The health care crisis goes far beyond the colossal challenge of caring for victims of COVID-19 and keeping others safe from its spread.
During the early stages of the pandemic, elective surgical procedures were postponed and people with non-urgent medical problems put off visits to the doctor. Such decisions were prudent as health care workers and facilities ramped up to handle the COVID-19 caseload.
Now, though the crisis is far from over, hospitals, doctors' offices and other medical facilities are trying to get the word out that they can safely accommodate patients seeking all types of care. There are two serious, intertwined concerns.
The first is the damage delayed medical care may be doing to those fortunate enough not to have encountered the novel coronavirus. It was never wise for those with other pressing medical problems to postpone care. But neglecting even “routine” care may lead to problems – especially if that care involves children.
In a statement and in remarks during Gov. Eric Holcomb's televised news conference Monday, Dr. Tony GiaQuinta, president of the Indiana Chapter of the American Academy of Pediatrics, reassured parents that it's safe and important to bring their children to the doctor for wellness visits or vaccinations.
“Some states,” said GiaQuinta, who practices in Fort Wayne, “are seeing precipitous dropoffs in vaccine rates, which can lead to outbreaks of serious vaccine-preventable diseases, such as measles, whooping cough, and some forms of meningitis.”
Children who miss routine visits also miss being screened and treated for mental health issues. The problem of adolescent mental health, Gia-Quinta noted, is particularly acute in Indiana.
Much has changed in the past few weeks. One of the most striking innovations has been the rapid rise in telehealth visits, which allow patients to consult physicians in digital visits from their homes. When there's a need for face-to-face visits and treatment, doctors' offices and medical facilities have new procedures to ensure the safety of patients and their families. Patients and parents with children who need to be seen may still, understandably, harbor some fear. But most concerns can be answered if they call their doctors and ask about safety procedures and treatment options.
The other problem created by the slowdown in non-COVID-related treatment is that our health care system, like so many other parts of our economy, is under incredible financial strain.
As we noted a few days ago, the sharp drop in patient volume since the beginning of the pandemic has left Indiana's hospitals struggling financially – particularly smaller, rural facilities. Not surprisingly, the same types of problems are affecting doctors.
According to a report by the Indiana State Medical Association, “more than 80% of practices report a decrease of more than 40% in patient volumes and associated revenues.” Some practices, the association said, have seen revenue drop by as much as 90% and are in danger of closing.
In an interview Thursday, Dr. Sara Brown, president of the Fort Wayne Medical Society, confirmed the problems highlighted in the state report are present here.
“The medical community really tried to divert and delay non-emergency care,” said Brown, an emergency room physician with Parkview Heath. “We were doing that to prepare for an influx of COVID patients. ... All those things worked, so that's great.”
But the strategy has led to “lots of practices with really low volume – not any different than large parts of the rest of the economy,” Brown said. “Certainly it's possible that we could lose some physician practices over this.” That, in turn, could make it harder for the medical community to meet the needs in what is certain to continue to be a challenging year.
The financial crisis may ease now that Holcomb has lifted the ban on elective surgery. But, Brown said, many people are still confused about whether it's OK to seek help for non-pressing problems.
So doctors and medical facilities trying to alert their patients to the dangers from COVID-19 now have another important message: It is both safe and wise to call for an appointment and seek the treatment or ongoing care you and your family need. The health of Hoosiers, and the future of Indiana health care, depends on that message getting through.