another frequently cited reason for the shortage of GPs is burnout. The Covid-19 pandemic has failed to help frontline doctors who have already struggled with feeling overwhelmed. But GPs have long reported that the demand seeing more patients in less time with a wider range of conditions has led to increased burnout.
If the telehealth trend continues as expected, GPs will need training, remuneration and support to ensure that virtual examination rooms are staffed with experienced, trained and knowledgeable GPs.
Telehealth as a tool, not a substitute for personal exams
The primary care delivered through telehealth has many advantages:
• Patients with transport or mobility problems can come to appointments more easily.
• The waiting times for a telehealth appointment can be shorter than the waiting times for a person.
• There are often fewer cancellations and no shows.
• Physicians with their own health problems have a lower risk of exposure to infectious diseases.
Even before the pandemic, the use of telehealth for primary care was increasing. The Telehealth Index: Doctor Survey 2019 800 physicians surveyed by American Well, 62.5% categorized as general practitioners, reported a dramatic increase in telehealth use. In 2015, 5% used telehealth to see patients and in 2018 22% did. Of those surveyed, the majority reported that telecare improves patients’ access to care, contributes to more efficient use of time and reduces healthcare costs.
Still, there are certain diagnoses, treatments, and important patient-doctor relationships that are only possible through personal exams. Telehealth is a great tool, but I think it should be seen as an adjunct to in-person visits and not a replacement.
The shortage of doctors is a problem that will affect all of us. Business leaders who want to be part of the solution can invest their time and money in supporting medical students, such as providing scholarships or expanding residency programs. Business leaders may also become involved in both state and federal efforts to pass legislation that addresses the physician shortage.
Meanwhile, healthcare providers can take steps to address the shortage of GPs in their own facilities. As I discussed earlier in “Addressing the Doctor Shortage as a Caregiver: Hiring Changes,” health care providers can hire uncertified doctors, provide shadow opportunities, and be creative in promoting job opportunities. These measures open doors for much-needed GPs.
GPs are an important part of the growing telehealth landscape. But healthcare providers, legislators and insurance companies should be wary of mandating virtual medical facilities only without ensuring primary care physician staff are ready and able to provide this vital service.