A Thoughtful Rebirth of Health Care: Lessons From the Pandemic

As COVID-19 infection makes another resurgence in the U.S, it allows many of us entrenched in health care to reflect on our disorganized and dysfunctional system. I agree with Dr. Rosenbaum that many of the pandemic emergency protocols we implemented to reduce community risk make sense to keep in the long-term. 



As a midwife working in NYC in sexual and reproductive health care these protocol changes include re-thinking how medications are dispensed to reduce trips to the clinic and pharmacy, offering more telehealth visits, and increasing access to Post Exposure Prophylaxis (PEP) and Pre-Exposure Prophylaxis (PrEP) for HIV prevention. 1 Urinary tract infections and oral contraceptive pill prescriptions can now be dispensed without an office visit.2 We have seen the rates of STIs rise exponentially in the years before and during this pandemic and it is critical to expand access to testing and treatment.3 For example, offering additional options for home testing, like the patient-controlled self-swab testing for gonorrhea and chlamydia and STI treatment visits remotely whenever possible.4  Person-centered health care that includes flexible appointment and testing options empowers patients to make healthier choices and honors autonomy.5
 


As health care providers, we are indeed resilient, adaptable and have endured an ongoing, uphill challenge. We are also qualified to make recommendations on how we can improve. These times are especially difficult when we work with a system at odds with many of the goals we have for our patients and community. A system set up to see more patients per hour threatens quality of care when needs are at their greatest. The US health care system is broken but not beyond repair; it can be rebuilt based on the ideals and beliefs that brought many of us here in the first place: health care for all and do no harm.




References List

1. Centers for Disease Control and Prevention. PrEP and PEP. Published Sept 10, 2020. https://www.cdc.gov/hiv/clinicians/prevention/prep.html
2. Gonden R. Planned Parenthood app lets women order birth control, UTI treatments. Healthline. Published Sep 11, 2019. https://www.healthline.com/health-news/planned-parenthood-launches-apps-...
3. Centers for Disease Control and Prevention. Reported STDs reach all time high for 6th consecutive year. Published April 13, 2021. https://www.cdc.gov/media/releases/2021/p0413-stds.html
4. US Preventive Services Task Force. Screening for Chlamydia and Gonorrhea: Recommendation Statement. Am Fam Physician. 2015 Apr 1;91(7):online. https://www.aafp.org/afp/2015/0401/od1.html
5. Altman, MR, McLemore, MR, Oseguera, T, et al. Listening to women: recommendations from women of color to improve experiences in pregnancy and birth care. J Midwifery Womens Health: 2020; 65(4):466-473.